Vital Signs: Assessment and Interpretation Importance ... - TMedWeb

9/8/2011Pulse can be palpated, but actualrhythm is determined byrecording an electrocardiogramVital sign #3: Respirations• Normal rate is 14-18/min for adults• Rate is driven by metabolic demandsand pCo2• Depth of respirations also important• Usually increases along with heart rate• Altered breathing seen in disease:Kussmaul’s, Cheyne-Stokes, SleepApneaRhythms that would causeIrregular and Regular Pulses:Vital sign 4: Blood Pressure• BP=Cardiac Output X Systemic VascularResistance (i.e. tone in wall of vessels)• Cardiac Output=HR X Stroke Volume (afunction of heart’s contractility andamount of blood in Left Ventricle), so• BP= HRXSVxSVR, so a change in any ofthese 3 factors will affect bloodpressureVital Sign #2 Temperature• Reflects normal homeostasis (98.6 d F)• Will increase with hypermetabolic andinflammatory states: cocaine, infection, tissuedamage, etc.• Every degree of temp above normal willincrease pulse by 10/min. Why?• Hypothermia -core below 92 degrees F willslow heart rate• Beware of mouth temperature/thermometerBlood pressure:normal 110/70• Expressed as systolic (upper number) and diastolic(lower number) pressure in mm of mercury (mmHg)• Determined by inflating BP cuff attached tomanometer and measuring gpressure in brachial artery• Flow must be occluded and then gradually releasedto obtain the (systolic pressure) sound• Loss of sound as cuff is further deflated is diastolicBP• Referred to as Korotkoff sounds• BP of 140/90 is consistent with hypertension ifrecorded at two or more sittings2