Vital signs/ Anthropometric Measurements

1. Vital signs/ Anthropometric Measurements Dr. Jennifer Lucy

2. Vital sign • Vital signs are physical signs that indicate an individual is alive • Includes heart beat, respiratory rate, temperature, blood pressures and recently oxygen saturation.

3. Vital sign • Signs may be observed, measured, and monitored • Assess an individual's level of physical functioning.

4. Vital sign • Before measurements, patient should sit for five minutes.

5. Observation • Does the patient seem anxious, in pain, upset? • Remember, anxiety can affect vital sign results

6. Temperature Vital signs

7. Temperature • Babies and young children tend to have higher temperatures • Elderly clients tend to have lower, hence a 97.9 might be a fever.

8. Temperature • Body temperature of affected by • Gender • Recent activity • Food and fluid consumption • Menstrual cycle.

9. Normal Temperature • Fahrenheit/Celcius Normal Range: 97.8 F – 99 F equivalent to 36.5 C-37.2 C

10. Oral • Oral ( do not take after food or smoking for 30 mins • Place probe under tongue • Second most accurate route after rectal • Converting F to C -30 then divide by 2 • C to F x2 + 30

11. Temperature ( Rectal ) • Rectal temperatures tend to be 1° higher than when taken by mouth. • Position patient in Sims ( left side lying position • Insert probe 1 inch for patients over 6 months old • ½ inch for under patients under 6 months old

12. Temperature ( Axillary) • Axillary temperatures can be taken under the arm. • Temperatures taken by this route tend to be 0.3 to 0.4° (Fahrenheit) lower than those temperatures taken by mouth.

13. Tympanic ( Aural) • Measure’s body's core temperature • For patients over 3 years gently pull pinna up and out • For under three years gently pull pinna down and back .

14. Temporal • Measures infrared heatwaves across skin of forehead

15. Fever • A fever is indicated when body temperature rises above 99.0 orally or 99.8° F rectally.

16. Hypothermia/ Hyperthermia • Hypothermia is defined as a drop in body temperature below 96° F. Hyperthermia is defined as a rise in body temperature above 104 F.

17. Respiratory rates Vital signs

18. What is the respiratory rate? • The respiration rate is the number of breaths a person takes per minute.

19. Respiratory Rate • Try to do this as surreptitiously as possible. Observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse.

20. Respiratory Rate • Breaths should be counted for at 30 second then times by 2 if regular • Count for one minute if irregular

21. Respiratory Rate • Respiration rates may increase with fever , illness or pain

22. Respiratory Rate • Normal respiration rates at rest range from 12 to 20 breaths per minute. 12 20

23. Abnormal Respiratory Rate • Bradypnea under 12 breaths per minute • Tachypnea over 20 breaths per minute under 12 breaths over 20 breaths

24. Pulse Vital signs

25. Pulse rate • The normal pulse for healthy adults ranges from 60 to 100 beats per minute.

26. Pulse rate • The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men.

27. Pulse rate • Athletes, such as runners, may have heart rates in the 50's and experience no problems.

28. Radial pulse • You feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body.

29. How to check your carotid pulse • The carotid pulse can be found on the side of the lower neck,.

30. Pulse: Quantity • Measure the rate of the pulse (recorded in beats per minute). Count for 30 seconds and multiply by 2 (or 15 seconds x 4) • Measure for a full minute • Regular Pulse Irregular

31. Pulse: Regularity • Is the time between beats constant?. Irregular rhythms, are quite common.

32. Brady / Tachycardia • Below 60: Bradycardia • Above 100: Tachycardia

33. Average Heart rate by Age • New born 120-160bpm • Infant ( 1 to 12 months) 80-140bpm • Toddler (1-3 years) 80-130bpm • Preschool (3-5-years )80-120bpm • School age ( 6-15) 70-100bpm • Adult ( over 15 years) 60-100bpm

34. Blood pressure Vital signs

35. Preparation for measurement • Patient should abstain from eating, drinking, smoking and taking drugs that affect the blood pressure 30 mins before measurement. 

36. Position of the Patient • Sitting position • Arm and back are supported. • Feet should be resting firmly on the floor • Feet not dangling. 

37. Equipment needed to measure blood pressure • Adult Cuff size • Indications for large cuff or thigh cuff • Upper arm circumference >34 cm • Indications for forearm cuff (with radial palpation) • Upper arm circumference >50 cm

38. Blood Pressure • If cuff is too small, the readings will be artificially elevated. The opposite occurs if the cuff is too large. Clinics should have at least 2 cuff sizes available, normal and large.

39. Cuff position • Patient's arm slightly flexed at elbow • Push the sleeve up, wrap the cuff around the bare arm

40. In order to measure the Blood Pressure (Cuff Position) • Cuff applied directly over skin (Clothes artificially raises blood pressure ) • Position lower cuff border about 2 inches above antecubital • Center inflatable bladder over brachial artery

41. What Abnormal Results Mean

42. Blood pressure for adult • Physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension and initiating treatment.

43. Blood pressure (mm Hg) • Normal blood pressure Systolic 100 to 119 Diastolic 60 to 79 • Pre hypertension Systolic 120 to 139 Diastolic 80 to 89

44. Hypertension • High blood pressure greater than 139-89..

45. Hypertension Stages • STAGE ONE ( Primary) • Systolic140-159 • Diastolic 90-99 • STAGE TWO • Systolic 160 or higher • Diastolic 100 or higher

46. Hypertensive Crisis • Systolic 180 or above • Diastolic 110 or above

47. Hypotensive stage • Systolic less than 90 • Diastolic less than 60

48. Blood pressure may be affected by many different conditions • Cardiovascular disorders • Neurological conditions • Kidney and urological disorders

49. Blood pressure may be affected by many different conditions • Preclampsia in pregnant women • Psychological factors such as stress, anger, or fear Eclampsia

50. PALPABLE B/P • Feel for radial pulse • Inflate cuff • Feel when pulse is no longer palpable • Add 30 • That is your starting point when you do B/P