Vital Signs

• Different types of vital signs


  • Temperature
  • Pulse
  • Respiration
  • Blood pressure
• Graphic method


  • Large amount of info. for healthcare professional to easily and quickly access
  • Record of vital signs that help provide diagnosis and respond to rapidly changing situations
  • Includes date, temp., pulse and respiratory rate, BP., and other important info.
• Frequent vital signs


  In serious condition, vital signs may be taken every 5, 10, or 15 mins.
• Body temperature


  • Heat inside the person's body
  • Balanced between heat produced and heat lost
  • Oral body temp normally: 37ºC
  • Measured in Degrees Celsius or Fahrenheit
• Signs of elevated temp.


  • Flushed face, hot skin, bright eyes, restlessness, chills, and thirst
• Follow temp. variations for specific person and ensure values do not deviate
• Body temp. Lowest in am highest in pm
• Newborns body temp. is generally higher than adults
• Elevated body temp.


  • Fever (pyrexia)
  • Accompanies illness and signifies the body fighting an infection
  • Useful in fighting the infection
  • Fever treatment may be delayed until confirmed diagnosis
• Fever terminology


  • Intermittent fever: alternates between fever and normal reading
  • Remittent fever: temp. rises several degrees above normal and returns to normal
  • Constant fever: stays elevated
  • Crisis: sudden drop from fever to normal temp.
  • Lysis: elevated temp. returns to normal
  • Relapsing fever: returns to normal for a day and reoccurs
• Lowered body temp.


  • Hypothermia
  • May lead to death
  • Caused by overexposure to elements
  • Good in some situations = slows metabolism and decrease oxygen need
  • Clinical hypothermia: used to perform some surgical procedures
  • Accidental hypothermia: life threatening and requires immediate treatment
• Where to measure body temp.


  • Rectal (R) - anus
  • Oral (O) - mouth
  • Temporal (TA) - forehead
  • Tympanic (TM) - ear canal
  • Axillary (Ax) - armpit
• How to measure body temp.

  1. Entire bulb/sensor of thermometer covered by tissue (TA)

  2. Covers probe with paper or plastic to ensure sanitary
• Rectal measurement of temp.


  • Highly accurate
  • May be uncomfortable
  • Used for unconscious patients
  • Cannot use after rectal surgery or conditions related to rectum
• Oral measurement of temp.

  • Measure within the sublingual arteries
  • Must be sealed when measuring
  • More accurate than axillary and less accurate than rectal
  • Wait before measuring if patient consumed foods
  • Confused, unconscious, uncooperative, must breathe through mouth = do not administer orally
• Temporal artery measurement of temp.

  • Scanner moves across the forehead and calculates peak body temp.
  • Uses infrared technology to measure temp. in artery
  • Quickest and most noninvasive method
  • More accurate than tympanic
• Tympanic measurement of temp.


  • Measures thermal radiation by tympanic membrane and ear canal
  • Ideal spot for measuring core temp.
  • Fast recording temp. (1-2s)
• Axillary measurement of temp.


  • Least accurate as skin surfaces do not tightly enclose
  • Used frequently on newborns
  • Only use if other methods are impossible or undesirable
• • Glass thermometers
  • Alcohol glass thermometers still in use
  • May be difficult to read and fragile
• Pulse/Heart rate


  Speed of the heartbeat measured by the contractions of the heart per min.
• How is the heart rate measured?


  1. By palpating the pulse with 3 fingers

  2. Changes during sleep, exercise, physical work, extreme emotion, or disease

  3. Many sights that the pulse can be palpated
• Doppler device


  Detect peripheral pulses with conductive gel (ultrasonic vascular)
• Measure pulse: locations


  • Radial pulse most convenient
  • Apical pulse: using stethoscope on heart
  • Always used for children under 2 years or when heart has stopped
  • Apical and radial taken if heart is not effectively pumping
  • Pedal pulse: determines blood circulation to lower extremities
  • Carotid pulse: used commonly or when other pulses not palpable
• Heart rate ranges


  • Normal resting HR: 60-100 bpm, regular and strong
  • Bradycardia (slow HR) below 60 bpm
  • Tachycardia (fast HR) above 100 bpm
• Respiratory rate


  # of breaths a person takes in a min.
• How is respiratory rate measured?


  1. Count # of breaths a person takes in a min.

  2. Look at rhythm, depth, and rate
• Respiratory rate ranges


  • Normal respiratory rate (eupnea): 12-20 breaths a min., deep and regular
  • Tachypnea (too many breaths) above 20
  • Bradypnea (too little breaths) below 12
• Breathing


  • All people sigh/yawn to cleanse the lungs and expand small airways and alveoli that are unused in ordinary breathing
  • Some drugs, poisons, conditions, or pressure decrease respiration rate
• Respiration sounds


  • Snoring: air passages is partially blocked commonly caused by a limp tongue
  • Stertorous breathing: air passes through secretions, common before death
• Dyspnea


  • Difficult or painful breathing
  • Caused by strenuous exercise, obesity, acute pneumonia, etc.
  • Orthopnea: patient can only breathe in an upright position
  • Asthma: causes difficult breathing due to spasms and edema of bronchi
• • Adult breath to heartbeat is 1:5
  • Respiration increases slower than heart rate
  • In diseases: increase faster than heart rate
• Breathing difficulties


  Distressed expression or cyanosis
• Cheynes-Stokes respirations


  • Slow and shallow at first, gradually grow faster and deeper
  • Cycle may repeat after several seconds
  • Serious condition that lead to death
• Blood pressure


  • Measure of pressure exerted by blood as it flows through the arteries
  • Determined by cardiac output and peripheral resistance
• Systolic blood pressure


  • Highest point of BP
  • Pressure exerted when blood is ejected into arteries
• Diastolic blood pressure


  • Lowest pressure obtained before beating again
  • Pressure blood exerts within arteries between heartbeats
• Arteriosclerosis


  Low pulse pressure = arteries not properly relaxing
• Mean arterial pressure (MAP)


  Calculated with mathematical formula
• Cardiac output


  Combination of heart rate and stroke volume over 1 min.
• Peripheral resistance


  • Resistance of blood vessels to the flow of blood
  • Affects BP and work required for heart to pump blood
  • Arteriosclerosis and atherosclerosis increase resistance to blood flow