Vital sign ppt updated.pdf

Objectives By the completion of this lecture students will be able to: Ø Define Vital Signs. Ø Define terms related to Vital sign. Ø Describe the physiological concept of temperature, respiration and blood pressure. Ø Describe the principles and mechanisms for normal thermoregulation in the body. Ø...

Objectives By the completion of this lecture students will be able to: Ø Define Vital Signs. Ø Define terms related to Vital sign. Ø Describe the physiological concept of temperature, respiration and blood pressure. Ø Describe the principles and mechanisms for normal thermoregulation in the body. Ø Identify ways that affect heat production and heat loss in the body. Ø Define types of body temperature according to its characteristics. Ø Identify the sign and symptoms of fever. Ø Discuss the normal ranges for temperature, pulse, respiration and blood pressure. Ø List the factors affecting temperature, pulse, respiration. Ø Describe the characteristics of pulse and respiration. Ø List factors responsible for maintaining normal blood pressure. Ø Describe various methods and sites used to measure T.P & B.P. Ø Recognize the signs of alert while taking TPR and B.P. Vital Signs Vital signs also called “sign of life” or “cardinal sign”. Vital signs are measurements of the body's most basic functions. All of these vital signs can be observed, measured, and monitored. This will enable the assessment of the level at which an individual functioning. Normal ranges of measurements of vital signs change with age and medical condition. Vital signs are useful in detecting or monitoring medical problems. Vital Signs These includes: Ø Temperature (T) Ø Pulse (P) Ø Respirations (R) Ø Blood pressure (BP) Ø Pain is our 5th Vital sign  Physiological Basis of Body Temperature Body temperature regulation requires the coordination of many body systems. For the core temperature to remain steady, heat production must equal heat loss. The hypothalamus, located in the pituitary gland in the brain, is the body’s built-in thermostat. It can sense small changes in body temperature and stimulates the necessary responses in the nervous system, circulatory system, skin, and sweat glands to maintain homeostasis (state of dynamic equilibrium). Temperature (T) ØThe normal body temperature of a person varies person to person depending on gender, recent activity, food and fluid consumption etc. ØNormal body temperature can range from 97.8° F (36.5°C) to 99°F (37.2°C) for a healthy person. How to monitor Temperature A person's body temperature can be taken in any of the following ways: Ø Orally The oral cavity temperature is considered to be reliable, accessible and convenient. Temperature can be taken by mouth using either the glass thermometer, or digital thermometers that use an electronic probe to measure body temperature. Note: If client has ingested hot or cold food or fluid or smoked, (the nurse should wait 30 minutes before taking orally temperature to ensure that the mouth is not affected by temperature of food, fluid, or smoke). Contraindications of oral thermometer 1. The child under 5-6 years 2. Unconscious patients 3. Patient who cannot breath from his nose. 4. Mouth surgery or infection 5. Patient on oxygen mask 6. Psychiatric patients or any disease condition Ø Armpit (axillary) Temperature is measured at the axilla by placing the thermometer in the central position and adducting the arm close to the chest wall. Axillary is the preferred site for measuring temperature in children. Ø Rectally Temperatures taken rectally (using a glass or digital thermometer) tend to be 0.5°F to 0.7°F higher than when taken by mouth. This is more common in babies because their body doesn't regulate temperature the way an older child or adult's body does. ØSkin site: (Forehead , abdomen skin temperature): A special thermometer can quickly measure the temperature of the skin. Ø Ear site: (Tympanic membrane): A special thermometer can quickly measure the temperature of the eardrum. The tympanic membrane thermometer is a portable, hand-held device resembling an otoscope. Factors Affecting Temperature ØBasal metabolic rate ( BMR): The basal metabolic rate is the rate of energy utilization in the body to maintain essential activities such as breathing. Ø Muscle activity: It including shivering, can greatly increase metabolic rate. ØThyroxin output: Increased thyroxin output increases the rate of cellular metabolism throughout the body. ØEpinephrine and sympathetic stimulation, these immediately increase the rate of cellular metabolism in many body tissues. Ø Age & Gender Ø Diurnal variation Ø Exercise: Hard work or strenuous exercise can increase body temperature Temperature scales: Centigrade or Fahrenheit scale are used to measured and record body temperature. A centigrade calibrated scale ranges from (34°C- 42°C), and a Fahrenheit calibrated scale ranges from ( 94°F- 108°F). Fever There are two primary alteration in body temperature: 1. Pyrexia, hyperthermia, fever: a core body temperature above the usual range { > 38 °C or 100.4 °F}. Hyperpyrexia: a very high fever above 41°C or 105.8 °F. Febrile: a client who has a fever. A febrile: a client who does not have a fever. 