Vital Signs Notes PDF

NOTES: VITAL SIGNS ASSESSMENT OF PATIENT -- 1. General conditions - Conscious / unconscious. Facial reaction -- Happy, sad, pain, pale. 2. Check the vital signs -- Body Temperature Pulse Respiration Blood Pressure Pain assessment Oxygen saturation...

NOTES: VITAL SIGNS ASSESSMENT OF PATIENT -- 1. General conditions - Conscious / unconscious. Facial reaction -- Happy, sad, pain, pale. 2. Check the vital signs -- Body Temperature Pulse Respiration Blood Pressure Pain assessment Oxygen saturation 3. History taking -- present complaint, problem, pain, allergy, past medical history. Vital sign -- [Body temperature] Normal adult - 36 C -- 37.5 C (Afebrile) Alteration body temp - 38 C (Hyperthermia / Fever / febrile) - 41 C (Hyperpyrexia) - \< 36 C (Hypothermia) Factors affect the body's heat production -- +-----------------------------------+-----------------------------------+ | FACTORS | EXPLANATION | +===================================+===================================+ | Basal metabolic rate | \- Higher BMR means more energy | | | is produced, generating more body | | | heat. | +-----------------------------------+-----------------------------------+ | Muscle activity | \- Muscle contractions generate | | | heat due to increased metabolic | | | activity. | +-----------------------------------+-----------------------------------+ | Thyroxine output | \- Increased thyroxine secretion | | | boosts metabolic rate, leading to | | | higher heat production. | +-----------------------------------+-----------------------------------+ | Epinephrine | \- Epinephrine stimulates | | | metabolic activity, increasing | | | heart rate, blood flow, and | | | energy release, resulting in | | | higher heat generation. | +-----------------------------------+-----------------------------------+ | Fever | \- The hypothalamus raises the | | | body\'s temperature set point. | | | | | | \- This triggers mechanisms like | | | shivering and increased | | | metabolism to produce more heat, | | | helping to fight off pathogens. | +-----------------------------------+-----------------------------------+ Heat lost from body -- HOW EXPLANATION ------------- -------------------------------------------------------------------------------------- Radiation Heat loss resulting from a temperature gradient. (equilibrium) Conduction Heat transfer from one object to another. Convection Heat loss via rapid movement of air or water around us. Evaporation When sweat, water evaporates off our skin, transferring heat into the air around us. Factors affecting body temperature -- +-----------------------------------+-----------------------------------+ | FACTORS | EXPLANATION | +===================================+===================================+ | Age | \- **Infants and Children**: They | | | have immature thermoregulatory | | | systems, making them more | | | sensitive to temperature changes. | | | | | | **- Elderly**: The metabolic rate | | | slows, reducing heat production | | | and often leading to lower body | | | temperatures. | +-----------------------------------+-----------------------------------+ | Diurnal variations | \- Body temperature naturally | | | fluctuates throughout the day. | | | | | | \- Lower in the early morning | | | (around 4-6 a.m.) | | | | | | \- Highest in the late afternoon | | | or early evening (around 4-6 | | | p.m.). | +-----------------------------------+-----------------------------------+ | Exercise | \- Muscle contraction raise body | | | heat. | +-----------------------------------+-----------------------------------+ | Hormones | Thyroid hormone -- Involved in | | | development, remodeling and | | | delivery of energy to tissue. | +-----------------------------------+-----------------------------------+ | Stress | \- Activate the sympathetic | | | nervous system, increasing | | | metabolic activity and heat | | | production. | +-----------------------------------+-----------------------------------+ | Environment | \- Cold Environment: Causes | | | vasoconstriction (narrowing of | | | blood vessels) to conserve heat. | | | | | | \- Hot Environment: Leads to | | | vasodilation (widening of blood | | | vessels) and sweating to | | | dissipate heat. | +-----------------------------------+-----------------------------------+ Types of fever -- TYPES -------------------- ----------------------------------------------------------------------------------------------------------------------- Intermittent fever Body temperature fluctuates, returning to normal at least once in 24 hours. Remittent fever Temperature fluctuates but never returns to normal, staying above the baseline throughout the day. Relapsing forever Periods of fever alternate with periods of normal temperature, often lasting days. Constant fever Fever where the body temperature remains elevated above normal without returning to normal. Fever spike Sudden, brief elevation in temperature that returns to normal quickly. Heat exhaustion ot a true fever but results from excessive heat exposure leading to dehydration and increased body temperature. Heat stroke