In this lesson, you will learn about vital signs. Included will be an example, the definition of vital signs and the processes of taking vital signs. Also, a quiz is provided to assist you with this lesson.
A nurse working at a clinic walks into the exam room and finds a person lying on the floor. The first thing the nurse does is take the person's vital signs. Why? Because knowing what a person's vital signs are will tell the nurse what to do next.
What are vital signs? Vital signs are the evidence of the current physical functioning of the body. They provide critical information that is 'vital' for life, and so they are called vital signs. In an emergency, the patient's heart rate is the first vital sign checked by a nurse. The nurse wants to know if the person's heart is beating and at what rate. Next, the nurse will check for the person's respirations and get a blood pressure cuff to check the blood pressure. The last vital sign is temperature.
Note that these ranges are the norms for the adult population. A health care worker will also look at the normal levels for the patient. Some patients' norms vary slightly from the norms listed above. For example, a softball player may have a slower heart rate. This is because of the athletic conditioning the softball player has achieved. The heart is a muscle, and it has learned to function at a lower rate.
Vital signs can provide the information needed by the health care professional to care for the needs of the patient. The alteration of vital signs in a patient can indicate an acute or chronic medical problem. The more off the norm the vital signs are usually indicates a sicker patient.
When taking vital signs in a non-emergency situation, the room should be quiet, and the patient should be as comfortable as possible. If possible, the vital signs should not be taken for at least 5 minutes after the patient enters the room. This is to avoid getting a reading that is altered due to activity. Of course, if the patient is very ill, this may not be feasible.
The patient should be seated when taking his or her vital signs. Take a moment to look over the patient. If the patient is anxious or in pain, this may cause alterations of the vital signs. The order of taking the different vital signs is not important in a non-emergency medical situation.
Usually, in a patient who is not critical, the health care worker will take the patient's temperature first, which is a measure of how the body generates and eliminates heat. There are several different ways to measure temperature in a patient.
Oral: A thermometer is placed under the tongue in the patient's mouth. Temperature is measured with a glass thermometer that is visually read or with an electronic device that provides a digital reading. Patients should not eat or drink anything prior to measurement. If using a glass thermometer, make sure it is clean, and shake the thermometer to get the mercury level below 95 degrees. Hold the thermometer under the patient's tongue for 3-4 minutes for a glass thermometer or until the unit beeps for an electronic device. A digital thermometer is the preferred method for measuring an adult's temperature.
Anal: Using a glass or digital thermometer, health care professionals will lubricate the thermometer and place it in the patient's anus about 1 inch. Note that the anal reading will be 1 degree higher because it is higher than the core temperature. So if the reading is 99.0, the recorded temperature would be 98.0. This is the preferred method for taking a child's temperature.
Axillary: The health care professional places a digital or glass thermometer under the patient's arm. Note that the axillary reading will be 1 degree lower because it is not a core temperature reading. So if the reading is 97.0, the recorded temperature would be 98.0.
Tympanic: For this reading, a special thermometer is inserted into the patient's ear. These are electronic, so the unit will beep when the reading is completed.
Skin: A strip thermometer can measure the temperature of a patient's skin. Since this is the least accurate method of taking a patient's temperature, health care professionals will only use it when there is no other way to obtain a patient's temperature.
Temporal: A special digital thermometer is used for this reading. The device is placed on the forehead and swiped along one side of the face. It is then held until the unit beeps.
Measuring the number of beats in a minute is how the heart rate is recorded. This measurement is usually known as BPM, or beats per minute. The heart rate can be taken at any large artery in the body, although it is usually taken at the radial artery in the wrist.
To measure BPM without a monitor, you place your index and middle finger just above the patient's wrist in line with the thumb. Push gently at first and then apply slight pressure once you feel the pulse. Make sure not to use your thumb to avoid confusing the patient's pulse with your pulse. Count for 1 full minute to get the most accurate reading.
Today there are many electronic devices to measure the heart rate. Some are very accurate, but a health care worker should always do a radial pulse measurement to compare to the digital reading.
Measuring the breaths per minute, or RR (respiratory rate), is the way to record respirations. This is done by counting the number of times the patient breathes in one minute. When taking this measurement, be careful not to alert the patient. If the patient feels like he or she is being watched, she or he may alter the rate of breathing.
The best way to count respirations is to do it immediately after you take the pulse measurement. Do not let go of the wrist, but start to count the rises and falls of the chest. One respiration is counted for each rise and fall of the chest. This way the patient will not become aware that you are counting respirations and alter his or her breathing.
Blood pressure is measured using a manometer and a stethoscope or using a digital device. The reading is measured in millimeters of mercury (mm Hg). The first number is the systolic number, which represents the contraction of the heart. It indicates the maximum pressure on the blood vessels. The second number is the diastolic number, which represents the minimum pressure on the blood vessels. This is when the heart is resting before the next contraction.
Digital devices are specifically designed to be applied to the upper arm, the wrist, the thigh, or the ankle. Because digital devices have less than 50% accuracy, the measurement for blood pressure will be described using the manometer and the stethoscope.
The patient should be seated and the arm should be bare. The cuff length should be measured against the patient's arm circumference. If the cuff does not fit properly, you may receive an incorrect reading. The cuff is placed on the upper arm of the patient on the patient's brachial artery.
According to the American Heart Association, the cuff is inflated to the level of at least 30 points above the patient's normal systolic reading on the manometer using the bulb. At the same time, the health care worker places the stethoscope in his or her ears and the bell on the patient's brachial artery. Slowly the cuff is deflated. The first sound you hear is the systolic blood pressure and the last sound you hear is the diastolic blood pressure. These two sounds represent the two values of the blood pressure reading.
Sometimes you may not hear the last sound. If this happens, deflate the cuff completely before repeating the procedure. If the measurement is very low or very high, repeat the procedure after deflating the cuff.
Vital signs are measurements of the current physical functioning of the body that can indicate acute and chronic conditions in a patient. The health care worker should always verify the heart rate, respirations, and blood pressure through manual methods if the norms are high or low.
There are six different methods to take a person's temperature. For adults, the oral method is preferred to get the temperature. In children, the preferred method for the temperature reading is the anal method.
Heart rate measures the number of beats in a minute. Using a patient's radial artery is the most efficient way to measure heart rate.
Measuring a patient's respiratory rate is done by counting the number of times the patient breathes in one minute.
Best measured by using the radial artery Measured by counting the number of times a patient breathes in one minute Measured using a manometer and a stethoscope Measured with a thermometer in one of the following ways: oral, anal, axillary, tympannic, skin contact, and temporal
Numbers 28:24 In this way you shall prepare daily, seven days, bread for a fire offering, a soothing fragrance to Jehovah. It shall be prepared besides the continual burnt offering and its drink offering.
LITV(i) 24 In this way you shall prepare daily, seven days, bread for a fire offering, a soothing fragrance to Jehovah. It shall be prepared besides the continual burnt offering and its drink offering.