Articulate Presenter version 4 Pro,build105d0 N:\Level I Content\BSN On-lineProgram\NRSG 268\Vital Signs-edited\Vital Signs pv.ppt 8/1/2003 1:02:18 PM Vital Signs pv slide1.swf bgtm1.swf Vital Signs 5 false 30 slide2.swf bgsm1.swf Vital Signs Key physiological measure of the person’s health status. Changes indicate valuable information about your patients. EXTREMELY IMPORTANT 35.37 false 30 slide3.swf bgsm1.swf Vital Signs (V.S.) T = Temperature P = Pulse R = Respiration BP = Blood Pressure 98.6-80-20-110/70 65.385 false 30 slide4.swf bgsm1.swf Temperature Hypothalamus Heat loss vs. heat production 37C 98.6F Range 35.8-37.3C 96.4-99.1F Diurnal - in AM in PM Increase with menstrual cycle, exercise, changes with age Lower in older age 128.34 false 30 slide5.swf bgsm1.swf Temperature Oral is most accurate Electronic thermometer – tympanic membrane Axillary temp – one lower Rectal temp – one higher Hyperthermia vs. Hypothermia (NR 96.4-99.1F) Centigrade = 5/9 (F-32) Fahrenheit = (C x 9/5) + 32 127.504 false 30 slide6.swf bgsm1.swf Pulse Stroke volume – blood every beat Pads of fingers (1st three) 15 sec x 4 if regular Irregular = full 60 sec Rate = 60-100 (brady vs tachycardia) CO = S V x Rate CO = approx 5L/min 174.028 false 30 slide7.swf bgsm1.swf Pulse Rhythm = even (not irregular) Force 3+ full, bounding 2+ normal 1+ weak, thready 0 absent Elasticity = springy, resilient 74.162 false 30 slide8.swf bgsm1.swf Respirations Regular, relaxed, automatic, silent Maintain counting pulse Don’t tell you are counting!!!!!! 30 sec if normal x two Full 60 if irregular Children increased Pulse 4 : resp. 1 Normal: 12-24 resp./min 104.151 false 30 slide9.swf bgsm1.swf Blood Pressure The force of the blood against the vessel wall during contraction of the heart and relaxation of the heart. 26.384 false 30 slide10.swf bgsm1.swf Factors affection BP Cardiac output Peripheral vascular resistance Volume of circulation blood Viscosity Elasticity 88.817 false 30 slide11.swf bgsm1.swf Factors affecting BP BP = 120/80 Variations/ranges Varies with: Age Gender Race Time of day (increased in a.m.) Weight Exercise Emotion/stress 145.058 false 30 slide12.swf bgsm1.swf Stethoscope Sphygmomanometer Size important Too narrow = high BP Too large = low BP Procedure Auscultatory Gap Korotkoff’s sounds 263.55 false 30 slide13.swf bgsm1.swf Stethoscope Sphygmomanometer Lying, sitting, standing Thigh pressure Higher than arm 32 false 30 slide14.swf bgsm1.swf Blood Pressure Systolic (contraction) top # Diastolic (resting) bottom # Hypertension = high BP Hypotension = low BP Pulse Pressure = systolic – diastolic PP is approx same as SV So…CO=pp x rate 40 x 80 = 3200 or 3.2L (approx) 158.877 false 30 slide15.swf bgsm1.swf Blood Pressure Phase I – first sound Phase IV – muffling Phase V – last sound I and V in adults I and IV in children 36.049 false 30 slide16.swf bgsm1.swf Common errors in BP measurement Anxiety – increase Arm position Above heart = low BP Below heart = high BP Cuff size Small = high Large = low High inflation = pain Low inflation = inaccurate Deflate too quickly = miss it 82.391 false 30 slide17.swf bgsm1.swf Common errors in BP measurement Pushing too hard with stethoscope = pain and obliteration of pulse Halt and reinflate = high BP Haste = false BP Uncalibrated cuff = inaccurate Bad hearing = inaccurate 63.086 false 30 slide18.swf bgsm1.swf Developmental Considerations Infants Take temperature last Oral temp after age 5 Axillary temp in premature and newborns Apical pulse 73.483 false 30 slide19.swf bgsm1.swf Older Adults Temperature regulatory mechanism changes Less likely to develop fever More likely to develop hypothermia Radial artery may fell stiff, rigid, tortuous Shallower respirations and increased rate BP may rise 83.096 false 30