A medical emergency where the body temperature rises to dangerous levels (above 40°C) due to prolonged heat exposure. Measuring body temp \- Oral \- Tympanic membrane Vital sign -- [Pulse] Factors affecting pulse +-----------------------------------+-----------------------------------+ | FACTORS | EXPLANANTION | +===================================+===================================+ | Age | -Pulse rate tends to be higher in | | | infants and children compared to | | | adults. | | | | | | -Infants- smaller heart size | +-----------------------------------+-----------------------------------+ | Sex | \- Females generally have a | | | slightly higher pulse rate than | | | males. | | | | | | \- Female heart slightly smaller | | | than men, heart must beat faster | | | to pump the amount of | | | blood[.] | +-----------------------------------+-----------------------------------+ | Exercise | \- Physical activity increases | | | pulse rate as the heart pumps | | | more blood to meet the body\'s | | | oxygen and energy demands. | +-----------------------------------+-----------------------------------+ | Fever | \- Arise in body temperature | | | increases the pulse rate because | | | the heart works harder to deliver | | | oxygen and regulate body | | | temperature | +-----------------------------------+-----------------------------------+ | Medications | \- Digitalis (Digoxin): Lowers | | | heart rate. | | | | | | \- Epinephrine: Increases heart | | | rate and pulse as part of the | | | body\'s \"fight or flight\" | | | response. | +-----------------------------------+-----------------------------------+ | Dehydration | \- Reduced blood volume or | | | dehydration increases pulse as | | | the heart pumps faster to | | | maintain blood pressure and | | | oxygen delivery. | +-----------------------------------+-----------------------------------+ | Stress | \- Stress triggers the release of | | | adrenaline, increasing pulse as | | | part of the \"fight or flight\" | | | response. | +-----------------------------------+-----------------------------------+ | Position | \- Such as standing up quickly, | | | can cause a temporary increase in | | | pulse due to blood | | | redistribution[.] | +-----------------------------------+-----------------------------------+ | Pathology | \- Illnesses such as heart | | | disease, thyroid issues, or | | | infections can significantly | | | impact pulse rate. | +-----------------------------------+-----------------------------------+ [Assessing pulse ] Rate -- Tachycardia, Bradycardia Rhythm - Dysrhythmia/ Arrhythmia Volume - Pulse Volume Vital sign -- Respiration - Respiration is the act of breathing. - Inhalation or inspiration refers to the intake of air into the lungs. - Exhalation or expiration refers to breathing out or the movement of gases from the lungs to the atmosphere. - Ventilation is also used to refer to the movement of air in and out of the lung. Typer of breathing - Costal (thoracic) breathing - Diaphragmatic (abdominal) breathing Assessing -- Respirations - The rate, depth (normal, deep / shallow), rhythm (regular / irregular), quality and effectiveness of respirations. Terminology - Eupnea - Bradypnea - Tachypnea - Apnea - Hyperventilation -- very deep, rapid respirations - Hypoventilation -- very shallow respirations Factors affecting respirations [Factors Affecting Respirations Increased respiratory rate:] Exercise (increases metabolism) Stress (readies the body for "fight or flight") Increased environmental temperature Lowered oxygen concentration at increased altitudes [Decreased respiratory rate: ] Decreased environmental temperature Certain medications (eg; narcotics: morphine; large doses of barbiturates : pentobarbital) Increased intracranial pressure Altered Breathing Patterns and Sounds 1\. BREATHING PATTERNS - Rate - Volume - Rhythm - Ease or Effort 2\. BREATH SOUNDS - Audible without Amplification - Chest Movements - Secretions and Coughing Vital Sign -- Blood pressure Sphygmomanometer / Dynamap blood pressure -- 120/80 mmHg \- Systolic pressure/ Diastolic pressure Determinants -- Blood pressure +-----------------------------------+-----------------------------------+ | Pumping action -- heart | \- If the heart pumps blood | | | forcefully, it increases blood | | | pressure. | +===================================+===================================+ | Peripheral Vascular Resistance | \- Higher resistance increases | | | blood pressure and can occur due | | | to narrowed or less flexible | | | vessels. | +-----------------------------------+-----------------------------------+ | Blood volume | \- More blood volume increases | | | pressure, while lower volume | | | reduces it. | +-----------------------------------+-----------------------------------+ | Blood Viscosity | \- Refers to the thickness or | | | stickiness of the blood. | | | | | | \- Thicker blood (higher | | | viscosity) requires more effort | | | to circulate, raising blood | | | pressure. | +-----------------------------------+-----------------------------------+ Factors Affecting Blood Pressure +-----------------------------------+-----------------------------------+ | Factor | Explanation | +===================================+===================================+ | Age | \- Tends to increase with age due | | | to the stiffening of arteries and | | | other age-related cardiovascular | | | changes. | +-----------------------------------+-----------------------------------+ | Exercise | | +-----------------------------------+-----------------------------------+ | Stress | \- Temporary increases in blood | | | pressure due to the release of | | | stress hormones. | +-----------------------------------+-----------------------------------+ | Sex | \- After menopause, however, | | | blood pressure increases in women | | | to levels even higher than in men | +-----------------------------------+-----------------------------------+ | Medications | \- Medications like ibuprofen and | | | aspirin can cause blood vessels | | | to narrow | +-----------------------------------+-----------------------------------+ | Obesity | \- Increases the workload on the | | | heart, contributing to higher | | | blood pressure. | +-----------------------------------+-----------------------------------+ | Diurnal Variations | \- Blood pressure fluctuates | | | naturally throughout the day, | | | typically being lower during | | | sleep and higher during waking | | | hours. | +-----------------------------------+-----------------------------------+ | Medical conditions | \- Chronic conditions like kidney | | | disease, diabetes, and heart | | | disease can significantly impact | | | blood pressure. | +-----------------------------------+-----------------------------------+ | Temperature | \- Cold weather tends to raise | | | Bp. | | | | | | \- Warmer conditions may lower | | | it. | +-----------------------------------+-----------------------------------+ Classification -- blood pressure - Hypertension -- High blood pressure - Hypotension -- Low blood pressure - Orthostatic Hypotension - Medical condition wherein a person\'s blood pressure drops when they are standing up or sitting down. Vital sign -- Oxygen Saturation \- Pulse oximeter Factors affecting oxygen saturation +-----------------------------------+-----------------------------------+ | Factors | Explanation | +===================================+===================================+ | Hemoglobin | \- Protein in red blood cells | | | responsible for carrying oxygen | | | from the lungs to tissues. | | | | | | \- Hemoglobin levels are low | | | (e.g., anemia), oxygen saturation | | | may decrease because there is | | | less hemoglobin available to bind | | | with oxygen. | +-----------------------------------+-----------------------------------+ | Circulation | \- If circulation is impaired | | | (e.g., due to shock, hypothermia, | | | or poor perfusion), oxygen | | | transport to tissues is reduced, | | | and oxygen saturation can drop. | +-----------------------------------+-----------------------------------+ | Activity | \- Increases oxygen demand by | | | tissues. | | | | | | \- In individuals with | | | compromised respiratory/ | | | cardiovascular function, | | | increased activity may lead to | | | decreased oxygen saturation | | | because the body cannot supply | | | enough oxygen to meet demand. | +-----------------------------------+-----------------------------------+ | Carbon monoxide poisoning | \- Carbon monoxide binds to | | | hemoglobin more readily than | | | oxygen, forming | | | carboxyhemoglobin, which reduces | | | oxygen-carrying capacity. | +-----------------------------------+-----------------------------------+ Vital sign -- Pain assessment Types of pain +-----------------------------------+-----------------------------------+ | Location | **Part of the body:** Pain can be | | | localized to a specific part, | | | such as the head, abdomen, or | | | joints. | | | | | | **Referred pain:** Pain that is | | | felt in an area distant from the | | | actual site of injury or disease | | | (e.g., shoulder pain caused by | | | gallbladder issues). | | | | | | **Visceral pain**: Pain arising | | | from internal organs, often | | | described as cramping or | | | throbbing (e.g., pain in the | | | stomach or chest). | +===================================+===================================+ | Duration | **Acute Pain:** Sudden onset, | | | short duration, typically lasting | | | a few hours to days (e.g., | | | post-surgery pain, injury). | | | | | | **Chronic Pain:** Persistent pain | | | lasting for weeks, months, or | | | even years, often associated with | | | long-term conditions like | | | arthritis or nerve damage. | +-----------------------------------+-----------------------------------+ | Intensity | **Mild:** Minimal discomfort, | | | manageable without significant | | | intervention. | | | | | | **Moderate:** Noticeable pain | | | that may require medication or | | | treatment. | | | | | | **Severe**: Intense pain that | | | significantly disrupts daily life | | | and often requires immediate | | | intervention. | +-----------------------------------+-----------------------------------+