I.

Vital Signs a. First, take temperature, then pulse, respirations, and blood pressure. b. Temperature i. 36.5 37.7 Celcius or 96 99.9 Fahrenheit (orally) ii. Exercise, stress, and ovulation can raise temp. iii. Lowest early in the morning (4 6 a.m.) and highest in the late evening (8 - midnight) iv. Hypothermia below normal, can be seen in prolonged cold, hypoglycemia, hypothyroidism, or starvation. v. Hyperthermia above normal, can be seen in viral or bacterial infections, malignancies, trauma, and various blood, endocrine, and immune disorders vi. In older adults, temperature can range from 95 97.5 Fahrenheit. vii. Oral, axillary, rectal, and tympanic temperatures. 1. For oral, wait 15 minutes after drinking, 2 minutes after smoking. 2. For glass (mercury), 3 4 minutes if febrile and 8 minutes if febrile. 3. Rectal only used if other routes are not practical 4. Axillary good for infants and young children 5. Tympanic takes 2 3 seconds; accurate core temperature. 6. Electronic are the most accurate; take 20 30 seconds. c. Pulse i. Shockwave is produced when the heart contracts and forcefully pumps blood out of the ventricles into the aorta; shockwave travels along the fibers of the arteries and is commonly called aterial or peripheral pulse. d. Respirations i. Watch chest rise and fall without alerting patient before removing stethoscope. e. Blood Pressure i. Pressure varies with cardiac cycle reaching a high point (systole) and low point (diastole). ii. BP measures the pressue of the blood in the arteries when the ventricles are contracted (systolic BP) and relaxed (diastolic BP). iii. Can vary because of: time of day, caffeine or nicotine intake, exercise, emotions, pain, and temperature. iv. Pulse pressure difference between systole and diastole. v. BP in a normal person standing is usually higher to compensate for the effects of gravity; lower in reclining person because of decreased resistance.