2. Hypothermia: a core body temperature below the lower limit of normal {< 36°C or 96.8 °F}. There are three physiological mechanics of hypothermia include: a. Excessive heat loss. b. Inadequate heat production to counteract heat loss. c. Impaired hypothalamic thermoregulation.  Signs & Symptoms Clinical Manifestation of fever: Rigor: 1. Onset (cold or chill phase): When the heat regualting center in the Ø Increased heart rate. brain is disturbed ……………….. Ø Increased respiratory rate. An attack of intense shivering is called Ø Shivering. Rigor. Ø Pallid, cold skin. ØCold Stage……chills sheviring Ø Complaints of feeling cold. ØHot Stage…… Ø Cyanotic nail beds. ØSweating stage..perspiration/Diuresis Ø Cessation of sweating. Signs & Symptoms 2. Course (plateau phase): Ø Absence of chills. Ø Skin that feels warm. Ø Photosensitivity. Ø Glassy- eyed appearance. Ø Increased pulse and respiratory rate. Ø Increase thirst. Ø Mild to severe dehydration. Signs & Symptoms Clinical manifestation of hypothermia: Ø Decrease body temperature, pulse, and respirations. Ø Severe shivering (initially). Ø Feelings of cold and chills. Ø Pale, cool, waxy skin. Ø Frostbite (discolored, blistered nose, fingers, toes). Ø Hypotension. Ø Decrease urinary output. Ø Lack of muscle coordination. Ø Disorientation, Drowsiness progressing to coma. TYPES O F FEVER ASSIGNMENT no 1 ?????????????  Pulse (P) “Pulse is a wave of blood created by contraction of the left ventricle of the heart”. Pulse provides valuable data about person’s cardiovascular status. The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse rate is a measurement of the heart rate. This is the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood.  Bradycardia is a heart rate less than 60 beats per minute in an adult. Tachycardia is a heart rate in excess of 100 beats per minute in an adult. Pulse rhythm is the regularity of the heartbeat. It describes how evenly the heart is beating. Regular (the beats are evenly spaced). Irregular (the beats are not evenly spaced). Dysrhythmia (arrhythmia) is an irregular rhythm caused by an early, late, or missed heartbeat. By: Sir Yasir Ali Pulse locations Factors Factors Contribute to Increase Pulse Rate 1. Pain. 2. Fever. 3. Stress, exercise. 4. Bleeding. 5. Decrease in blood pressure. 6. Some medications as (adrenalin, aminophylline). Factors May Slow The Pulse 1. Rest. 2. Increasing age. 3. People with thin body size. 4. Some Medications. 5. Thyroid gland disturbances. Respiration (R) ØPulmonary ventilation (breathing ): movement of air in and out of the lungs. ØInspiration (inhalation) is the act of breathing in. ØExpiration (exhalation ) is the act of breathing out. Respiration Rate (RR) Normal breathing is automatic and involuntary. At rest, the normal adult respiratory rate is 12 to 20 breaths per minute and respiratory rate for an infant is 30 to 60 breaths per minute. Tachypnea is an abnormally fast respiratory rate (usually above 20 breaths per minute in the adult). Bradypnea is an abnormally slow respiratory rate (usually less than 12 breaths per minute in the adult). Apnea, the absence of respirations, is often described by the length of time in which no respirations occur (e.g., a 10-second period of apnea). Factors Affecting Respiration Ø Pain, anxiety, exercise Ø Medications Ø Trauma Ø Infection Ø Respiratory and cardiovascular disease Ø Alteration in fluids, electrolytes, acid- base balances Blood Pressure (BP) Blood pressure is the force that blood exerts against the walls of the blood vessels. The pressure in the systemic arteries is most commonly measured in the clinical setting. Blood pressure is stated in millimeters of mercury (mm Hg). The normal BP is 120/ 80 mmHg. Hypertension: refers to a systolic blood pressure more than 120 mm Hg or 20 to 30 mm Hg more the client’s normal systolic pressure. Hypotension, refers to a systolic blood pressure less than 90 mm Hg or 20 to 30 mm Hg below the client’s normal systolic pressure. Ways to measure BP Direct: Blood pressure may be measured directly with a catheter placed into an artery. Direct measurement provides a continuous reading of blood pressure and is used in critical care settings. Indirect: Indirect methods, using an inflatable cuff to temporarily occlude arterial blood flow through one of the limbs. As the cuff is deflated and flow returns, the blood pressure is determined by pal-pation, auscultation, or oscillations. Alert Signs