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Vital Signs

Indicators of health status and effectiveness of circulatory, respiratory, neural, and endocrine body fxns.

Measures temperature, pulse, BP, respiratory rate, and O2 saturation. Pain, a subjective symptom, is also a vital sign that is frequently measured. p. 503
Vital Signs: Acceptable ranges for Adults
Temperature Ranges: 36C to 38C (96.8 to 100.4 F)
Oral and Tympanic avg: 37C (98.6 F)
Rectal avg. : 37.5C (99.5F)
Axillary avg. : 36.5C (97.7F)

Pulse avg: 60-100 beats/min.

Respiration avg: 12-20 breaths/min.

Blood Pressure avg: 120/80
Pulse Pressure avg: 30-50 mmHg
Heat is lost through...
Radiation - transfer of heat from the surface of one object to the surface of another without direct contact between the two. Peripheral vasoDilation increases radiant heat loss. Peripheral vasoConstriction minimizes radiant heat loss. p. 505.

Conduction - transfer of heat with direct contact. Solids, liquids, and gases conduct heat through contact.

Convection - through movement of air.

Evaporation - energy transfer when liquid changes to gas. eg.: diaphoresis
Factors affecting body temperature
Age - Temp. regulation is unstable in children until they hit puberty. Normal temp. range gradually drops as individuals approach older adulthood. Avg. oral temp. for older adults is approx. 36C (96.8F). Older adults are more sensitive to temp. changes due to poor vasomotor control, reduced amounts of subQ tissue, reduced sweat gland activity, and reduced metabolism.

Exercise- increase metabolism = increase in heat production. Can raise body temp. up to 41C (105.8F).

Circadian Rhythm - Temp. is usually lowest between 1:00 - 4:00 am and during the day rises steadily until it reaches max. temp. at 6:00
pm, and then declines to early morning levels.

Stress - stress = increases body temp. through hormonal and neural stimulation (physio changes increase metabolism)

Environment - Affect infants and older adults more often b/c their temp.-regulating mechanisms are less efficient.
Pyrexia
Fever. Occurs b/c heat-loss mechanisms are unable to keep pace w/ excess heat production, resulting in an abnormal rise in body temp. Fever is usually not harmful if it stays below 39C. or 102.2F
Patterns of Fever
Sustained - A constant body temp. continuously above 38C (100.4F) that has little fluctuation

Intermittent - Fever spikes interspersed w/ usual temp. levels. Temp. returns to acceptable value at least once in 24 hours.

Remittent - Fever spikes and falls w/o a return to normal temperature levels

Relapsing - Periods of febrile episodes and periods with acceptable temp. values. Febrile episodes and periods of normothermia are often longer than 24 hours.
Classification of Hypothermia
Mild : 34-36C (93.2F-96.8F)
Moderate : 30-34C (86.0-93.2F)
Severe : < 30C (<86.0F)
Fahrenheit to Celsius

Celsius to Fahrenheit
C = (F-32) x 5/9

F = (9/5 x C) +32
Dangers of Fever p. 507
Cellular Hypoxia

a. Myocardial Hypoxia = produces angina

b. Cerebral Hypoxia = produces confusion and may include O2 therapy.

Dehydration (water loss through increased respiration and diaphoresis)
Hyperthermia and Malignant Hyperthermia
Hyperthermia - elevated body temp. related to body's inability to promote heat loss or reduce heat production. Results from an overload of the body's thermoregulatory mechanisms.

Any disease or trauma to the hypothalamus impairs heat-loss mechanisms.

Malignant Hyperthermia - hereditary condition of uncontrolled heat production, occurring when susceptible persons receive certain anesthetic drugs.
Heatstroke
heat depresses hypothalamic fxn. caused by prolonged exposure to sun or high environmental temp.

It's a dangerous heat emergency with high mortality rate.

very young/old, those who have cardiovascular disease, hypothyroidism, diabetes, or alcoholism are at risk. Also at risk are those who take medications that decrease the body's ability to lose heat.

The most important sign of heatstroke is hot, dry skin. Victims of heatstroke do not sweat because of severe electorlyte loss and hypothalamic malfuction.
Heat exhaustion
occurs when profuse diaphoresis results in excess water and electrolyte loss.