Vital signs

• Vital Signs


  Signs reflecting the body's physiological state, which are governed by body's vital organs (brain, heart, lungs) and necessary for sustaining life
• Vital signs are a set of quantifiable physiological parameters that provide essential information about the body's fundamental life-sustaining functions
• Vital signs are routinely monitored in clinical settings to detect any deviations from normal ranges that may indicate underlying health issues
• Vital signs


  • Temperature
  • Pulse
  • Respiration
  • Blood pressure
• Times to Assess Vital Signs

  1. Upon admission

  2. Routinely in inpatient settings

  3. Before, during, and after transfusions or medication administration

  4. In outpatient settings

  5. When the patient's/client's general physical condition changes

  6. Before and after surgery or an invasive diagnostic procedure

  7. Before and/or after administration of certain medication

  8. Before and after nursing interventions influencing a vital sign

  9. When the patient reports non-specific symptoms of physical distress
• Body Temperature


  The state of heat or coldness within a substance, which can be measured against a standard scale (0C or 0F)
• Man and other mammals are homoeothermic, that is warm blooded and maintain their body temperature independently of the environment
• Core temperature


  The temperature of the deep tissues of the body such as abdominal cavity, and pelvic region. It remains relatively constant.
• Surface temperature


  The temperature of the skin, the subcutaneous tissue, and fat. It rises and falls in response to the environment.
• The normal core body temperature is a range of temperatures fluctuating between 36.1 and 37.2°C
• Thermoregulation


  The body's physiological function of heat regulation to maintain a relatively constant internal body temperature
• Thermoregulation process


  1. Hypothalamus senses minor changes in body temperature

  2. Activates heat loss (cooling) or heat production to ensure core temperature remains within safe range
• Heat Production


  The chemical oxidation of food substances (metabolism of food substances) that results in the release of energy
• Heat production increases when a person is active and most heat production comes from the deep tissue organs (brain, liver, and heart) and the skeletal muscles
• Heat production in the body is increased by epinephrine, nor epinephrine, thyroxine and triiodothyronine
• Muscular activity also produces heat from breakdown of carbohydrates and fats and through shivering
• Vital Signs


  • A set of quantifiable physiological parameters that provide essential information about the body's fundamental life-sustaining functions
  • Measurements that are pivotal in assessing the overall health status of an individual and are routinely monitored in clinical settings to detect any deviations from normal ranges that may indicate underlying health issues
• Heat Loss


  When the body heat rises, nerves in the hypothalamus send signals to decrease heat production and increase heat loss through perspiration, vasodilation, and inhibition of heat production
• Vital Signs


  • Temperature
  • Pulse
  • Respiration
  • Blood pressure
• Heat Loss Mechanisms


  • Radiation
  • Conduction
  • Convention
  • Evaporation
• Behavioral Control of Body Temperature

  Voluntary acts that people take to maintain comfortable temperatures in response to body signaling conditions of either being overheated or too cold
• Factors Influencing Body Temperature

  • Age
  • Exercise
  • Circadian Rhythms (Diurnal Variations)
  • Hormone Level
• At birth, the newborn's temperature control mechanisms are not fully developed, so their temperature may change drastically with changes in the environment
• Times to Assess Vital Signs

  • Upon Admission
  • Routinely in Inpatient Settings
  • Before, During, and After Transfusions or Medication Administration
  • In Outpatient Settings
  • When the patient's/client's general physical condition changes
  • Before and after surgery or an invasive diagnostic procedure
  • Before and/or after administration of certain medication
  • Before and after nursing interventions influencing a vital sign
  • When the patient reports non-specific symptoms of physical distress
• Strenuous exercise can increase body temperature to as high as 38.3 – 40°C (101°F to 104°F) measured rectally
• Temperature


  The state of heat or coldness within a substance, which can be measured against a standard scale (0C or 0F)
• Body temperature normally changes throughout the day, varying as much as 1.0°C (1.8°F) between the early morning and the late afternoon
• Women usually experience greater temperature fluctuations than men due to greater hormonal fluctuations
• Increased metabolism causes


  1. Increased blood supply

  2. Increase in carbohydrate and fat breakdown for more energy

  3. Increase in heat production

  4. Increase in body temperature
• Hard work or strenuous exercise can increase body temperature to as high as 38.3 – 40°C (101°F to 104°F) measured rectally
• Normal core body temperature


  A range of temperatures fluctuating between 36.1 and 37.2°C
• Circadian Rhythms (Diurnal Variations)


  Body temperature normally changes throughout the day, varying as much as 1.0°C (1.8°F) between the early morning and the late afternoon
• Thermoregulation


  1. Heat regulation to maintain a relatively constant internal body temperature

  2. Achieved by a complex interplay of physical and chemical/hormonal mechanism and sympathetic stimulation

  3. Coordinated by the heat regulating center in the brain called the hypothalamus
• The point of highest body temperature is usually reached between 1600 and 1800 hours (4:00 pm and 6:00 pm), and the lowest point is reached during sleep between 0400 and 0600 hours (4:00 am and 6:00 am)
• Hypothalamus


  Controls the body temperature in the same way that a thermostat works in the home
• Older adults' temperatures may vary less than those of younger persons due to the changes in autonomic functioning common in aging
• Heat Production


  1. Chemical oxidation of food substances (metabolism of food substances) that results in the release of energy

  2. Increased by epinephrine, norepinephrine, thyroxine and triiodothyronine

  3. Increased by muscular activity and shivering
• Women usually experience greater temperature fluctuations than men


  This has been attributed to greater hormonal fluctuations women experiences
• Heat Loss


  1. Triggered by nerves in the hypothalamus when body heat rises

  2. Achieved through perspiration, vasodilation, and inhibition of heat production

  3. Primarily through radiation, convention, and evaporation of water from the lungs and skin
• Heat Loss Mechanisms


  • Radiation
  • Conduction
  • Convection
  • Evaporation