2. VViittaall SSiiggnnss
• Provide information about body function
• Include:
– temperature
– pulse
– respiration
– blood pressure
• Changes may be the first
sign of disease
• Accuracy is imperative!
3.01 Understand Diagnostic and
Therapeutic Services
2
3. VViittaall SSiiggnnss
Temperature
Measurement of the balance between heat
lost and heat produced
Heat lost through:
• Perspiration
• Respiration
• Excretion
Heat produced by:
• Metabolism of food
• Muscle and gland activity
3.01 Understand Diagnostic and
Therapeutic Services
3
4. VViittaall SSiiggnnss
Temperature
3.01 Understand Diagnostic and
Therapeutic Services
NNoorrmmaall rraannggeess
– 97º - 100º F
– 36.1º - 37.8º C
4
5. VViittaall SSiiggnnss
Temperature
Hypothermia
•Temperature below 95º F
•Death can occur if below 93º F
3.01 Understand Diagnostic and
Therapeutic Services
5
6. VViittaall SSiiggnnss
Temperature
Hypothermia
Temperature decreases with:
– environment
– exposure to cold
– inactivity
– sleep
– starvation
Symptoms:
– shivering
– cold skin
– confusion
3.01 Understand Diagnostic and
Therapeutic Services
6
7. VViittaall SSiiggnnss
Temperature
Hyperthermia
•Temperature 100-104º F
•Temperature above 104º F is life-threatening
•Prolonged hyperthermia may cause brain
injury.
3.01 Understand Diagnostic and
Therapeutic Services
7
8. VViittaall SSiiggnnss
Temperature
Hyperthermia
Temperature increases with:
– environment
– exercise
– illness, infection, injury
– stress
Symptoms:
– hot, dry, red skin
– nausea/vomiting
– headache
– low blood pressure
3.01 Understand Diagnostic and
Therapeutic Services
8
9. VViittaall SSiiggnnss
Temperature
Clinical
Non-mercury glass
Electronic
Thermometers
3.01 Understand Diagnostic and
Therapeutic Services
Aural
9
10. VViittaall SSiiggnnss
Temperature
Sites to measure temperature:
•Aural – auditory canal
•Axillary – armpit
•Oral – mouth
•Rectal – rectum
3.01 Understand Diagnostic and
Therapeutic Services
10
11. VViittaall SSiiggnnss
Temperature
To record temperature:
– Oral 98.6º (O)
– Rectal 99.6º (R)
– Axillary 97.6º (ax)
– Aural 98.6º (T)
3.01 Understand Diagnostic and
Therapeutic Services
11
12. VViittaall SSiiggnnss
Temperature Measurement
OOrraall
•Ask the patient if they have ingested hot or
cold food or drink, or smoked within the last
½ hour
•If yes, wait at least 15 minutes before
measuring the oral temperature
3.01 Understand Diagnostic and
Therapeutic Services
12
14. TTeemmppeerraattuurree
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
14
VViittaall SSiiggnnss
OOrraall
15. VViittaall SSiiggnnss
Temperature Measurement
• AAuurraall
• Pros:
– Measures core body temperature
– Fast and convenient
• Con:
– Inaccurate if not placed correctly in the ear
canal
– Ear infection
– Ear wax
3.01 Understand Diagnostic and
Therapeutic Services
15
16. TTeemmppeerraattuurree
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
16
VViittaall SSiiggnnss
AAuurraall
17. VViittaall SSiiggnnss
Pulse
Pressure of blood on artery walls as the heart
beats and relaxes
•Sites:
Temporal – side of the forehead
Carotid – side of the neck
Brachial – inner elbow
Radial – above the thumb at radius
Femoral – upper thigh
Popliteal – behind the knee
Dorsalis pedis – top of the arch of the foot
3.01 Understand Diagnostic and
Therapeutic Services
17
18. VViittaall SSiiggnnss
Pulse
When would you use these pulse sites?
Temporal
Carotid
Brachial
Radial
Femoral
Popliteal
Dorsalis pedis 3.01 Understand Diagnostic and
Therapeutic Services
18
19. VViittaall SSiiggnnss
Pulse
Normal rate adult (male) 60 – 70 beats per minute
adult (female) 65 – 80 beats per minute
children (over 7) 70 – 100 beats per minute
children (1 – 7) 80 – 110 beats per minute
infants (less than 1 year) 100 – 160 beats per
minute
Rhythm regular or irregular
Volume strength of the pulse
3.01 Understand Diagnostic and
Therapeutic Services
19
20. VViittaall SSiiggnnss
Pulse
• Pulse can be increased by:
– exercise
– stimulant drugs
– excitement
– fever
– shock
– nervousness
3.01 Understand Diagnostic and
Therapeutic Services
20
21. VViittaall SSiiggnnss
Pulse
• Pulse can be decreased by:
– sleep
– depressant drugs
– heart disease
– coma
3.01 Understand Diagnostic and
Therapeutic Services
21
23. RRaaddiiaall PPuullssee
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
23
VViittaall SSiiggnnss
24. VViittaall SSiiggnnss
AAppiiccaall Pulse
• Pulse count taken with the stethoscope.
