UNIT 2: VITAL SIGNS - Conduction,

- Convection,
VITAL SIGNS
- Vaporization.
- are measurements of physiologic functioning.
These are body temperature,

Consist of pulse rate, respiratory rate, and blood

pressure.

-Health professionals often take these measures

of various physiological statistics to assess the
most basic body functions.

LESSON 1: BODY TEMPERATURE

NOTE: 2 types of body temperature 1.) Core

Temperature; and 2.) Surface Temperature.

- Your body's temperature requires a balance » Types of Fever (CIRR)

between heat production and heat loss. 1. Intermittent type (A) of fever is
- Normal body temperature ranges from 36.5° C characterized by body temperature
alternating regularly between a period
to 37.5°C.
of fever and a period of normal or
» Common terminologies subnormal temperature. (within the
day)
1. Pyrexia, also known as hyperthermia or
2. Remittent type (B) of fever is associated
fever in lay terms, refers to body
with the body temperature that
temperature above the usual range.
fluctuate several degrees more than 2°C
2. Hyperpyrexia refers to a very high fever,
above normal but does not reach normal
such as 41°C.
between fluctuations. (happened for a
3. Hypothermia refers to a body
day)
temperature below the lower limit of
3. Continuous Fever (C) is a type of fever
normal.
where the body temperature remains
4. Febrile is a condition of a client who has
consistently elevated and fluctuates very
a fever
little less than 2°C. (happened for days)
5. Afebrile refers to a client without fever
4. Relapsing/Recurrent (D) type refers to a
» factors affecting Heat production fever with a body temperature that is
elevated for several days, returns to
- Basal Metabolic Rate,
normal for a day or two but then fever
- Muscle Activity,
returns again. (changes for days)
- Thyroxine Output,
- Epinephrine, Norepinephrine, And
Sympathetic Stimulations And
- Fever.

» factors affecting Heat Loss

- Radiation,
 4. Infrared Thermometer is another non-
invasive type of thermometer that uses
advance infrared technology. (For the
advantages and disadvantages look for
the handout)
a. Non-contact type of infrared
thermometer also known as laser
thermometer uses thermal radiation
and convert this to an electrical
signal that is displayed in units of
temperature.
» Equipment for Assessing Body Temperature b. Contact type of infrared
thermometer works by scanning the
- A thermometer is used to measure your body
temporal artery. Contact types of
temperature.
infrared thermometer are usually
* Mercury in glass type of thermometer are no longer seen in the clinical setting most
used nowadays due to its easy breakability and
commonly used among pediatric
possible exposure to the toxic substance mercury
itself. patients.

1. Electronic Thermometer has a battery » Procedure for Assessing Temperature

powered display unit, a thin wire cord (ORAyTT)
and a temperature-sensitive probe 1. Oral Thermometer Placement
covered by a disposable plastic sheath to 2. Rectal Thermometer Placement
prevent transmission of infection. (For 3. Axillary Thermometer Placement
the advantages and disadvantages look 4. Tympanic Thermometer Placement
for the handout) 5. Temporal Artery Thermometer
2. Disposable, Single-use Thermometer Placement
are thin strips of plastic with chemical
thermometer paper with heat sensitive Note: Rectal is the best location to get the core
liquid crystals. These can be used for temperature.
axillary or oral temperature, particularly
with children. They can be inserted in
the same way as an oral thermometer or
can be applied to the skin. (For the
advantages and disadvantages look for
the handout)
3. Tympanic Membrane Thermometer is a
small, handheld device similar to an
otoscope that has a disposable cover.
This uses infrared sensing electronics
and liquid crystal displays. Most of these LESSON 2: PULSE RATE
types are battery operated and Pulse is the wave of blood in your arterial wall
rechargeable. (For the advantages and created by the contraction of the left ventricle of
disadvantages look for the handout) your heart.
Pulse Rate refers to the number of beats/pulse
per minute. The pulse is expressed in
beats/minute (bpm).

