vital

• Vital signs


  • Body Temperature
  • Pulse Rate / Heart Rate
  • Respiratory Rate
  • Blood Pressure
  • Pain
  • Oxygen Saturation

  
• Body temperature


  Determined by the balance between heat production by tissues, particularly the liver and muscles, and heat loss from the periphery

  
• Normal body temperature


  37°C (98.6°F)
• Hypothalamus


  The temperature center

  
• Types of body temperature

  • Core Temperature
  • Surface Temperature

  
• Core temperature


  Temperature of the deep tissues of the body abdominal and pelvic cavity, relatively constant

  
• Surface temperature


  Temperature of the skin, subcutaneous tissue, and fat, rises and falls in response to the environment

  
• Temperature measurement methods


  • Oral
  • Rectal
  • Axillary
  • Tympanic
  • Electronic

  
• Factors affecting body temperature

  • Circadian Rhythm
  • Basal Metabolic rate
  • Hormones (Progesterone, Thyroxin, Epinephrine and Norepinephrine)
  • Chemical thermogenesis

  
• Variables affecting body temperature

  • Age
  • Exercise
  • Stress
  • Environmental Extremes (Hot or Cold)
  • Pyrogens

  
• Factors affecting heat loss

  • Radiation
  • Conduction
  • Convection
  • Vaporization
• Febrile states


  • Pyrexia (Hyperthermia - 38-40°C)
  • Hyperpyrexia - very high temp 41°C
  • Remittent fever - temp fluctuates but non-normal in fluctuation
  • Relapsing Fever - short febrile periods of a few days
  • Intermittent fever - fever fluctuates & normal on fluctuation
  • Constant fever - temperature that fluctuates minimally
• Converting temperature


  1. Celsius to Fahrenheit: °F = (Temp in °C x 1.8) + 32

  2. Fahrenheit to Celsius: °C = (Temp in °F - 32)/1.8
• Signs and symptoms of fever

  • Elevated Temperature
  • Skin Warm/Hot to touch
  • Cessation of sweating
  • Shivering/chills
  • Increase thirst
  • Skin Flushed
  • Convulsions/seizure
• Signs and symptoms of hypothermia

  • Decrease Temperature
  • Skin cold to touch
  • Feeling of cold and chills/shivering
• Physiologic mechanisms of temperature regulation

  • Excessive heat loss
  • Inadequate heat production to counteract heat loss
  • Impaired hypothalamic thermoregulation
• Pulse


  Wave of blood as a result by the contraction of the left ventricle of the heart

  
• Pulse rate


  Number of times in one (1) full minute that the arteries pulsate in every beat of the heart as the left ventricles pushes blood to the arteries

  
• Factors affecting pulse


  • Age
  • Gender
  • Exercise/Activity
  • Medical condition
  • Medications
  • Stress
  • Diet
• Normal pulse for adults

  60 to 100 beats per minute
• Pulse characteristics


  • Rate/Frequency (Bradycardia, Tachycardia)
  • Rhythm (Regular, Irregular)
  • Quality (Full or bounding, Weak/feeble or thready)
• Pulse sites


  • Apical
  • Radial
  • Temporal
  • Carotid
  • Brachial
  • Ulnar
  • Femoral
  • Popliteal
  • Posterior Tibial
  • Dorsalis Pedis
• Pulse deficit


  Difference between the apical and the peripheral pulse
• Respiration


  Act of breathing that consist a cycle of inhalation of oxygen and expiration of carbon dioxide
• Inspiration


  Occurs when the diaphragm and the intercostal muscles contract, resulting in the lungs filling with air
• Expiration


  Occurs when the external intercostal muscles and diaphragm relax, the abdomen and chest return to a resting position
• Normal adult respiratory rate

  12 to 20 breaths per minute
• Respiratory centers

  • Medulla
  • Pons
• External respiration (ventilation)


  Process of taking oxygen into the alveoli and eliminating carbon dioxide in the body
• Internal respiration (perfusion)


  Process of use of oxygen, production of carbon dioxide and exchange of these gases between the cells and the blood
• Factors that increase respiratory rate


  • Exercise
  • Strong emotion
  • Infection
  • Increased body temperature
  • Increased metabolism
  • Pain
• Factors that decrease respiratory rate

  • Rest/sleep
  • Depression
  • Drugs/medications
  • Meditation
• Observations when measuring respirations

  • Rate
  • Rhythm; regularity
  • Depth; shallow, normal, deep
  • Symmetry
  • Effort it involves
  • Discomfort it causes
  • Position patient/resident adopts
  • Sounds that accompany it
  • Color of skin and mucous membranes, nail beds (cyanosis)
  • Changes in patient's/resident's behavior
• Abnormal breathing patterns


  • Labored
  • Orthopnea
  • Stertorous
  • Abdominal
  • Shallow
  • Dyspnea
  • Tachypnea
  • Bradypnea
  • Apnea
  • Cheyne-stokes respirations

  
• Audible respiratory sounds


  • Stridor
  • Wheeze
  • Bubbling
• Chest movements


  • Intercostal Retraction
  • Substernal Retraction
  • Suprasternal Retraction
• Respiratory secretions


  • Hemoptysis
  • Productive Cough
  • Non-productive Cough
• Blood pressure


  The force (pressure) of the blood pushing against the walls of arteries, produced primarily by the contraction of the heart muscle

  
• Systolic pressure


  Pressure at highest in arteries when the heart contracts and forces blood into the artery

  
• Diastolic pressure


  Pressure at lowest in arteries when the heart is at rest and the arteries are completely open