Vital Signs

• Vital signs are physical signs that indicate an individual is alive,

such as heart beat, breathing rate, temperature, blood pressures and
recently oxygen saturation.
• They are the measurement of the body’s most basic functions
. • These signs may be observed, measured, and monitored to
assess an individual’s level of physical functioning.
• Normal vital signs change with age, sex, weight, exercise,
tolerance and condition
■ Normal Vital Sign Ranges
■ • Normal vital sign ranges for the average healthy adult while resting are:
■ Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg
■ Breathing: 12 to 18 breaths per minute
■ Pulse: 60 to 100 beats per minute
■ Temperature: 97.8°F to 99.1°F (36.5°C to 37.3°C)/average 98.6°F (37°C)
  Pulse
■ Pulse is the wave of expansion and recoll occurring in an artery in response to the
pumping action of heart.
■ The pulse rate is a measurement of the heart rate, or the number of times the heart
beats per minute. •
■ Taking a pulse not only measures the heart rate but also indicate following: Heart
rhythm Strength of the pulse
 Characteristics of pulse :-
.1 Pulse rate : It is the number of pulse beats per minute. Normal pulse rate in adults
varies from 72 to 80 beats per minute.
2 . Rhythm or regularity: It is the time interval between pulse beats. Normally the time
intervals between pulse beats are equal or regular
3. Tension : It is degree of compressiblty and depends upon the resistance of the wall of
the artery.
4. Strength/volume : It is the fullness of artery. It is force of blood felt at each beat.
 Types of pulse (Based on Pulse Rate) :
• Tachycardia:
When the resting pulse rate increases to more than 100 beats per minute in an adult , this
usuall indicates the abnormal condition and is called tachycardia.
• Bradycardia:
A pulse rate of less than 60 beats per minute is called bradycardia.
 PURPOSE OF TAKING PULSE:
To establish baseline date •
To check abnormalities in rate, rhythm and volume •
To monitor any changes in health status of the patient •
To assess response of heart to cardic medications, activity, blood volume and gas
exchange
• To check the peripheral circulation
• To determine number of heart beat per minute.
.•
■  Factors affecting the pulse: •
■ Age
■ • Sex
■ • Exercise/activity
■ • Stature
■ • Emotions
■ • Fever
■ • Blood pressure
■ • Drugs
■ • Disease conditions
■ • Acute pain and anxiety
■ • Position •
■ Hypovolemia/hemorrhage
■ • Age: Very old person have slow pulse rate and children will have faster beat/ Pulse Rate ( Per min)
■ Before Birth 140-150
■ New Born 130-140
■ 1st year 115-130
■ 2nd year 100-115
■ 3rd year 90-100
■ 4th-8th year 86-90
■ 8th-15th 80-86
■ At adult 70-80
■ At old age 60-70
■ • Sex : Females have a slightly higher pulse rate than males.
•
■ Exercise/Activity : Pulse rate is much faster during
exercise. •
■ Stature : The short and thin persons have a more rapid
pulse than tall and heavy.
■ Emotions : Anger or excitement increases the pulse rate
temporally.
■ • Fever : When body temperature is elevated, the pulse rate
usually increases as well. Pulse increases at a rate ofabout
10 beats per minute each degree rise of body temperature .
■ Blood pressure : When the blood pressure decreases, pulse rate may increase to
increase the flow of blood. If the blood pressure increases, pulse rate may decreases
to correct the blood flow.
■ • Drugs : Stimulant drugs increase the pulse rate. Depressant drugs decrease the
pulse rate.
■ • Disease condition : Heart diseases, thyroid disease and other infections effect on
pulse rate
■ ACUTE pain and anxiety :Increase pulse
■ • Severe and chronic pain : Decrease pulse
■ . • Hemorrhage : Loss of blood increases pulse rate because of demand of oxygen.
Position : Slow while lying down and rapid while standing.
■ Sites for checking Pulse •
■ Temporal
■ • Carotid
■ • Apical
■ • Brachial
■ • Radial
■ • Femoral
■ • Popliteal
■ • Posterior tibial
■ . Dorsalis pedis
■ . Radial : Inner aspect of the wrist on thumb site.
■ • Temporal : Over the temporal bone or superior and lateral to the eye.
■ • Carotid : At the side of the trachea where the carotid artery runs between the trachea and the sternocleidomastoid muscle.
■ • Apical : Left side of the chest in the 4th , 5th or 6th intercostals space in the midclavicular line

■ • Brachial : Medially in the antecubital space, above the elbow.

• Femoral : Below inguinal ligament, midway between symphysis pubis and anterosuperior iliac spine of illium.
• Popliteal : Medial or lateral to the popliteal fossa with knees slightly flexed.
• Tibial : On the medial surface of the ankle behind the medial malleolus.
• Dorsalis pedis : Along dorsum of foot between extensor tendons of great and first toe.
■ Procedure of taking pulse •
■ Explain procedure to patient and check if the patient had been involved in any
activity. If so, allow the patient to rest for 10 minutes before taking pulse because
activity can increase the pulse rate.
■ • Select the pulse site. Usually radial pulse is selected.
■ • Assist the patient to a comfortable position. For radial pulse, keep the arm, resting
over chest or on the side with palm facing downward.
■ • Palpate and check pulse.
■ Place tips of 3 fingers other than thumb lightly over pulse site.
■ Thumb is not used for assessing pulse as it has its own pulse which can be mistaken
for patient’s pulse.
■ Do not press the artery with more force.
■ After getting the pulse regularly, count the pulse for one whole minute looking a the
second hand on the wrist watch.
■ Assess for rate, rhythm, and volume of pulse and condition of blood vessel. • Assist
client in returning to comfortable position.