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    Vital Signs

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    tabi
    The document provides information about the four classic vital signs: temperature, pulse, respiration, and blood pressure. It defines each vital sign and describes normal ranges, factors that influence them, common assessment sites and devices, and terminology used to describe alterations. Temperature reflects the body's heat balance and has two types; pulse is produced by heart contraction; respiration is the process of breathing; and blood pressure refers to arterial force from heart pumping. The document outlines the key details about each vital sign.

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    Vital Signs

    Uploaded by

    tabi
    48 views44 pages
    The document provides information about the four classic vital signs: temperature, pulse, respiration, and blood pressure. It defines each vital sign and describes normal ranges, factors that influence them, common assessment sites and devices, and terminology used to describe alterations. Temperature reflects the body's heat balance and has two types; pulse is produced by heart contraction; respiration is the process of breathing; and blood pressure refers to arterial force from heart pumping. The document outlines the key details about each vital sign.

    Original Description:

    Vital/Cardinal Signs are the fundamental component of nursing assessment.

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    The document provides information about the four classic vital signs: temperature, pulse, respiration, and blood pressure. It defines each vital sign and describes normal ranges, factors that influence them, common assessment sites and devices, and terminology used to describe alterations. Temperature reflects the body's heat balance and has two types; pulse is produced by heart contraction; respiration is the process of breathing; and blood pressure refers to arterial force from heart pumping. The document outlines the key details about each vital sign.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    48 views44 pages

    Vital Signs

    Uploaded by

    tabi
    The document provides information about the four classic vital signs: temperature, pulse, respiration, and blood pressure. It defines each vital sign and describes normal ranges, factors that influence them, common assessment sites and devices, and terminology used to describe alterations. Temperature reflects the body's heat balance and has two types; pulse is produced by heart contraction; respiration is the process of breathing; and blood pressure refers to arterial force from heart pumping. The document outlines the key details about each vital sign.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 44

    VITAL

    SIGNS
    OBJECTIVES/LEARNING
    OUTCOMES:
    1. Identify the classic vital signs
    2. Describe the normal ranges of the vital signs
    3. Describe the following issues related to the four classic vital
    signs:
    a. Types of devices commonly used
    b. Common sites for assessing each vital signs
    4. Describe factors that affect the vital signs
    5. Recognize the common terminologies / alterations used in
    documenting and discussing vital signs.
    01
    TEMPERATUR
    E
    TEMPERAT
    URE

    Reflects the balance


    between the heat
    produced and heat loss
    from the body
    2 KINDS OF BODY
    TEMPERATURE SURFACE TEMPERATURE

    - The temperature of the skin, the


    CORE TEMPERATURE subcutaneous tissue and fat. It
    rises and falls in response to the
    - the temperature of the deep environment.
    tissue of the body, such as the
    abdominal cavity and pelvic
    cavity.
    HEAT HEAT
    PRODUCTION LOSS
    1. Radiation
    2. Conduction
    1. Basal metabolic rate
    2. Muscle activity
    3. Convection
    3. Thyroxine output 4. Vaporization
    4. Epinephrine, norepinephrine
    and sympathetic
    stimulation/stress response
    5. Fever
    ● Age
    FACTORS ● Diurnal Variations
    AFFECTING ● Exercise
    TEMPERATUR ● Stress
    ●
    E ●
    Hormones
    Environment
    COMMON SITES
    FOR
    TEMPERATURE
    ● ORAL
    ● RECTAL
    ● AXILLARY
    ● TYMPANIC
    MEMBRANE
    ● TEMPORAL
    TYPES OF
    THERMOMETER

    CHEMICAL
    ELECTRICAL INFRARED
    DISPOSABLE
    THERMOMETER THERMOMETER THERMOMETER
    GLASS /
    PACIFIERS MERCURY
    THERMOMETE THERMOMETE
    R R
    ALTERATIONS
    PYREXIA/ HYPERTHERMIA / FEVER
    - body temperature above the usual range as
    38 to 40 C

    HYPERPYREXIA
    - very high fever as 41 C 2
    itle. P5
    Book T

    HYPOTHERMIA
    - lower than the usual body temperature
    INTERMITTENT
    This fever has a fluctuating baseline
    between normal temperatures and fever

    4
    levels over the course of the day.

    REMITTENT

    COMMON
    A wide range of temperature fluctuations
    more than 2 C occurs over the 24 hour
    period, all of which above normal

    TYPES OF RELAPSING
    Short febrile periods of a few days are

    FEVER interspersed with periods of 1 or 2 days of


    normal temperature

    CONSTANT
    is a type or pattern of fever in which
    temperature does not touch the baseline and
    remains above normal throughout the day.
    NORMAL RANGES OF
    TEMPERATURE
    PULSE
    PULSE
    Produced when the heart
    contracts and forcefully
    pumps blood out of
    ventricles into the aorta.
    PERIPHERAL PULSE

    a pulse located away from PULSE DEFICIT


    the heart, for example, in the
    foot, wrist, or neck. - The difference
    between apical and
    APICAL PULSE
    radial pulse
    is a central pulse, that it is
    located at the apex of the
    heart.
    PULSE SITES
    • Age
    • Gender
    FACTORS • Exercise
    INFLUENCIN • Hemorrhage/
    G PULSE hypovolemia
    • Postural changes
    ASSESSING THE RHYTHM
    PULSE DYSRHYTHMIA or
    PULSE ARRHYTHMIA
    RATE - Abnormal rhythm of heart beat

