1. Vital Signs Created by Debbie Johnson RN- 2003

2. Vital Signs (VS) • Temperature ( T) • Pulse (P) • Respiration (R) • Blood Pressure (BP)

3. Normal Range Temperature Ideal Normal Range Oral 98.6 97.6-99.6 Axillary 97.6 96.6-98.6 Rectal 99.6 98.6-100.6 Tympanic 98.6 98.6

4. Glass Thermometer

5. Steps to taking temperature with glass thermometer • Ask if client has had anything to eat drink or smoke in the last 15 minutes • Shake down thermometer • Place disposable cover over thermometer • Insert thermometer under tongue • Hold thermometer in place for 3 minutes

6. Reading a thermometer Hold thermometer to view mercury column

7. Steps to taking temperature- continued • Remove thermometer from mouth • Remove disposable cover • Read and record temperature • Shake down thermometer • Report any abnormalities to charge nurse

8. Normal Pulse Range • Adult- 60-100 • Birth to 4 weeks- 80-180 • 4 weeks to 1 year-80-160 • 1 to 2 years- 80-130 • 2 to 6 years- 80- 120 • 6-12 years-70-110

9. Normal Respiration • Adult- 12-20 • Infants and children normally breathe faster than adults • Respirations should be quiet, effortless, and regular • Both sides of the chest should raise and fall equally

10. Taking Pulse and Respiration Leave hand in place after taking pulse and count respiration

11. Steps to taking pulse and respiration • Wash hands • Identify self and client • Explain procedure • Provide privacy • Find radial pulse and count for one full minute and record- Must be + or – 4 beats of evaluator

12. Steps to taking pulse and respiration - continued • Count respirations for one full minute and record- Must be + or – 2 respirations of evaluator • Leave signal light in place • Wash hands • Report any abnormalities to charge nurse

13. Normal Blood Pressure Ranges • Adults: 120/80 • Range: Systolic- 100-140 • Diastolic- 60-90 • Children and infants have lower blood pressure readings • New research has indicated that the above numbers may actually be “Pre-hypertensive”

16. Steps to taking Blood Pressure • Wash hands • Identify self and client • Explain procedure • Provide privacy • Clean earpieces and diaphragm with alcohol • Expose forearm • Palpate brachial pulse

17. Always Clean Equipment Wipe diaphragm and earpieces with alcohol

18. Steps to taking Blood Pressure-continued • Inflate sphygmomanometer to 30 millimeters of mercury where pulse last felt • Deflate cuff slowly • Remove cuff • Record Bp reading within 4 beats of mercury of evaluator’s reading

19. Steps to taking Blood Pressure-continued • Give client signal light • Return equipment to proper storage • Wash hands • Report any abnormalities to charge nurse

20. Vital Signs Accuracy is the key! Recheck if necessary Report abnormalities