N103F Week 3 Vital Signs Part 1 PDF

LEARNING OUTCOMES After completion of this class, students should be able to: Explain the physiological processes involved in homeostatic regulation of vital signs Describe the factors that cause variations in vital sign measurements Identify sites of assessing vital signs Identify method...

LEARNING OUTCOMES After completion of this class, students should be able to: Explain the physiological processes involved in homeostatic regulation of vital signs Describe the factors that cause variations in vital sign measurements Identify sites of assessing vital signs Identify methods and equipment in measuring vital signs Demonstrate knowledge of the normal ranges for vital signs across the lifespan Record and report vital sign measurements accurately  WHAT ARE VITAL SIGNS? Vital Signs indicators of physiological functioning reflect the health status of a person include temperature, pulse, respiration, blood pressure Pain assessment is often included along with measurement of vital signs Pulse oximetry is included with measurement of vital signs UNITS OF VITAL SIGNS Vital Sign Abbreviation Units Temperature T C ̊ / ̊F Pulse P bpm or beats/min Respiration RR bpm or breaths/min Blood Pressure BP mmHg Pain Level Pain 0-10 (Numeric Pain Scale) Pulse oximetry SpO2 % Why are Vital Signs Important Monitoring the physiologic functions of patient Identifying changes in health status Early detection of risk for a serious adverse event, contributing to timely intervention Vital signs should be evaluated with reference to patient’s present and prior health status The measured values should be compared with patient’s usual baseline pattern and accepted normal values When to Assess Vital Signs On admission When the patient has a change in health condition Before or after any surgery or invasive procedures Before and after activities that may increase risk such as ambulating a patient after surgery Before administering medications that affect cardiovascular or respiratory function Common Prescription Abbreviations for Reference Prescription Frequency Abbreviation Prescription Frequency Abbreviation Q1H Every one hour Daily Once per day Q2H Every two hours BD Twice per day Q4H Every four hours TDS Three times per day Q6H Every six hours QID Four times per day Q8H Every eight hours Stat Immediately Q12H Every twelve hours prn If necessary Q15min Every 15 minutes OM Every morning Q30min Every 30 minutes Nocte At night Who to Assess Vital Signs Doctors Nurses Nursing students Patient care assistants (PCAs) Other members of the healthcare team Nurses’ responsibilities... To interpret and analyse the measurements To assess individual patient’s condition To provide corresponding nursing interventions for abnormal measurements  How to Assess Vital Signs Assess and select appropriate equipment Acquire relevant knowledge on vital sign measurement Understand patient’s medical history and current condition Collaborate with physicians to decide the frequency of vital signs assessment Document measurement findings accurately and appropriately Verify and communicate significant/ abnormal findings Determine appropriate interventions for abnormal findings TEMPERATURE  Body Temperature The difference between the heat produced by the body and the heat lost to the environment Two kinds of body temperature: Core temperature - The temperature of the deep tissues of the body - Remains relatively constant Surface temperature - Temperature of the skin, subcutaneous tissues and fat - Subject to change in response to the environment  Example of Body Temperature Core temperature Surface temperature The temperature of the deep Temperature of the skin, tissues of the body subcutaneous tissues and fat Remains relatively constant Subject to change in response to the environment Oral Cavity Ear Canal Rectum Forehead Armpit Physiology of Body Temperature Homeostasis - Thermoregulation Factors Affecting Body Temperature Circadian Rhythm (Diurnal Variations) Predictable fluctuations of body temperature throughout the day Vary as much as 0.5℃ (1.0℉) throughout a day Lower in the morning than in the late afternoon Peak elevation Peak elevation between 3pm and 6pm  Factors Affecting Body Temperature Age Both older adults and Infants have change in body temperature more rapidly in response to both hot and cold environmental temperature Older adults at higher risk of developing hypothermia Biological Sex Women tend to experience more temperature fluctuation than men Progesterone secretion increases at ovulation, increases body temperature about 0.3℃–0.5℃  Factors Affecting Body Temperature Physical Activity Physical exertion increases body temperature due to increased metabolism from muscle activity results in heat production Stress Increase the production of epinephrine and norepinephrine, thus increasing metabolic activity and heat production Environmental Temperatures Human responds to changes in environmental temperatures to increase heat loss and retain heat Temperature Scale Celsius (℃) vs Fahrenheit (℉) Conversion formula: ℃ = (℉ - 32) x 5/9 ℉ = (℃ x 9/5) + 32 Examples: If ℃ = 38 ℃, then ℉ = 100.4℉ If ℉ = 98.6 ℉, then ℃ = 37 ℃ Normal Body Temperature Body temperature varies among people A range of 0.3℃- 0.6℃ (0.5℉ - 1.0℉) from the averagetemperature considered to be within normal limit Sites Normal Ranges (℃) Normal Ranges (℉) Oral 35.8℃- 37.5℃​ 96.4℉ – 99.5℉​ Rectal 36.1℃ – 37.8℃​ 96.98℉ – 100.04℉​ Axillary 35.5℃ – 37.2℃​ 95.9℉ - 98.96℉​ Tympanic 36.1℃ - 37.8℃​ 96.98℉ - 100.04℉​ (Taylor et al, 2023) Terminology to Describe Changes in Body Temperature ℉ ℃ Death Hyperpyrexia Febrile Pyrexia Afebrile Hypothermia Death Berman et al, 2016  Increased Body Temperature Pyrexia/ Hyperthermia/ Fever An increase above normal in body temperature Hyperpyrexia, a very high fever (≥41℃ or ≥106℉) A medical emergency A person with fever is referred as “febrile” A person without fever is referred as “afebrile” Fever occurs when an upward displacement of the thermoregulatory set point in the hypothalamus, caused by pyrogens  Decreased Body Temperature Hypothermia A decrease below normal in body temperature Death may occur when body temperature falls below