Vital Signs PDF

Prepared By Dr. Manar Fathy Hamza  V.S. Vital signs = Cardinal signs ( T., P., R., & B.P. ). It monitor the body function and reflecting any changes in these function, and it’s provide part of the baseline information for which a plan of care...

Prepared By Dr. Manar Fathy Hamza  V.S. Vital signs = Cardinal signs ( T., P., R., & B.P. ). It monitor the body function and reflecting any changes in these function, and it’s provide part of the baseline information for which a plan of care can developed. Because of their importance they are referred to as vital signs. N.B. Normally there are variation in an individuals vital signs.  Temp. TEMPERATURE ❖ Definition : Temperature is the degree of heat maintained by the body. It is the balance between the heat production and heat loss.  Temp. Process of thermoregulation : Heat regulation center is the Hypothalamus. Heat production – Heat loss = Body Temperature.  Temp. Types of body temperature: 1- Core temperature: it’s the temperature of the deep tissues of the body, such as the cranium, thorax, abdominal cavity and pelvic cavity. It assessed by using thermometer. 2- surface (shell) temperature is the temperature of the skin, the subcutaneous tissues and fat. It constantly rises and falls in relation to the environmental changes. It assessed by touching the skin.  Temp. A- Heat production :- 1. Basal metabolism. 2. Muscle activity : e.g. Exercise. 3. Thyroid hormones : Which break down glucose and fat. 4. Ingestion of food 5. Sympathetic stimulation :epinephrine and norepinephrine release increase metabolism and heat production. 6. Clothes. 7. Sun.  Temp. B-Heat loss :- :-Radiation- 1 It’s transfer of heat from the surface of one object to the surface of another, without actual.contact between the two :Heat loss by radiation can be decreased by Conserving body with clothes ( wool, dark )- - Body positions  Temp. :- Conduction- 2 Is transfer of heat to any object or surface.in contact with the body. e.g. Sitting on chair.Cold compresses  Temp. 3-Convection :- Is transfer of heat away from the surface e.g. Using fan.  Temp. 4-Evaporation :- Heat energy is needed to change water from liquid to a gas. e.g. Insensible loss of water from skin and lungs.  Temp. Measuring body temperature :- Normal body temperature 36.4 –37.2 C Sites and Duration of Reading methods of measuring measuring -Orally 3 min. = -Axillary 5 min. +0.5 -Rectally 1 min. -0.5 ?When to take temperature  Temp. Contraindications of taking temperature :- 1- Don’t take it orally in case of : Baby, infant or small children. Person can’t control oral muscles e.g. shivering, unconscious. Patient receiving oral O2 therapy Operation in mouth or nose to avoid close the breathing pass way Disease in the mouth Suspected infectious disease Eating, drinking or smoking less than ½ hr.  Temp. Contraindications of taking temperature :- 2- Don’t take it axillary Patient with tremors Patient with skin disease Burned patient  Temp. Contraindications of taking temperature :- 3- Don't take it rectally in case of : It can be taken by other way Diarrhea, rectal disease, or surgery in it Any disease can transmuted by stool Patient with heart disease  Temp. ❖ Temperature alteration :- Pyrexia Fever Hyperthermia Normal range Hypothermia  Temp. ❖ Signs and symptoms of fever : Any in temperature 1C Pulse 10 b/min. andurineRespiration 4 br/min. 1. Concentrated 2. Constipation 3. Flushed face and skin 4. Dry mouth and bitter taste 5. Loss of appetite 6. Shivering and cold peripherally 7. Thirst 8. Headache and drowsiness 9. Perspiration  Temp. ❖ Nursing care of patient with fever : 1- Increases fluid to 3 lt. / day 2- Fluid balance chart 3- Cold drink 4- Frequent mouth wash 5- Bath 6- Fan & good ventilation & quiet environment 7- Decrease cover 8- Take temperature /15min. at 1st hr. and / 30min. at 2nd hr. then / 1 hr. 9- Cold compresses 10- Report to doctor 11- Give antipyretic as Dr. order 12- Decrease fat, increase protein, increase salt in diet  Temp. ❖ FACTORS AFFECTING BODY TEMPERATURE:- 1- Which increase body temperature : Food metabolism Prolonged smoking. Shivering Illness e.g. infection Food ingestion Hormonal secretion Exercise Increase metabolism of young age Exposure to extreme temperature Age  Temp. ❖ FACTORS AFFECTING BODY TEMPERATURE:- 2- Which decrease body temperature : Decrease metabolism of old age Illness e.g. poisoning , bleeding Fasting Low vitality Exposure to extreme temperature Increase intake of cold fluids  Temp. N.B. :Normally the body temperature is lowest early morning and highest during the early afternoon or early evening.  