1. VITAL SIGNS Temperature, Pulse, Respirations and Blood Pressure (TPR, BP)

2. VITAL SIGNS Vital signs provide information about the basic body condition of the patient. The four main vital signs are: Temperature Pulse (radial) Respirations Blood Pressure

3. TEMPERATURE Temperature is a measurement of the balance between heat lost and heat produced by the body. Heat is lost through perspiration (sweating), respiration (breathing), and excretion (urine and feces) Heat is produced by the metabolism of food, and by muscle and gland activity. Temperature can be measured: Orally (mouth) Rectally (rectum) Axillary (armpit) Aural (ear) Temporal (temporal artery in the forehead)

4. TEMPERATURE The normal range for body temperature is 97-100 degrees Fahrenheit, or 36.1-37.8 degrees Celsius. Many factor affect body temperature. Time of day – Body temperature is usually lower in the morning (after the body has rested), and higher in the evening (after muscle activity and daily intake of food has taken place). Body sites – Temperature will vary depending on the site it is taken. Individual differences – Some people have a higher metabolism which increases their temperatures. Some people have a slower metabolism which lowers their temperature.

5. TEMPERATURE Oral temperatures – taken in the mouth. Thermometer is left in the mouth for 3-5 minutes Most common site for taking temperature No eating, drinking, or smoking for at least 15 minutes before taking oral temp Rectal temperatures – taken in the rectum. Thermometer is left in place for 3-5 minutes The most accurate of all methods. Measures internal body temperature. Axillary temperatures – taken in the armpit Thermometer left in place 10 minutes – Less accurate Aural temperature – measures blood in the blood vessels in the tympanic membrane (ear drum) Temporal temperature – scanned across the forehead

6. TEMPERATURE A FEVER is an elevated body temperature, usually above 101. FEBRILE means FEVER AFEBRILE means WITHOUT FEVER Hypothermia is a low body temperature, below 95 degrees Fahrenheit Hyperthermia is a high body temperature, above 104 degrees Fahrenheit.

7. PULSE PULSE refers to the pressure of the blood pushing against the wall of an artery as the hear beats and rests. Pulse sites include: Temporal – on either side of the forehead Carotid – at the neck on either side of the trachea Brachial – inner aspect of the forearm at the antecubital space (crease of the elbow) RADIAL – at the inner aspect of the wrist, above the thumb Femoral – inner aspect of the upper thigh where the thigh joins the trunk Popliteal – behind the knee Dorsalis pedis – at the top of the foot arch When taking vital signs, the pulse is usually taken at the RADIAL SITE

8. PULSE THREE FACTORS TO BE NOTED WHEN TAKING PULSE: 1. Rate – number of beats per minute Adults: 60-90 beats per minute (bpm) Children: 70-110 beats per minute (bpm) Bradycardia – pulse under 60 beats per minute Tachycardia – pulse rate over 100 beats per minute EXCEPT IN CHILDREN 2. Rhythm – the regularity of the pulse or spacing of the beats. Regular/Irregular Arrhythmia – irregular rhythm 3. Volume – the strength or intensity of the pulse. Strong, weak, thread or bounding.

9. RESPIRATIONS Respirations – the process of taking in oxygen and expelling carbon dioxide from the lungs and respiratory tract. One respiration = one inspiration (breathing in) and one expiration (breathing out) Rate - number of breaths per minute Normal rate for adults is 12-20 breaths per minute Normal rate for children is 16-30 breaths per minute Dyspnea – difficult or labored breathing Apnea – absence of breathing Tachypnea – rapid breathing Bradypnea – slow breathing Cheyne-Stokes – periods of dyspnea, followed by periods of apnea (noted in the dying) Wheezing – high pitched sound on expiration (as in asthma) Cyanosis – blueish color to skin, lips, nail beds due to lack of oxygen Rales – bubbling sounds caused by fluid or mucus

10. BLOOD PRESSURE Blood pressure (BP) – a measurement of the pressure that blood exerts on the walls of the arteries during the various stages of heart activity. Sphygmomanometer – reads BP in millimeters of mercury (mm of Hg) https://www.youtube.com/watch?v=AdGo9CwvYcQ There are two types of blood pressure measurement: Systolic – pressure on the walls of arteries when the heart contracts Diastolic – pressure on the walls of the arteries when the heart rests, between contractions.

11. BLOOD PRESSURE Blood pressure is written as a fraction. The systolic reading is on top, the diastolic reading is on the bottom. For example, a systolic reading of 120 and diastolic reading of 80 is written as 120/80. Normal blood pressure is <120/80 Hypertension (high blood pressure) is >140/90 Hypotension (low blood pressure) is <90/60