Vital Sign Monitor...

2.  It is a objective guideposts that provide data to determine a
person state of health.
 Provide information about patient’s overall condition.
 Vital sign are useful in detecting or monitoring medical problems.
 Vital sign can be measured in a medical setting, at home at the
site of a medical emergency, or elsewhere.

3.  Temperature
 PULSE
 RESPIRATION
 BLOOD PRESSURE

4.  Febrile:
Body temperature above patient’s normal
range
o Fever – sign of inflammation or infection
o Hyperpyrexia – extremely high temperature
 A febrile:
Normal body temperature
o Body temperature varies with time of day

5. Axillary
Oral
Rectal
Tympanic
 Measurements
› Degrees Fahrenheit
(°F)
› Degrees Celsius
(centigrade; °C)
 Normal adult oral
temperature
› 98.6°F
› 37°C
Temperature
Routes
Temporal

6.  Measured using either electronic or disposable
› Electronic digital
 Accurate, fast, easy to read
 Comfortable for the patient
› Tympanic
› Temporal
› Disposable
 Single use
 Less accurate

7. Route Normal Range ºF / ºC Sites
Oral 98.6 ºF / 37.0 ºC Mouth
Tympanic 99.6 ºF / 37.6 ºC Ear
Rectal 99.6 ºF / 37.6 ºC Rectum
Axillary 97.6 ºF / 36.6 ºC Axilla (armpit)

8.  Measure to nearest tenth of
a degree
 Oral temperatures
› Wait at least 15 minutes
after eating, drinking, or
smoking
› Place under tongue in
either pocket just off-
center in lower jaw.

9.  Tympanic temperatures
› Proper technique essential
› Adult – pull ear up and back
› Child – pull ear down and back
› Fast, easy to use, and preferred
in pediatric offices

10.  Rectal temperatures
› Standard precaution – gloves
› Patient is positioned on side (left side preferred) or
stomach
› Lubricate tip of thermometer
› Slowly and gently insert tip into anus
 ½ inch for infants
 1 inch for adults
› Hold thermometer in place while temperature is taken
Vital Signs: Taking Temperatures (cont.)

11.  Axillary temperatures
› Place patient in
seated or lying
position
› Place tip of
thermometer in
middle of axilla with
shaft facing forward
› Probe must touch skin
on all sides
Vital Signs: Taking Temperatures (cont.)

12.  Temporal temperatures
› Temporal scanner
› Noninvasive, quick
› Stroke scanner across
forehead, crossing over the
temporal artery
Vital Signs: Taking Temperatures (cont.)

13.  Children
› Take temperature last
if child cries or
becomes agitated
› Agitation will cause
pulse, respiration, and
blood pressure to
elevate
› Oral not appropriate
for children under 5
years old
Vital Signs: Taking Temperatures (cont.)

14. Circulatory
Pulse
Respiratory
Respirations
Pulse and respirations are related because the heart and lungs
work together. Normally, an increase or decrease in one causes the
same effect on the other.

15.  Pulse – number of times the heart beats in
1 minute
 Respiration – number of times a patient
breaths in 1 minute
› One breath = one inhalation and one exhalation
 Ratio of pulse to respirations is 4:1

16.  Indirect measurement
of cardiac output
 Problems if
› Tachycardia
› Bradycardia
› Weak
› Irregular
 Sites of measurement
› Adults – radial artery
› Children – brachial artery
(antecubital space)
› Apex of heart
 5th intercostal space directly
below center of left clavicle
 Apical pulse taken with a
stethoscope

17.  Locate pulse by pressing
lightly with index and
middle finger pads at the
pulse site
 Count the number of
beats felt in 1 minute
 If regular – may count
beats for 30 seconds and
multiply by 2

18. Regular Pulse Rhythm
 Count for 30 seconds,
then multiply by 2
(a rate of 35 beats in 30
seconds equals a pulse
rate of 70 beats/minute)
Irregular Pulse Rhythm
 Count for one full minute
 May use stethoscope to
listen for apical pulse and
count for a full minute

19.  Electronic devices
› Blood pressure machines
› Pulse oxymetry
 Infrared light measures
pulse and oxygen levels
 Report oxygen level below
92% not improved by deep
breathing

20.  Respiratory rate – indication of how well the body
provides oxygen to the tissues
 Check by watching, listening, or feeling
movement

21. 0
5
10
15
20
25
30
35
40
0-1 yrs 1-6 yrs 6-11 yrs 11-16 yrs ADULT ELDERLY
(26-40)
(20-30)
(18-24) (16-24)
(12-20)
(12-24)
Normal Respiratory Rates

22.  Check respirations
› Look, listen, and feel
for movement of air
› Count with a
stethoscope
 Count for one full
minute
› Rate
› Rhythm – regular
› Effort (quality) –
normal, shallow, or
deep

23.  Irregularities – indication of possible disease
› Hyperventilation – excessive rate and depth
› Dyspnea – difficult or painful breathing
› Tachypnea – rapid breathing
› Hyperpnoea – abnormally rapid or deep breathing

24.  The force at which blood is pumped against
the walls of the arteries (mmHg)
 Two pressure measurements
› Systolic pressure
• measure of pressure when left ventricle contracts
› Diastolic pressure
 Measure of pressure when heart relaxes
 Minimum pressure exerted against the artery walls
at all times

25. Diastolic Pressure
 Heart at rest
 Bottom or second
number
Systolic Pressure
 Contraction of left
ventricle
 Top or first number
120/80

26.  High blood
pressure
readings
 Major contributor
to heart attacks
and strokes
 Low blood pressure
 Normal for some
people
 Severely low blood
pressure readings
occur with:
› Shock
› Heart failure
› Severe burns
› Excessive bleeding
Hypertension
Hypotension

27.  Equipment
› Sphygmomanometer
 Inflatable cuff
 Pressure bulb or other
device for inflating cuff
 Manometer
› Types of
sphygmomanometers
 Aneroid
 Electronic
 Mercury

28.  Aneroid sphygmomanometers
› Circular gauge for registering pressure
› Each line 2 mmHg
› Very accurate
› Must be checked,
serviced, and
calibrated every
3 to 6 months

29.  Electronic sphygmomanometers
› Provides a digital readout of the
blood pressure
› No stethoscope is needed
› Easy to use
› Maintain equipment according to
manufacturer’s instructions

30.  Mercury sphygmomanometers
› A column of mercury rises with an
increased pressure as the cuff is
inflated
› No longer available for purchase
› If in use, must be checked,
serviced, and calibrated every
6 to 12 months

31.  Measuring blood pressure
› Place cuff on the upper arm above the brachial pulse
site
› Inflate cuff about 30 mmHg above palpatory result or
approximately 180 mmHg to 200 mmHg
› Release the air in cuff and listen for the first
heartbeat (systolic pressure) and the last heartbeat
(diastolic pressure)
› Record results with systolic as the top number and
diastolic as the bottom number (i.e., 120/76)

32.  Orthostatic or postural hypotension
› Blood pressure becomes low and pulse increases
when the patient moves from lying to standing
› Indicates fluid loss or malfunction of
cardiovascular system
› Vital signs are taken in different positions
› Positive tilt test – increase in pulse > 10 bpm and
a drop in BP > 20 mmHg