Prepared by:
CYRIL C. DOMINGUEZ,RM,BSM

A.TEMPERATURE
- balance between the heat produce & heat
loss in the body.
2 Types:
1.Surface Temperature-temp. on skin,
subcutaneous & fats
2.Core Temperature-deep tissue
temperature

BEQ
Temperature is mainly d/t metabolism
Temperature is regulated by the
Hypothalamus
Normal Adult Temp.
36.7°C (98°F-98.06°F)

Factors Affecting Temperature
1.Hormone
(Epinephrine,Norephinephrine,Thyroxine,Progesterone)
2.Muscle Activity – exercise
3.BMR- younger ,older
4.Sympathetic Stimulation- stress
5.Fever –infection
6.Diurnal Variation- temp 8-12 pm, temp 4-6am

Normal Range:
Oral 36.5-37.5°C
Axilla 35.8-37°C
Rectal 37-38.1°C
Tympanic 36.8-37.9°C

Sites:
1.ORAL
Most accessible and convinient
Allow 15 minutes to elapse if intake
hot or cold
Take 2-3 minutes
Not indicated among: very young,
persons with altered consciousness,
oral surgery, nausea

2.RECTAL
Most accurate
lateral position, lubricate
Newborn-to rule out patency of
the anus
0.5-1.5 inch insertion, 2 mins
(neonate: 5mins)

3. AXILLARY
Safest and non-invasive
Pat dry the axilla
5-9 min taking
Infant -5 minutes
4.TYMPANIC MEMBRANE
Excellent site

Equipments:
1.Glass Mercury Thermometer
Oral-pear shape
Axilla-slender
Rectal-blunt
2.Electronic Thermometer- provides reading in less
than 60 secs; ideal for children
3.Tympanic Membrane Thermometer- can provide
reading in 2 secs; ideal for infant
4.Temperature Sensitive Strips-placed on forehead
or abdomen; measured body surface temp.
5.Disposable Paper Thermometer- thin strips of
chemically treated paper with raised dots.
BEQ

Conversion
 Celsius to Fahrenheit
F=(9/5 x C°) + 32
=(9/5 x 39.5°C) + 32
= 103.1°F
 Crisis
- sudden decline of temperature or fever
 Lysis
- gradual decline of temperature or fever
Decline of Fever
 Fahrenheit to Celsius
C=(F° - 32) x 5/9
= 37.7°C

Types of Fever
 CONSTANT
–temperature that is constantly elevated
 RELAPSING
-patient is febrile in several days then become
normal for a day or 2 then will return on being
febrile again.
 INTERMITTENT –BEQ
-on & off ,temperature is fluctuating, temperature
becomes normal b/w fluctuation; short interval
 REMITTENT –BEQ
-not reacting normal b/w fluctuation

B. PULSE
 Wave of blood by the contraction of the left
ventricle.
Pulse is regulated by ANS (Autonomic
Nervous System) start at the SA (Sinoatrial)
Node which is the normal pacemaker of
the heart.
BEQ

Characteristics
1.RATE- number of pulsation or bpm
Adult: 60-100bpm Average: 80bpm
NB: 120-160 bpm
2.RHYTHM- pattern and interval of beats
Arrhythmia/Dysrhythmia-abnormal
pattern or interval
Tachycardia-fast
Bradycardia-slow

3. QUALITY- strength of pulsation
Bounding
Weak and Thready
4. PULSE DEFICITS- apical minus radial
pulse
(e.g. 100-80 = 20 pulse deficits)

Pulse Sites
1. Apical-most ideal; in bet. 3 & 4 ICS(inter coastal spaces)
2.Radial
3.Ulnar
4.Brachial-BP,CPR for infant
5.Temporal-superior lateral of the eyes
6.Carotid-lateral part of neck
7.Femoral-inguinal area
8.Popliteal-medical aspect of the ankle
9.Dorsalis Pedis
10.Posterior Tibial

Factors Affecting Pulse
1.Age –pulse is inversely proportioned with age( age: pulse)
2.Autonomic Nervous System - HR
3.Medicine e.g. Epinephrine HR
Beta Blocker HR

C. RESPIRATION
 Act of breathing
2 TYPES
1.External- refers to taking of O2 & exchange of gas
in the lung, expiration of CO2
2.Internal- (Perfusion or Cellular respiration)
-lungs to cell, then cell will use the O2
Ventilation-movement of air in and out of the
lungs

BEQ
Primary Respiratory Center
Medulla Oblongata
Stimulant of Breathing
Carbon Dioxide (CO2)

Factors Affecting Respiration
1.Stress- Stress= respiration
2.Exercise- RR
3.Environment-hot ;cold
4.High Altitude- RR
5.Medications-narcotics RR

Characteristics:
1.RATE-normal adult: 16-20 cpm;
normal newborn: 30-60 cpm
2.RHYTHM & DEPTH-normal
expiration is 2x longer than
inspiration.
3.QUALITY- regular, effortless,
automatic

Eupnea-normal breathing
Tachypnea- increased RR
Bradypnea- decreased RR
Dyspnea- difficulty of breathing in any
position
Orthopnea-difficulty of breathing when
supine
Labored Breathing-inspiration is longer

Abnormal Breathing Pattern:
1.Bradypnea- < 12cpm; narcotics ,neurologic
disturbance
2.Tachypnea- > 20cpm; pain, stress, tense,
anxiousness
3.Biots- cycle with a shallow breathing
alternating with apnea
4.Cheyne-Stoke-increase rate and depth
alternating with apnea
5.Kussmaul-increase rate (above 20)& depth of
respiration

D. BLOOD PRESSURE
 The force of blood against the wall of the
arteries. “Korotkoff Sound”
 Pulse Pressure- difference between systolic
and diastolic
e.g. 130-80 = 50 PP
Normal Pulse Pressure: 30-50
If widen- increase intracranial pressure(ICP)

Factors Affecting Blood Pressure
1.Age-BP is directly proportioned with age
2.Stress
3.Exercise
4.Obesity
5.Disease
6.Medications
7.Race
8.Sex/Gender
MALE: After puberty & before 65 yrs old
FEMALE: After 65 yrs old
BEQ