Res. RESPIRATION Definitions : Respiration : Is the exchange of O2 &CO2 between live organism & it’s environment Inspiration : Is the act of breathing in Expiration : Is the act of breathing out External respiration : Is the interchange of gases in lung Internal respiration : Is the interchange of gases in tissues  Res. NATURE OF RESPIRATION :- - Breathing is automatic and respiration is the noiseless, regular, without effort. - The major respiratory center is located in the medulla oblongata of the brain. - The breathing is voluntary and involuntary. - The normal rate of respiration is 12 –20 br./min. for adult.  Res. Mechanism of respiration Respiratory cycle :Inspiration, expiration, & a pause 1- Inspiration : Contraction of inspiratory muscle ( intercostal & diaphragm muscles ) result in increase chest expansion & air flows to lungs. 2- Expiration : Relaxation of respiratory muscles (main muscles intercostal and diaphragm muscles ) result in recoil of lungs. 3- Pause : After expiration there is a period of rest before the next cycle begins  Res. Diffusion of gasses ( exchange of gasses ) Gasses move by diffusion from higher concentration to the lower concentration until balance is established. 1- External respiration : It’s process of taking O2 into the body & eliminating CO2 from the body.  Res. 2-Internal respiration : It’s exchange of gasses by diffusion between body cells & blood in capillaries.  Res. Characteristics of normal respiration Rate : a- From 12 – 20 br/min Normal rate b- Below 12 br/min Bradypnea c- Above 20 br/min Tacypnea Rhythm : a- Regular b-Irregular Depth : a- Deep b-Shallow c- Normal depth  Res. Factors affecting respiration 1- Which increase respiration rate : 1-Age e.g. infant. 2-Exercise. 3-Stress e.g. anxious, fear. 4-Pain. 5-Fever. 6-Increase CO2 concentration. 7-Lung disease. 8-Heart disease. 9-Smoking. 10-Brain injury.  Res. 2- Which decrease respiration rate : 1-Rest and sleep. 2-Decrease activity of old age. 3-Some drugs e.g. analgesics. 4-Heart disease. 5-Some lung diseases.  Res. Abnormalities of respiration Euopnea : Easy respiration with a normal rate for age Bradypnea : Respiratory rate below 12 br/min. Tachypnea : Respiratory rate above 20 br/min. Apnea : Temporary cessation of breathing or absent of breathing. Dyspnea : Difficult in breathing. Orthopnea : Difficult in breathing in flat position. e.g. In case of cardiac patient.  Pulse Pulse Definition : The pulse is palpable bounding of blood flow noted at various points on the body , resulting from left ventricular contraction. It's an indicator of the circulatory status.  Pulse Methods of counting pulse : Palpation. The pulse is palpated with the first and second or second and third fingers of one hand.The number of pulses is counted in full " 1 " minute Auscultation. Each heart beat consists of 2 sounds which described as a " lub-dub" together they consist one heart beat.  Pulse Sites of taking pulse  Pulse Characteristics of normal pulse Rate : 60 - 100 b./min. normal range of adult Above 100 b./min. tachycardia Below 60 b./min. Bradycardia Rhythm : Regular Irregular Strength ( volume ) : Bounding +3 Normal +2 Weak +1 Absent 0  Pulse N.B. Pulse deficit = Apical pulse - Radial pulse (it must be taken at the same time) Normal ( 5 -10 b./min. ) e.g. If apical pulse = 100 b./min. and radial pulse = 90 b./min... Pulse deficit = 100 - 90 = 10b./min. within normal  Pulse Factors affecting pulse rate A-Which increase the pulse rate : 1-Exercises 2-Gender : female more than male 3-Age : Young age more than old age 4-Emotions : fear, anger, stress and emotional changes 5-Position : in standing position than in flat position 6-Metabolism : during eating 7-Pain 8-Caffeine 9-Fever 10-Bleeding :decrease blood pressure 11-Some drugs  Pulse B-Which decrease the pulse rate : 1-Calmness 2-Rest and sleep 3-Fasting 4-Age : P.R. decrease with increase in age 5-Medications : e.g. digitalis 6-Parasympathetic stimulation 7-Some diseases  B.P. Blood pressure Introduction:- The heart generates pressure during the cardiac cycle to perfuse the organs of the body with blood. Blood flows from the heart to the arteries , into the capillaries and veins, and then back to the heart.  B.P. The heart and circulatory system https://www.youtube.com/watch?v=CWFyxn0qDEU  B.P. Definition Blood Pressure :- it’s the force that blood exerts against the wall of blood vessels resulting from contracting of Lt. ventricle Blood vessel  B.P. Physiology of Blood Pressure:- During ventricle contraction the maximum pressure exerted against the arterial walls is called “systolic B.P. ” When the ventricle relaxation the minimum pressure exerted against the arterial walls it is called “diastolic B. P.”  