Normal adult pulse rate is 60 to 100 bpm. In

healthy individuals, this is the same as the heart
rate.

» Common Terminologies

1. Stroke Volume (SV) is the amount of

blood that enters your arteries with
» Pulse Sites
every ventricular contraction.
2. Cardiac Output (CO) is equivalent to 1. Temporal pulse is superior (above) and
stroke volume multitplied by your heary lateral to (away from the midline of) the
rate. In a normal adult, this amounts to eye.
about 4 to 6 liters at rest. The cardiac 2. Carotid pulse is at the side of the neck
output is illustrated by this formula: CO= below tube of the ear. This is the area
SV x HR where the carotid artery runs between
3. Peripheral pulse is a pulse located in the the trachea and the sternocleidomastoid
periphery of the body like that in the muscle.
foot, neck, and groin. 3. Apical pulse is at the apex of the heart.
4. Central pulse is located at the apex of routinely used for infant and children < 3
the heart. This is your apical pulse. yrs In adults – Left midclavicular line
5. Pulse deficit is the difference that under the 4th, 5th, 6th intercostals
between the apical and radial pulse. This space Children < 4 yrs of the Lt. mid
may indicate that the contraction of the clavicular line
ventricle is not efficient enough to 4. Brachial pulse is at the inner aspect of
circulate the blood as the pulsations do the biceps muscle of the arm or medially
not reach the peripheral (radial) pulse in the antecubital space (elbow crease)
with each beat. 5. Radial pulse can be found on the thumb
6. Tachycardia is a consistently above side of the inner aspect of the wrist–
normal (greater than 100 bpm) pulse readily available and routinely used
rate. 6. Femoral pulse is along the inguinal
7. Bradycardia refers to a continuously ligament. Used or infants and children
slow (less that 60 bpm) pulse rate. 7. Popiliteal pulse is found just behind the
8. Pulse rhythm is the pattern, interval or knee by flexing the knee slightly.
spacing of the beats. Regular rhythm 8. Posterior tibial pulse is on the medial
should have same interval between surface of the ankle
beats.
9. Pulse volume pertains to the force of
blood with each of the ventricular
contraction. In normal condition, the
pulse volume has to be full and strong.
 9. Pedal (Dorslais Pedis) pulse can be 5. hyperventilation pertains to a very
palpated by feeling the dorsum (upper deep, rapid respiration
surface) of the foot on an imaginary line 6. Hypoventilation refers to very shallow
drawn from the middle of the ankle to respiration
the surface between the big and 2nd
toes

LESSON 3: RESPIRATORY RATE

Respiration is the act of breathing, taking in

oxygen and removing carbon dioxide.

Ventilation refers to the movement of air in and

out of the lungs. This is measured by counting
the inhalation and exhalation as one cycle for a
full minute.

Normal adult respiratory rate is 12-20 cycles per

minute (CPM).