    VOLUME
    TACHYCARDIA Also called pulse strength or amplitude,
    - An excessive fast heart rate over refers to the force of blood with each beat.
    100 BPM in adult
    ARTERIAL WALL
    BRADYCARDIA ELASTICITY
    -slow heart rate in an adult of 60 BP Reflects it expansibility or its deformities
    M or less
    NORMAL RANGES OF
    AGE PULSE BPM (beats/min)

    Infant 120-160

    Toddler (1 to 3) 90-140

    Preschooler (4 to 6) 80-110

    School – age (7 to 12) 75-100

    Adolescent 60-90

    Adults 60-100
    03
    RESPIRATI
    ON
    RESPIRATI
    ON The act
    of breathing(inhaling and
    exhaling) during which the
    lungs are provided with air
    through inhaling and the
    carbon dioxide is removed
    through exhaling.
    RESPIRATI Ventilation
    ON Movement of gases in and out of the
    PROCESS lungs

    Diffusion
    Movement of oxygen and carbon
    dioxide, between the alveoli and the
    RBC

    Perfusion
    Distribution of RBC to and from the
    pulmonary capillaries
    2 TYPES DIAPHRAGMATIC
    OF (ABDOMINAL)
    BREATHIN BREATHING
    G
    COSTAL (THORACIC)
    BREATHING Involves the contraction and relaxation
    of the diaphragm, and it is observed
    Involves the external intercostal muscles by the movement of the abdomen,
    and other accessory muscles, such as which occurs as a result of the
    sternocleidomastoid muscles. It can be
    observed by the movement of the chest diaphragms contraction and
    upward and outward downward movement
    ● Exercise
    FACTORS ● Stress
    INFLUENCI ● Body position
    ●
    NG ●
    Medications
    Body size
    RESPIRATI ● Temperature
    ON
    NORMAL RANGES
    OF RESPIRATION
    AGE RATE (breaths/ min)

    Newborn 30-60

    Infant 30-50

    Toddler 25-32

    School age 20-30

    Adolescent 16-19

    Adult 12-18
    ALTERATIONS
    RATE
    EUPNEA
    noiseless, effortless breathing / normal

    APNEA
    Absence of breathing

    BRADYPNEA
    Abnormally slow breaths. Less than 10 breaths/min

    TACHYPNEA
    Quick, shallow breaths. More than 24 breaths/min
    ALTERATIONS (cont.)
    QUALI
    TY
    DYSPNEA
    Difficulty in breathing

    ORTHOPNEA
    Difficulty of breathing in all portion

    VOLU
    ME
    HYPERVENTILATION
    Rate and depth of respiration increase / rapid and deep breaths

    HYPOVENTILATION
    Rate and depth of respiration decrease / shallow respiration
    ALTERATIONS (cont.)
    RHYTHM
    CHEYNE- STOKES RESPIRATION
    Respiratory rate and depth is irregular, characterized by alternating
    periods of apnea and hyperventilation

    KUSSMAL’S RESPIRATION
    Abnormally deep, regular, increase respiratory rate / rapid
    hyperventilation

    BROT’S RESPIRATION
    Abnormally shallow for 2-3 breaths followed by apnea
    ALTERATIONS (cont.)
    NORMAL BREATH SOUNDS
    ALTERATIONS (cont.)
    BLOOD
    PRESSURE
    BLOOD
    PRESSURE

    Refers to the force exerted on


    the wall of the artery by the
    pulsing blood under pressure
    from the heart
    BLOOD SYSTOLIC
    PRESSURE The pressure of the blood as a result of
    contraction of the ventricles

    DIASTOLIC
    The pressure when the ventricles are at
    rest
    PULSE
    PRESSURE
    Refers to the difference between the
    systolic and diastolic pressure
    ● Age
    FACTORS ● Gender
    INFLUENCI ● Daily variations/ the
    NG BLOOD time of the day
    ● Medications
    PRESSURE ● Obesity
    Blood pressure is measured in millimeters
    of mercury (mmHg) and recorded as a
    fraction. The systolic pressure is written
    over the diastolic pressure. The average
    blood pressure of a healthy adult is 120/80
    mmHg
    NORMAL RANGES OF BLOOD
    PRESSURE
    ALTERATIONS
    Hypertension
    A blood pressure that is persistently above normal.

    Primary hypertension
    An elevated blood pressure of unknown cause

    Secondary hypertension
    an elevated blood pressure of known cause

    Hypotension
    a blood pressure that is below normal.

    Orthostatic hypotension
    a blood pressure that falls when the client sits or stands
    AUSCULTATORY
    PALPATORY SITES
    BLOOD PRESSURE
    1. TheMEASUREMENT
    patient should be seated comfortably with the
    back supported and the upper arm bared without
    constrictive clothing

    2. The arm should be supported at heart level, and the


    bladder of the cuff should be encircle at least 80% of
    the arm circumference

    3. The mercury column should be deflated at 2 to 3


    mm per second, and the first and last audible sounds
    should be taken as systolic and diastolic pressure
    ELECTRONIC
    ANEROID BLOOD
    SPHYGMOMANOM
    ETER
    PRESSURE
    MONITOR
    KOROTKOFF’S
    SOUNDS
    PHASE III
    PHASE I - Return of distinct, crisp and louder
    - First appearance of faint, clear tapping sounds as the blood flows freely
    or thumping sound that gradually through an increasingly open artery
    intensify for at least 2 consecutive
    beats. PHASE IV
    - Systolic pressure - muffled, less distinct and softer

    PHASE II PHASE V
    - Muffled or swishing, softer and longer - All sounds disappearing completely
    than phase I sounds
    THANK
    YOU FOR
    LISTENI
    NG
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