Vital Signs and Temperature

Vital Signs

• Vital signs are cardinal signs, including temperature (T), pulse (P), respiration (R), and blood pressure (BP).
• Vital signs monitor body function and reflect any changes in those functions.
• Baseline information gleaned from vital signs helps in creating a care plan.
• Individual variations exist in vital signs.

Temperature

• Temperature is the body's heat degree and the balance between heat production and loss.
• The hypothalamus regulates body temperature.
• Heat production factors include basal metabolism, muscle activity, thyroid hormones, food ingestion, sympathetic stimulation, clothing and sun exposure.
• Heat loss occurs through radiation, conduction, convection, and evaporation.
• Core temperature refers to the deeper body tissues (cranium, thorax, abdomen, pelvis) measured using a thermometer.
• Surface (shell) temperature refers to the skin, subcutaneous tissue and fat and is measured by touching the skin.
• Normal body temperature ranges from 36.4°C to 37.2°C.

Measuring Body Temperature

• Common measurement sites include orally, axillary, and rectally.
• Oral temperature measurement duration is 3 minutes.
• Axillary temperature measurement duration is 5 minutes.
• Rectal temperature measurement duration is 1 minute.
• Contraindications for oral temperature measurement include infants, small children, individuals unable to control oral muscles (e.g. shivering, unconsciousness), patients receiving oral oxygen therapy, and people with mouth or nasal surgery/operations to avoid close-the breathing pass way.
• Contraindications for axillary temperature measurement include patients with tremors, skin diseases, and burns.
• Contraindications for rectal temperature measurement include diarrhea, rectal disease or surgery, diseases transmittable through stool, and heart disease patients.

Temperature Alterations

• Pyrexia (fever) is high temperature above the normal range.
• Hyperthermia refers to abnormally high temperatures.
• Hypothermia refers to abnormally low body temperatures.

Signs and Symptoms of Fever

• Symptoms of fever include a one-degree Celsius increase in temperature, pulse and respiration rate of 4 breaths per minute, constipation, flushed face, dry mouth and bitter taste, loss of appetite, shivering, cold peripherally, thirst, headache, drowsiness, and perspiration.

Nursing Care of Patients with Fever

• Nursing care for patients with fever includes increasing fluid intake to 3 liters per day, monitoring fluid balance, providing cold drinks, frequent mouth washes, bath or shower, creating a well-ventilated and quiet environment, decreasing covers, monitoring temperature every 15 minutes in the first hour and every 30 minutes in the second hour, and then every hour, providing cold compresses, reporting to the doctor, administering antipyretics as per doctor's orders, and adjusting diet with increased protein and electrolytes.

Factors Affecting Body Temperature

• Factors increasing body temperature include food metabolism, prolonged smoking, shivering, infectious illnesses, food ingestion, hormonal secretion, increased metabolism of young age, and exposure to extreme temperatures.
• Factors decreasing body temperature include decreased metabolism of old age, diseases (e.g. poisoning and bleeding), fasting, low vitality, exposure to extreme temperatures, and increased intake of cold fluids.
• Body temperature is lowest early morning and highest during early afternoon or early evening.

Respiration

• Respiration is the exchange of oxygen (O2) and carbon dioxide (CO2) between a living organism and its environment.
• Inspiration is the act of breathing in.
• Expiration is the act of breathing out.
• External respiration is the exchange of gases in the lungs.
• Internal respiration is the exchange of gases in tissues.

Nature of Respiration

• Breathing is automatic and noiseless and is regular, without effort.
• The major respiratory center is the medulla oblongata in the brain.
• Breathing can be either voluntary or involuntary.
• Normal respiratory rate for adults is 12-20 breaths per minute.

Mechanism of Respiration

• The respiratory cycle involves inspiration (contraction of intercostal and diaphragm muscles, chest expansion, and air entering the lungs), expiration (relaxation of these muscles, lung recoil, and air leaving the lungs), and a pause.

