1. Measuring & Recording Vital Signs
Clinical Rotations

2. The Four Vital Signs Blood Pressure
Temperature Pulse Respirations

3. Objectives: Students will: List the 4 major vital signs
Describe the principles for measuring and recording oral, rectal, axillary, tympanic and temporal temperatures
Convert Fahrenheit to Celsius
Define- temperature, pulse, respirations, blood pressure and apical pulse

4. WHAT IS BLOOD PRESSURE?
When your heart beats, it pumps blood around your body to give it the energy and oxygen it needs
As the blood moves, it pushes against the sides of the blood vessels( arteries) –
The strength of the force exerted on your vessels is called your blood pressure

5. How is blood pressure it measured?
Measured in millimeters of mercury
A blood pressure machine is called a sphygmomanometer
BP is read at two points:
Systolic
Diastolic

6. Systolic Blood Pressure
Pressure that occurs in the walls of the arteries when the LEFT VENTRICLE OF THE HEART is contracting
Normal systolic reading is BELOW
120 mm or mercury
Normal range is mm or mercury
Systolic is the FIRST sound heard

8. Diastolic Blood Pressure
The constant pressure in the walls of the arteries when the LEFT VENTRICLE is at rest (between contractions)
Normal diastolic reading is below 80mm or mercury
Normal range is mm of mercury
It is noted as the reading on the BP gauge when the sound STOPS or becomes very FAINT

9. Recording Blood Pressure
Recorded in the form of a fraction
Systolic is the top number
Diastolic is the bottom number
Example:
120/70

10. Pulse Pressure
The difference between the SYSTOLIC and the DIASTOLIC pressure
Important indicator of the health & tone of the arterial walls
Normal pulse pressure is: mm of mercury
Example: what is the pulse pressure of
110/80

11. Answer:
The pulse pressure of 110/80 is:
30 mm of mercury

12. Abnormal Blood Pressure
Pre Hypertension
Warning that high blood pressure is likely to develop
This condition can harden arteries, dislodge plaque, and block vessels that nourish the heart
Indicated by pressure readings of:
Systolic – mm of mercury
Diastolic – mm or mercury

13. Hypertension Indicated when pressures are greater than
140 mm of mercury
COMMOM CAUSES:
Stress
Anxiety
High salt intake
Advanced age
Thyroid disease
Vascular disease such as arteriosclerosis

14. Hypotension COMMOM CAUSES Indicated when BP is less than
90 mm of mercury
COMMOM CAUSES
Occurs with heart failure
Dehydration
Depression
Severe burns
Hemorrhage
Shock

15. Orthostatic or Postural Hypotension
Occurs when there is a sudden drop in BOTH the systolic & diastolic pressures
Occurs when an individual moves from a lying to a sitting or to a standing position
Blood vessels fail to compensate for the change in position
Individual experiences- may last a few seconds
Lightheadedness
Dizziness
Blurred vision

16. Factor affecting BLOOD PRESSURE
Heartbeat
Condition of the arterial system
Elasticity of the arteries
Volume of circulating blood
Position

17. Factors which may Increase BP
Anxiety
Nervousness
Obesity
Stimulant drugs
Exercise
Smoking
Pain

18. Factors which can Decrease BP
Sleep
Depressant drugs
Shock
Dehydration
Hemorrhage
Fasting

19. Sphygmomanometers Aneroid Does not have a mercury column
It has a round gauge
Each line equals 2 mm of mercury
Position at eye level
Needle must start at 0 ZERO

21. Electronic Sphygmomanometers
Used in most health care facilities
Record blood pressure automatically after cuff is placed on patient
Will show reading in a digital display

24. Factors to Follow When taking a BP
American Heart Association recommends:
Patient should be quite for at least 5 minutes
Take 2 separate readings
Wait at least seconds between readings

25. Continued Correct size and placement of the cuff
Patient should be sitting or lying down
Arm should be freely extended and free of constricting clothes
BP cuff must be deflated and free of any air
BP cuff should be placed over directly over the brachial artery
Edge of cuff should sit 1” above the antecubital space

29. How to take a Blood Pressure
Person should be comfortably seated or lying down
Should have rested for minutes prior to the reading
Arms that are paralyzed, injured, have an IV or shunt should not be used**** never take BP the same side as a mastectomy
Infant blood pressures can be taken on the leg

30. Blood Pressure Procedure
Excess air should be squeezed out of the cuff
Cuff should be placed snugly on upper arm.
Gauge should be easily visualized
Valve should be closed, but easily able to be opened

31. Blood Pressure Procedure
Two techniques for obtaining the pressure
TECHNIQUE #1
Find radial pulse. Pump cuff till pulse no longer palpated.
Then pump another 30 mm Hg higher
Place diaphragm of stethoscope on brachial artery about ½ - 1 inch above the elbow
Release the valve and listen for the two measurements - slowly deflating the cuff.

32. Blood Pressure Procedure
TECHNIQUE #2
Find brachial artery and put diaphragm over the site.
Pump cuff to 120 mm Hg and listen for the heart beat. If it is heard, pump another 30 mm Hg and listen again.
When the pulse is no longer heard, then pump another 30 mm Hg and slowly deflate, listening for the two measurements.

33. Reporting & Recording Reading
If reading is uncertain, wait 30 seconds to 1 minute before remeasuring
Record the reading and report any abnormalities
If the B/P reading is outside of the normal limits, retake it before reporting the value to a supervisor to be certain of accuracy

34. Blood Pressure Skills Lab
OBJECTIVE:
Successful completion of Skills Check list after demonstrating proficiency in this hands on lab experience
Students will have the opportunity to practice taking and recording BP as recommended by the AHA
Successful completion of the skills check list is required to pass this skills section of this lesson

35. Temperature Conversions
Fahrenheit to Celsius
C=(F-32)/ 1.8
Celsius to Fahrenheit
F=(C X 1.8) + 32