Medical Foundations by Dr. Z VITAL SIGNS Medical Foundations by Dr. Z

Vital Signs (Signs of Life) Temperature (usually in degrees Fahrenheit) Pulse (heart beats per minutes) Respirations (inhalations and exhalations per minute) Blood Pressure (1 reading, two numbers) Other important items: Pupil size and symmetry Oxygen concentration (percentage)

TEMPERATURE afebrile hypothermia pyrexia pyrogenic a = without, febrile = fever hypothermia Below 950 F pyrexia Above normal temperature pyrogenic Anything that causes fever

Types of Thermometers Aural (ear) Temporal Artery (forehead) Chemically Treated Paper or Plastic Electronic/Digital Thermometer

Sites to Take Body Temperature Oral: mouth Simple and most common, convenient, and comfortable site. Ranges from 97.60 to 99.60 Rectal: above the anus Used on young patients or those who mouth breathe. Most accurate. Ranges from 98.60 to 100.60 Aural: ear canal Accurate, easy to use. Normal is 98.60 Axillary: armpit Least accurate. Normal range is 96.60 to 98.60 Use this site if the first three are not available.

PULSE Definition = pressure of the blood on the walls of arteries as the heart contracts and relaxes Throbbing pattern; indicates how well the blood is circulating around the body Measured in beats per minute (bpm) Count for 15 seconds and multiply by 4 = 60 seconds Count for 30 seconds and multiply by 2 = 60 seconds

Pulse Sites temple neck apex of the heart inside elbow groin wrist back of knee top of foot

PULSE CHARACTERISTICS Rate: number of beats per minute Normal 60-100 beats per minute Over 100 = tachycardia Under 60 = bradycardia Rhythm: regularity of beats steady or uneven? irregular pulse = arrhythmia Volume: strength of pulse bounding = forceful thready = weak

RESPIRATIONS Taking oxygen (O2) into the body Inhale, inspiration, breathing in Expelling carbon dioxide (CO2) out of the body Exhale, expiration, breathing out 1 breath in + 1 breath out = 1 respiration Watch the chest rise and fall. *Do not let the patient know that you are measuring his/her respiratory rate or they may not breathe normally. Do while taking blood pressure.

RESPIRATORY CHARACTERISTICS Rate = number per minute Normal is 12-20 per minute Rhythm = regularity of breathing Quality = amount of air exchanged and effort it takes to breathe

RESPIRATORY CHARACTERISTICS Dyspnea shortness of breath, difficulty breathing Tachypnea abnormally fast breathing Apnea no breathing present Cheyne-Stokes labored breathing followed by apnea Rales; Wheezing bubbling or rattling sounds; wheezing noise

OXYGEN CONCENTRATION Pulse oximeter = measures oxygen in arteries by passing infrared light through vascular bed Fingertip, ear lobe, bridge of nose, or toe Indicator of respiratory and cardiac condition Normal is 95 – 100% oxygen Below 90% calls for oxygen treatment

Pupil size can change from 2 millimeters to 8 millimeters Pupil size can change from 2 millimeters to 8 millimeters. This means that by changing the size of the pupil, the eye can change the amount of light that enters it by 30 times. PEARRL: Pupils Equally Round and Reactive to Light If a patient’s pupils are not PEARRL, that patient is in severe distress, usually from an acute spinal cord or head injury/stroke in brain. Rush to E.R. PUPILS

PUPIL SIZE Glaucoma: mid-dilated pupil may be a sign Aneurysm: dilated pupil Brain tumor: problems within the pupil Recreational drug use: dilated or constricted Medications: dilated pupils Head trauma: unequal pupils Cluster headaches: constricted pupil Stroke: changes in the size Syphilis: small, unequal, misshapen pupils that constrict with near focusing but do not react normally to light

BLOOD PRESSURE

Tips for Taking Blood Pressure

How to take a blood pressure reading: 1) Make sure the proper size cuff is circled around the upper arm and fixed in place. 2) Inflate the cuff 3) Listen to the brachial artery at the edge of the lower part of the cuff. 4) When beats first become audible: systolic pressure 5) When beats are last audible: diastolic pressure Written as: (for example): 120/80 (systolic pressure over diastolic pressure)