» Types of breathing
LESSON 4: RECORDING TEMPERATURE, PULSE
1. Costal (thoracic) breathing involves the AND RESPIRATION ON TPR SHEET
use of external muscles and other
accessory muscles Vital signs should be recorded promptly and as
(sternocleidomastoid). It can be accurate as possible to provide continuous and
observed by looking at the movement of current documentation. The record of a client's
the chest upward and downward. vital signs is found on the TPR Graph Sheet.
2. Diaphragmatic (abdominal) breathing.
This helps the providers immediately respond to
Includes the contraction and relaxation
the client's changing condition. it also serves as a
of the diaphragm. It can be observed by
quick and handy reference for the entire
noting the movement of abdomen.
healthcare team.
» Common Terminologies
1. Write the date and time The date is
1. Eupnea refers to normal breathing rate written in the day format alone on the
and depth top most row while the time is written
2. Bradypnea is slow respiration below it. By policy, vital signs is
3. Tachypnea is fast breathing monitored twice every shift of every 4
4. Apnea is temporary cessation of hours unless specified by the physician’s
breathing order.
2. Record the temperature by placing a dot
in the middle of the block between the
 time lines. To connect readings, use a 5. Hypotension refers to low blood
ruler or straight edge. In many facilities, pressure
temperature is recorded in red ink.
3. Record the pulse rate by making a dot in
the middle of the block between the
time lines parallel to the pulse rate.
Connect the dot to the previous reading
with a short line. This is usually recorded 1. Cardiac Output (CO) is a combination of
using a black ink. the heart rate and the amount of blood
4. Record the respiratory rate at the pumped out of the heart with each
bottom of the graph by placing a dot in contraction (stroke volume) over 1
the middle of the block between the minute.
time lines. Connect the dot to the 2. Peripheral Resistance (PR) is the
previous reading with a short line. This is resistance of blood vessels to the flow of
also usually recorded using a black ink blood. Peripheral resistance basically
like the pulse rate. affects blood pressure and the work
needed by the heart to pump the blood.
LESSON 5: BLOOD PRESSURE
If peripheral resistance↑, ↑ pump to
Blood pressure (BP) is a measure of the force push blood through the blood vessels.
exerted by the blood as it flows through the 3. Blood volume or the amount of blood
arteries. circulating within the vascular system
affects blood pressure. Naturally, ↑
This is the pressure that is exerted on the wall of
blood volume will lead to an ↑ blood
the arteries when the left ventricle of the heart
pressure as there exert more pressure
pushes blood into the aorta.
on the walls of the arteries.
The blood pressure is recorded in the form of a 4. Blood viscosity or the thickness of blood
fraction and uses millimeters of Mercury that flows through the small vessels
(mmHg) as a standard unit of measurement. affect is flow and pressure required to
120/80 mmHg is the average blood pressure of a move them.
healthy adult. 5. Elasticity of the vessels refers to the
flexibility and distensibility of the
» Common Terminologies vessels.
1. Systolic pressure is the pressure of the » Factor affecting BP: one’s age, exercise, stress,
blood as a result of contraction of the obesity, gender, medications and diurnal
ventricles. This is the highest point of variations.
pressure.
2. Diastolic pressure is the drop of arterial » Increased blood pressure can be due to
pressure occurring during the relaxation presence of fever, stress, arteriosclerosis,
of the ventricles. This is the lowest point obesity and even exposure to extreme cold
of pressure. temperature.
3. Pulse Pressure is the difference between
systolic and diastolic pressure.
4. Hypertension is a consistent increase in
blood pressure
» Alterations in Blood Pressure

1. Hypertension is a blood pressure that is Phase 2: The period during deflation when the
persistently above normal. sound has a swishing quality
2. Essential Hypertension is also known as
Phase 3: The period during which the sounds are
primary hypertension where the cause is
crisper and more intense
unknown.
3. Secondary Hypertension is due to a Phase 4: The time when the sounds become
known pathology. muffled and have a soft blowing quality
4. Hypotension is a blood pressure below
the normal limits. Phase 5: The pressure level when the sounds
disappear

» Assessing Blood Pressure

This procedure refers to monitoring blood

pressure using palpation and/or a
sphygmomanometer and a stethoscope.

» Methods of Measuring Blood Pressure

1. Direct or invasive monitoring measurement

involves the insertion of catheter in to the
brachial, radial, or femoral artery. The physician
inserts the catheter and the nurse monitors the
pressure reading. With use of correct placement,
it is highly accurate.

2. Indirect or non-invasive methods includes the

auscultatory and the palpatory method.

The auscultatory method is the commonest

method used in health activities. When taking
blood pressure using stethoscope, the nurse
identifies five phases in series of sounds called
Korotkoff's sound.

Phase 1: The pressure level at which the 1st joint

clear tapping sound is heard, these sounds
gradually become more intense. To ensure that
they are not extraneous sounds, the nurse
should identify at least two consecutive tapping
sounds.