INTRODUCTION TO VITAL SIGNS

DEFINITION

Vital signs are a group of most important medical signs that indicate the status of the body’s important life-sustaining functions. These measurements are taken to measure the basic functions of the body, assess general physical health of a person, give clues to possible diseases, and show progress toward recovery

PURPOSES OF TAKING VITAL SIGNS

• To Identify the client’s General Condition
• To assess the clients clinical problems
• To evaluate the haemostatic balance of the client
• To provide information about the client’s status in a quick & efficient way
• To monitor the progress of the client’s condition
• To anticipate the type of Intervention required
• To assess the effectiveness of the Intervention provided
• To compare the results with the future measures

GUIDELINES FOR TAKING VITAL SIGNS

Clinical Problem Solving:

• Vital Signs are physiological measure that serve as a basis for clinical Decision Making
• Any alteration in the vital signs will anticipate the need for Therapeutic Intervention

Skills in measuring Vital signs:

• Must be able to measure accurately
• Must make Clinical decisions based on the measurements

Relevant Knowledge:

• Know the normal range of each Vital Signs
• Anticipate the disease condition when the vital sign measures deviate from the normal Range
• Interpret the Significance of measuring Vital Signs
• Know the Interpretation of Results and make Clinical Decisions

Selection of Equipment’s:

• Equipment should be selected based on patients condition and characteristics
• Equipment’s should be functional & appropriate

Client Information:

• Know about the Client’s History, Therapies & prescribed medications
• Medications mostly affect any one or more of the client’s Vital signs
• Certain Illnesses may cause predictable Vital Sign changes

Minimize or control the factors that affect the Vital Signs:

• Certain Environmental factors like hot or cold temperatures can cause changes in client’s body temperature
• Certain Psychological factors like stress, fear and anxiety can cause changes in the pulse rate, respiratory rate and Blood Pressure
• Certain physical factors like physical Exertion can cause changes in the Vital Signs.

Organization:

• Perform the procedure in an organized manner.
• Collect all Equipment’s and arrange it in a clean tray before checking Vital signs.

Systematic Approach:

• Follow Universal precautions like hand hygiene and use of personal protective equipment as needed
• Follow step by step approach in a systematic way for accurate measurements of Vital Signs

Frequency:

• Vital Signs should be checked at regular Intervals or continuous monitoring as per the client’s Condition
• Based on the patients condition and prescription of the physician frequency of measurements should be maintained

Indications:

• Vital Signs measures are used as an Indication for Prescribing medications
• They also serve as an Indication for prescribing further diagnostic measures and to plan therapeutic Interventions

Analysis:

• Interpret the results of Vital Signs as a whole and make clinical Decisions
• Compare the results to Identify the effectiveness of Interventions.

Verify & Document:

• Verify the Findings with the previous measurements to avoid errors
• Communicate the Significant changes in Vital Signs by accurately Documenting the results with Date, time & patient details

PRIMARY VITAL SIGNS MEASUREMENTS

1. BODY TEMPERATURE

Body temperature is the heat produced by the body. The normal body temperature can range from 97.8 degrees F (or Fahrenheit, which is equivalent to 36.5 degrees C, or Celsius) to 99 degrees F (37.2 degrees C) for a healthy adult. The normal Body temperature of a person varies depending on gender, recent activity, food and fluid consumption, time of day, and, in women, the stage of the menstrual cycle.

A person's body temperature can be measured in any of the following ways:

• Oral: Temperature taken by mouth by placing the thermometer under the tongue
• Rectal: Temperatures taken through rectal route using a glass or digital thermometer. Temperatures measured rectally tend to be 0.5 to 1 degrees F higher than when taken by mouth due to increased vascularity of the rectal region.
• Temperatures can be measured by placing the thermometer in the armpit (under the arm) using a thermometer. Temperatures taken in axillary route tend to be 0.5 to 1 degrees F lower than those temperatures taken by mouth due to the presence of moisture under the arm and it is recommended to wipe the armpit with a tissue or towel before placing the thermometer
• Tympanic Membrane. A special thermometer is placed in the ear drum that can quickly measure the temperature, the reflects the body's core temperature (the temperature of the internal organs).
• By skin. A special thermometer called the Infrared thermometer is used to quickly measure the temperature of the skin on the forehead.

2. PULSE

Pulse is the beat of the heart that is felt through the peripheral arteries. When the blood is pushed through the walls of the arteries a shock wave travels along the walls of the arteries as the heart contracts.

This shock wave is generated by the pounding of the blood as it is ejected from the heart under pressure. It is like the hammering sound felt in arteries as the steam of blood is forced into the arteries under pressure from the ventricles

The pulse rate is counted by starting at one, which correlates with the first beat felt by palpating with fingers. Count for one minute to obtain the pulse rate. The Normal Pulse Rate at beats per minute are as follows.

3. RESPIRATION

• Respiration is defined as the act of breathing in which oxygen is inhaled through the nose and the carbon dioxide is exhaled out.
• It is the process of taking in oxygen & leaving out carbon dioxide.
• Respiratory rate is one of the main vital signs and is measured by the number of breaths taken per minute.
• The normal respiratory rate for children varies by age.
• When the Respiratory rate is high the breathing is rapid
• When the rate is below normal range the breathing is slow.

4. BLOOD PRESSURE

Blood pressure is the force exerted on the walls of the arteries when the blood is pumped from the heart into the blood vessels.

The Normal Blood Pressure is 120/80 mmHg

• SYSTOLIC BLOOD PRESSURE:When the left Ventricle of the heart ejects the blood into the aorta the maximal aortic pressure exerted by the ejection of blood is termed as Systolic Blood Pressure. The Normal Systolic Pressure is 120mmHg.
• DIASTOLIC BLOOD PRESSURE:As the left ventricle is relaxing and refilling, the pressure in the aorta falls. The lowest pressure in the aorta, which occurs just before the ventricle ejects blood into the aorta, is termed the diastolic pressure. The Normal Diastolic Pressure is 80mmHg.