Diffusion of Gases

• Gases move from higher to lower concentration until equilibrium is reached.
• External respiration involves taking in oxygen and expelling carbon dioxide.
• Internal respiration involves the exchange of gases between body cells and blood capillaries.

Characteristics of Normal Respiration

• Normal respiration rate is 12 - 20 breaths per minute.
• The rhythm of respiration should be regular.
• The depth of respiration may be varied in a range between deep, shallow, and normal.

Factors Affecting Respiration

• Factors increasing respiratory rate include age (infants), exercise, stress/anxiety/fear, pain, fever, increased carbon dioxide concentration, lung disease, heart disease, smoking, and brain injuries.
• Factors decreasing respiratory rate include rest/sleep, decreased activity in old age, some analgesics (pain medications), heart diseases, and some lung diseases.

Abnormalities of Respiration

• Euopnea refers to normal respiration rate based on age guidelines.
• Bradypnea means a respiratory rate below 12 breaths per minute.
• Tachypnea means a respiratory rate above 20 breaths per minute.
• Apnea is a temporary cessation or complete absence of breathing.
• Dyspnea is difficulty in breathing.
• Orthopnea means difficulty breathing when lying flat.

Pulse

• The pulse is the palpable bounding of blood flow resulting from left ventricular contraction, indicating circulatory status.
• Pulse measurement methods are palpation (using fingers) and auscultation (listening to heart sounds with a stethoscope).
• Pulse sites for measurement include temporal, carotid, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial.
• Normal pulse rate for adults is 60 - 100 beats per minute.
• Pulse rhythm should be regular unless otherwise specified.
• Pulse strength/volume is classified as bounding (+3), normal (+2), weak (+1), and absent (0).
• Pulse deficit is the difference between the apical pulse and radial pulse, ideally 5 - 10 beats per minute.

Factors Affecting Pulse Rate

• Factors increasing pulse rate include exercise, female gender, young age, emotions (fear, anger, stress), standing/upright position, metabolism (during eating), pain, caffeine, fever, bleeding/decrease blood pressure, and some medications.
• Factors decreasing pulse rate include calmness, rest/sleep, fasting, increasing age, some medications (e.g. digitalis), parasympathetic stimulation and/or some diseases.

Blood Pressure

• The heart generates pressure during the cardiac cycle to perfuse organs with blood.
• Blood flows from heart to arteries to capillaries to veins and back to the heart.
• Blood pressure is the force blood exerts against blood vessel walls. This occurs due to the contraction of the left ventricle.

Physiology of Blood Pressure

• During ventricular contraction (systole), maximum pressure exerted against the arterial walls is known as systolic blood pressure.
• During ventricular relaxation (diastole), minimum pressure exerted is called diastolic blood pressure.
• Blood pressure is recorded as two numbers (systolic/diastolic) in millimeters of mercury (mmHg).

Factors Affecting Blood Pressure

• Factors increasing blood pressure include age, sympathetic response (anxiety, stress, pain), exercise, posture (standing vs. lying down), diet (high salt/fat foods), alcohol and smoking, and certain diseases (e.g. renal, cardiac).
• Factors decreasing blood pressure include fasting, lower temperatures, some medications (e.g. diuretics, analgesics, antihypertensives), some diseases (e.g., anemia, bleeding, shock).

Blood Pressure Categories and Abnormalities

• The American Heart Association categorizes blood pressure as normal, elevated, stage 1 and stage 2 high blood pressure.
• Normal BP is less than 120/80 mmHg.
• Elevated BP is 120-129 systolic and less than 80 diastolic.
• Stage 1 hypertension is 130-139 systolic or 80-89 diastolic.
• Stage 2 hypertension is 140 or higher systolic or 90 or higher diastolic.
• Hypertension is high blood pressure, and hypotension is low blood pressure.
• Orthostatic hypotension is a drop in blood pressure when changing from a lying to a standing position

Test your knowledge on vital signs, their importance, and how temperature is regulated in the body. This quiz covers the basics of temperature measurement, factors affecting temperature, and variations in vital signs. Perfect for healthcare students or anyone interested in understanding body functions.