Health and Wellness

Health – Overall condition of a person’s body, mind and the presence or absence of illness and injury.

Wellness – How much you are physically, mentally and socially fit.

Vital Signs or Cardinal signs

- Temperature rate
- Blood pressure rate
- Pulse rate
- Respiration rate

Purpose

- Assess patients and collect baseline data

- Diagnostics purpose(Can collect raw or rough data of the patients)
- Therapeutic Purpose

Equipments for measuring vital signs

1) Vital sign tray

2) Stethoscope
3) Sphygmomanometer
4) Thermometer
5) Second hand watch
6) Red and blue pen
7) Pencil
8) Vital sign sheet
9) Cotton swab in bowl
10) Disposable gloves if available
11) Dirty receiver kidney dish

Time for assessing vital signs

1) On admission
2) Change in health status
3) If there is medical order from the expertise
4) Before and after certain medications
5) Before and after surgery or an invasive diagnostic procedures
6) Before and after nursing interventions e.g. Ambulation
7) As per health policies
Temperature rate

Temperature – it is the balance between heat production and heat loss of the body
1) Normal body temperature – 37 degree C or 98.6 degree F

Two kinds of temperature rate

1) Core Temperature
- Temperature of the internal organs and it is the temperature of the deep tissues
- It stay relatively constant and thermometer is used to measure the rate
- Range is between 36.5 – 37.5 degree C
2) Surface Temperature
- Temperature of the skin, surface tissue and fat cells.
- It rises and falls accordingly with the environment.
- Range is between 20 – 40 degree C

Alterations in body temperature

- 37 degree C or 98.6 degree F

- Body temperature may be abnormal due to fever or hypothermia
- Pyrexia fever – body temperature is above the normal temperature(100.4 – 105. 8 degree F)(38
– 41 degree C)
- Hyperpyrexia – Very high fever (41 degree C – 42 degree C)
- Hypothermia – Body temperature is between 34 degree C – 35 degree C

Common types of Fever

1) Intermittent fever – Body temperature alternates at regular intervals between periods of fever
and periods of normal temperature
2) Remittent feve7ur – A wide range of temperature fluctuations
3) Relapsing fever – Short repeated episodes of fever
4) Constant fever – Body temperature fluctuates minimally but always remains above the normal
temperature
 Factors that affect Temperature

1) Age
2) Diurnal variations (circadian rhythm) – Basically your sleep cycle
3) Exercises
4) Hormones
5) Stress
6) Environment

Ways to measure Temperature

1) Oral
2) Rectal
3) Auxiliary
4) Tympanic

Oral site – Mouth

- Place the thermometer under the tongue and wait for minimum 2-3 minutes
- Range should be 0.65 less than rectal site and 0.65 greater than auxiliary site
- Oral site is usually used for the infants and unconscious patients(Unconscious in the sense that
they can at least follow your instructions)
- Only disadvantage is that it can lead to false reading if a person had consumed something
before the test(You can take the test after 10-150 minutes in this current scenario)

Contraindications – Cases where we cannot undertake oral site

- Child below 7 years

- Epileptic or mentally ill patients – Basically oral site is not recommended to people with mental
issues
- Patients with persistent or continuous cough
- If patients are in severe or intense pain
- Patients who had mouth surgery probably cannot take this test
- Patients with nasal obstruction – people with problems related to nose so you can see that
mouth plays a vital role in their situation
- Patients with nasal and gastric tubes in place(People who depend on tubes for survival or food)
- Patients who are receiving Oxygen(People using oxygen tubes)
*Not every point is mandatory but at least try to remember five situations
Rectal site – Rectum

- Obtained by inserting the thermometer through rectum or anus

- Hold for 3-5 minutes
- Disadvantages are it can lead to injury to the rectum, it requires privacy so not as comfortable
as we want, and lastly it is not appropriate for the patients with diarrhea or anal fissure

Contraindications

- Patients with perineal injury

- People who have faecal impaction
- Clients with rectal infection
- Definitely not recommended to new born infants as their internal organs are at the verge of
developing

Auxiliary site - ‘Auxilia’ meaning armpit

- It is safe and non–invasive meaning we don’t have to put it inside our body
- It is mostly recommended to infants and children
- It’s disadvantages are it is a long term process - Have to hold the thermometer under your
armpit for 5-10 minutes at the maximum
- It is less accurate as it not close to major vessels

*Usually Auxiliary site is the last option for measuring the temperature of a person

Tympanic Site – Ear

- Placed in outer ear canal

- It is readily accessible
- It is a fast method
- It’s disadvantages are that it may be uncomfortable and there is high risk of injury to the ear
and brain
 Pulse Rate – (60 – 100bpm)(bpm – beats per minute)
- It is a wave created by the contraction of left ventricle
- It reflects our heart beat
- Pulse rate is regulated by our autonomic nervous system

Types of pulse rate

1) Periphery pulse – Pulse which are found at the periphery of the body meaning pulse which
we can measure by just touching our body like neck, and feet.
2) Apical Pulse – Apex of the heart (Meaning at the surface of our heart)

We can measure our heart beat through two ways;

1) Palpation meaning by feeling like checking on our neck and arm (Commonly used)
2) Auscultation meaning measuring our heartbeat using stethoscope

Factors affecting Pulse rate

- Age (Children, adolescents and young adults will have different level of pulse rate compared to
old aged people)
- Sex –gender (After puberty, men are said to have lower pulse rate compared to the pulse rate of
women)

Sites for taking pulse

1) Carotid – meaning neck

2) Temporal – temporal bones like the bones beside our eyes usually where our brain lies
3) Apical – Apex of heart
4) Brachial – inner aspect of our biceps - usually the place where we take our blood samples
5) Radial and ulnar – the most common way of taking pulse
6) Femoral – adjacent to the genital parts
7) Popliteal – Places around patella
8) Posterior tibial – ankle
9) Dorsalis pedis – arms of the feet