B.P. - Blood pressure is expressed as the reflection of two numbers; systolic blood pressure and diastolic blood pressure. - Systolic Blood Pressure is the highest blood pressure on the arteries during systole; the phase of the heartbeat when the right and left ventricles contract. Systole causes the ejection of blood out of the ventricles into the aorta and pulmonary arteries. - Normally the value of Systolic Blood Pressure is less than 120 mmHg  B.P. - Diastolic blood pressure is the pressure when the ventricles are at rest during diastole; the phase between each contraction of the heart when the ventricles are filling with blood. It is the lowest pressure, present at all times within the arteries. - Normally Diastolic blood pressure is less than 80 mmHg. - The standard unit for measuring blood pressure is millimeters of mercury (mmHg). - According to the American Heart Association an adult blood pressure is normally less than 120/80 mmHg. Pulse Pressure :- The difference between systolic and diastolic pressure  ;Factors affecting blood pressure A physiological background Five factors influence blood pressure which are:. Cardiac output. Peripheral vascular resistance. Volume of circulating blood. Viscosity of blood. Elasticity of vessel walls - Blood pressure increases with increased cardiac output, peripheral vascular resistance, volume of blood, viscosity of blood, and rigidity of vessel walls. - Blood pressure decreases with decreased cardiac output, peripheral vascular resistance, volume of blood, viscosity of blood, and elasticity of vessel walls. 1-Cardiac output: is the volume of blood flow from the heart through the ventricles, and is usually measured in liters per minute (L/min). Cardiac output can be calculated by the stroke volume multiplied by the heart rate. Cardiac out put:- Is the amount of blood which bumped from the heart /min. Stroke Volume :- Is the amount of blood pumped from each ventricle with each heart beat  :Peripheral vascular resistance-2 ❑ Normally an artery or vein has a compliance to expand to accommodate surges in blood flow without increased resistance or blood pressure. Veins are more compliant than arteries and can expand to hold more blood. ❑ as vascular disease causes stiffening of arteries (e.g., atherosclerosis or arteriosclerosis), compliance is reduced and resistance to blood flow is increased. The result is more turbulence, higher pressure within the vessel, and reduced blood flow. This increases the work of the heart.  Blood Volume-3 ❑ Most adults have a circulating blood volume of 5000 - 6000 ml． ❑ Normally the blood volume remains constant． ❑ As circulating blood volume increases more pressure is exerted against arterial walls and Bp rises.  Blood Viscosity-4 ❑ Refers to the blood’s thickness which affects the ease with which blood flows through small vessels and is influenced by the presence of plasma proteins and formed elements in the blood. Blood is viscous and somewhat sticky to the touch. It has a viscosity approximately five times greater than water.  4-Blood Viscosity (Cont) ❑ The hematocrit is the percentage of red blood cells in the blood, determines blood viscosity as the hematocrit rises and blood flow slows，arterial blood pressure increases and the heart must contract more forcefully to move the viscous blood through the circulatory system.  Elasticity of Vessel Walls-5 ❑ Normally the walls of an artery are elastic and easily distensible． ❑ Arterial distensibility prevents wide fluctuations in blood pressure． ❑ With a reduced elasticity there is greater resistance to blood flow，and the systemic pressure rises． ❑ Systolic pressure is more significantly elevated than diastolic pressure as a result of reduced  B.P. Factors affecting of blood Pressure:- ( A ) which increase the B.P. :- 1. Age ---------> B.P ↑ with age old age due to ↓ elasticity of blood vessels. ↑ sympathetic Activity as in Anxiety, pain ,stress, Exercises --> ↑ H.B. -----> bl. Volume. ↑ B.P. 2. Position 3. Diet ---------> Salty food, & fatty food. 4. Exercises. 5. Alcohol & smoking 6. Some Diseases e.g. Renal & Cardiac disease 7. Some Drugs e.g. Anti-hypotensive ( Effortel )  B.P. ( B ). Which decrease the B.P.:- 1-Fasting. 2-B.P. lower at night than the day. 3-Is lower in hot weather. 4-Medications e.g. Diuretics, Analgesics, Antihypertensive. 5-Some diseases e.g. Anemia, bleeding & shock.  B.P. A B C  Blood pressure categories According to The American Heart Association blood pressure is categorized as normal, elevated, or stage 1 or stage 2 high blood pressure: - Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (