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3. Unit summary:
Introduction.
Definition.
Purpose.
Normal value of vital signs.
Articles required for the procedure.
Body temperature( meaning, types of thermometer,
sites and procedure).
Pulse rate ( meaning, sites, procedure & assessment of pulse).
Respiration rate ( meaning and assessment).
Blood pressure (meaning, types and procedure).
Methods of recording vital signs
Evaluation ( questionnaires).
5. Introduction
Vital signs are done to check functioning and the
rhythm of the essential organs.
It is a clinical procedure and a part of physical
assessment.
Vital signs include:
1. Temperature
2. Pulse
3. Respiratory Rate
4. Blood Pressure.
6.
7. Definition
Vital signs are measurement of the body’s most basic
functions that reflect essential body function
including heart rate, respiratory rate, temperature &
blood pressure.
9. Purpose of vital sign
“The purpose of recording vital signs is to establish a
baseline on admission to a hospital, clinical,
professional office or other encounter with a health
care provider”.
10. When to take vital signs ?
On clients admission.
According to physician’s order.
Hospital policy.
Standard clinical practice.
Assessing client during home visit.
Before and after surgical or invasive diagnostic surgical
procedure.
Before and after administration of the medication that
affect the cardiovascular system, respiratory system
and neurological system.
14. Normal ranges of vital sign
TEMPERATURE:
The range of normal temperature in adults and children
is same.
IN Celsius: 37° C*
IN Farhenite: 98.6° F*
Temperature reference does not change with the age.
15. RESPIRATORY RATE:
For adults:
12-20 breathes per minute
For children's:
Infants(<12 months) - 30-60 breathes/min
Toddler(1-3 years) - 24-40 breathes/min
Preschool(4-5 years) - 22-34 breathes/min
School age(6-12 years) - 18- 30 breathes/min
Adolescence(13-16 years) - 12-16 breathes/min
19. Articles:
1. Thermometer(red/blue)
2. Sphygmomanometer (for paediatrics-size 2 to 4 acc.
to arm circumference).
3. Stethoscope ( for paediatrics- small sized are used).
4. Sterilium .
5. Cotton balls.
6. Small bowl.
7. Kidney tray.
8. Paper bag.
32. Points to kept in mind while
measuring temperature:
Measure balance between heat lost and heat produced
in body
Heat produced by metabolism of food, by muscle &
gland activity.
Conversion between Fahrenheit & Celsius.
35. Pulse Rate:
Pulse rate means heart beats per minute.
Pulse is never measured using thumb because thumb
has a small artery which leads to false measurement.
Usually, it is done using first 2 fingers of hands placing
thumb down the hand for better grip and palpation.
39. Procedure:
Assess: rate, rhythm and strength using palpation and
auscultation.
Pulse deficit: The difference between the radial and apical
pulse indicates a decrease in peripheral perfusion from some
heart condition that is arterial fibrillation.
Checking at different sites:
Peripheral:
1. Place 2nd, 3rd & 4th fingers lightly on skin where an artery
passes over an underlying bone.
2. Donot use thumb
3. Count for 30 sec and then multiply into 2.
4. If irregularity is there then count for 1 min.
40. Continue (procedure)…….
Apical:
1. Beat of the heart at it’s apex or PMI ( point of
maximum impulse)-5th intercostals space,
midclavicular line just below the nipple.
2. Listen lub-dub for a full minute.
Lub- close of AV value tricuspid and mitral valve.
Dub- close to semilunar valve aortic and pulmonic
valve
41. Continue (procedure)…….
For children’s sometime’s stethoscope is used if
difficulty is seen.
Pulse is obtained through pulse oximeter
Paediatric probe is small in size than adult and attach
to attach to thumb and big finger to thumb.
42. Assess: rate, rhythm, strength and tension:
RATE:
For adults:
No. of pulse – 60-100/min
Avg 80 bpm
Tachycardia- greater than normal range
Bradycardia- lower than normal range
For pediatric:
Increase or decrease than decided range
45. Respiration Rate:
Respiration rate means inhalation and exhalation per min.
Inhalation & exhalation is automatic and controlled by
medulla oblongata(resp. centre of brain).
I+E = 1 CYCLE
Normal breathes thoracically , while men and young
children breath diaphragmatically.
Assess after taking pulse, while still holding hand, so
patient is unaware you are counting respirations.
It is done using observation method and sometimes
stethoscope.
46.
47. Assessing respiration(main points):
RATE:
Increase or decrease in normal rates.
DEPTH:
#. Normal- Deep and even movements of chest
#. Shallow-Rise and fall of chest minimal
#. SOB-Shallow and rapid
55. Blood pressure in lower extremity:
Best prone position if not supine knee slightly flexed
locate popliteal artery( back of knee).
Large cuff 1 inch above artery located.
Same procedure as arm.
If unable to palpate pulse then we can also use
Doppler's stethoscope.
56. Important points while measuring
B.P.in arm:
Palpate brachial pulse.
Position of cuff 1 inch above.
Arm at level of heart.
Manometer at eye level.
57.
58. Methods of recording:
Maintain hourly chart(recording vital signs on hourly
basis).
Maintain graphs.
a.) plot points on figures and joint plotted points.
b.) easy to make out difference between 2 plotted
figures.
Entry in ipads.
a.) reduces errors
b.) the paper vital signs recording have an error of
18.75% and the wireless system has an error rate of 0%.