• Use if the patient has:
– Irregular heartbeat
– Arteriosclerosis
– Weak or rapid radial pulse
– Infants and children
3.01 Understand Diagnostic and
Therapeutic Services
24
25. AAppiiccaall PPuullssee
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
25
VViittaall SSiiggnnss
26. VViittaall SSiiggnnss
Respiration
Process of taking in oxygen and expelling
carbon dioxide
1 inspiration + 1 expiration = respiration
Normal rate:
adults – 12 – 20 breaths per minute
children – 16 – 30 breaths per minute
Evaluate for rhythm and character
Rhythm – regular or irregular
Character – depth, ease of breaths
3.01 Understand Diagnostic and
Therapeutic Services
26
27. VViittaall SSiiggnnss
Respiration
• Abnormal respiratory patterns
Apnea – periods of absent breathing
Cheyne-stokes – periods of apnea and
dyspnea
Dyspnea – difficult breathing
3.01 Understand Diagnostic and
Therapeutic Services
27
29. RReessppiirraattiioonnss
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
29
VViittaall SSiiggnnss
30. VViittaall SSiiggnnss
Blood pressure
Pressure of blood on the arterial walls
Recorded as a fraction: 120/80
Systolic pressure – wall of left ventricle
is contracting
Normal range: 100-140 mm Hg
Diastolic pressure– wall of left ventricle
is resting
Normal range: 60-90 mm Hg
3.01 Understand Diagnostic and
Therapeutic Services
30
31. VViittaall SSiiggnnss
Blood pressure
Factors that elevate blood pressure:
– anxiety
– eating
– exercise
– excitement
– stimulant drugs
Factors that lower blood pressure:
– depressant drugs
– excessive loss of blood
– rest
– shock
3.01 Understand Diagnostic and
Therapeutic Services
31
33. BBlloooodd PPrreessssuurree
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
33
VViittaall SSiiggnnss
34. CCoommbbiinneedd VViittaall SSiiggnnss
TTPPRR BBPP
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
34
VViittaall SSiiggnnss
35. DDiiaaggnnoossttiicc SSkkiillllss::
HHeeiigghhtt aanndd WWeeiigghhtt
Measured if warranted by patient’s age and physical
condition
• Measured routinely:
–on admission to health care facility
–as part of annual physical examination
–each provider visit for children
• Important for evaluation of laboratory tests
and calculation of medications
3.01 Understand Diagnostic and
Therapeutic Services
35
36. DDiiaaggnnoossttiicc SSkkiillllss::
DDaaiillyy WWeeiigghhttss
• Daily weights are used to monitor patients with
chronic disease processes:
– Hormone disorders
– Renal disorders
– Heart disease
– Cancer
3.01 Understand Diagnostic and
Therapeutic Services
36
37. DDiiaaggnnoossttiicc SSkkiillllss::
DDaaiillyy WWeeiigghhttss
• Guidelines for daily weights:
use the same scales
at the same time
wearing the same type of clothing
patient voids to empty bladder
• Make sure to balance the scales before
weighing the patient.
3.01 Understand Diagnostic and
Therapeutic Services
37
38. DDiiaaggnnoossttiicc SSkkiillllss::
DDaaiillyy WWeeiigghhttss
OOBBSSEERRVVEE SSAAFFEETTYY PPRREECCAAUUTTOONNSS!!
Prevent injury from falls and the
protruding height lever.
3.01 Understand Diagnostic and
Therapeutic Services
38
39. MMeeaassuurriinngg HHeeiigghhtt aanndd WWeeiigghhtt
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
39
DDiiaaggnnoossttiicc SSkkiillllss
40. DDiiaaggnnoossttiicc SSkkiillllss::
MMeeaassuurree VViissuuaall AAccuuiittyy
• Used to measure the ability to see
• Snellen charts: used to measure
distant vision
• Ishihara method tests for color
• Tonometer measures intraocular
pressure
3.01 Understand Diagnostic and
Therapeutic Services
40
41. DDiiaaggnnoossttiicc SSkkiillllss::
MMeeaassuurree VViissuuaall AAccuuiittyy
• OD – right eye (oculus dexter)
• OS – left eye (oculus sinister)
• OU – both eyes (oculus uterque)
• Myopia – nearsightedness, defect in
distant vision
• Hyperopia – farsightedness, defect in
near vision
3.01 Understand Diagnostic and
Therapeutic Services
41
42. MMeeaassuurree VViissuuaall AAccuuiittyy
Demonstrate the skill
Provide for guided practice
Provide for independent practice
Verify student passing
3.01 Understand Diagnostic and
Therapeutic Services
42
DDiiaaggnnoossttiicc SSkkiillllss