Vital
Signs
Vital
signs are measurements of the body's most
basic functions. The four main vital signs routinely
monitored by medical professionals and healthcare
providers include:
- body temperature
- pulse rate
- respiration rate (rate
of breathing)
- blood pressure (Blood
pressure is not considered a vital sign, but
is often measured along with the vital signs.)
Vital
signs are useful in detecting or monitoring medical
problems. Vital signs can be measured in a medical
setting, at home, at the site of a medical emergency,
or elsewhere.
The
normal body temperature of a person varies depending
on gender, recent activity, food and fluid consumption,
time of day, and, in women, the stage of the menstrual
cycle. Normal body temperature, according to the
American Medical Association, can range from 97.8°F
(or Fahrenheit, equivalent to 36.5° C, or
Celsius) to 99° F (37.2° C). A person's
body temperature can be taken in any of the following
ways:
What
is fever?
Fever
(also called pyrexia) is defined as body temperature
that is higher than normal for each individual.
It generally indicates that there is an abnormal
process going on within the body. The severity
of a condition is not necessarily reflected
by the degree of fever. For example, influenza
may cause a fever of 104° F, while pneumonia
may cause a very low-grade fever or no fever
at all. Consult with your physician if you have
any questions about whether a fever is significant.
- orally
Temperature can be taken by mouth using either
the classic glass thermometer or the more modern
digital thermometers that use an electronic
probe to measure body temperature.
- rectally
Temperatures taken rectally (using a glass
or digital thermometer) tend to be 0.5 to 0.7°
(Fahrenheit) higher than when taken by mouth.
- axillary
Temperatures can be taken under the arm using
a glass or digital thermometer. Temperatures
taken by this route tend to be 0.3 to 0.4°
(Fahrenheit) lower than those temperatures taken
by mouth.
- by ear
A special thermometer can quickly measure the
temperature of the ear drum, which reflects
the body's core temperature (the temperature
of the internal organs).
Body
temperature may be abnormal due to fever (high
temperature) or hypothermia (low temperature).
A fever is indicated when body temperature rises
above 98.6° F orally or 99.8° F rectally,
according to the American Medical Association.
Hypothermia is defined as a drop in body temperature
below 95° F.
According
to the Environmental Protection Agency (EPA),
mercury is a toxic substance that poses a threat
to the health of humans, as well as to the environment.
Because of the risk of breaking, glass thermometers
containing mercury should be removed from use
and disposed of properly in accordance with local,
state, and federal laws. Contact your local health
department, waste disposal authority, or fire
department for information on how to properly
dispose of mercury thermometers.
The
pulse rate is a measurement of the heart rate,
or the number of times the heart beats per minute.
As the heart pushes blood through the arteries,
the arteries expand and contract with the flow
of the blood. Taking a pulse not only measures
the heart rate, but also can indicate:
- heart rhythm
- strength of the pulse
The
normal pulse for healthy adults ranges from 60
to 100 beats per minute. The pulse rate may fluctuate
and increase with exercise, illness, injury, and
emotions. Girls ages 12 and older and women, in
general, tend to have faster heart rates than
do boys and men. Athletes, such as runners, who
do a lot of cardiovascular conditioning, may have
heart rates in the 40's and experience no
problems.
As the
heart forces blood through the arteries, you feel
the beats
by firmly pressing on the arteries, which are
located close to the surface of the skin at certain
points of the body. The pulse can be found on
the side of the lower neck, on the inside of the
elbow, or at the wrist. When taking your pulse:
- Using the first and
second fingertips, press firmly but gently on
the arteries until you feel a pulse.
- Begin counting the
pulse when the clock's second hand is on
the 12.
- Count your pulse for
60 seconds (or for 15 seconds and then multiply
by four to calculate beats per minute).
- When counting, do not
watch the clock continuously, but concentrate
on the beats of the pulse.
- If unsure about your
results, ask another person to count for you.
If your
physician has ordered you to check your own pulse
and you are having difficulty finding it, consult
your physician for additional instruction.
The
respiration rate is the number of breaths a person
takes per minute. The rate is usually measured
when a person is at rest and simply involves counting
the number of breaths for one minute by counting
how many times the chest rises. Respiration rates
may increase with fever, illness, and with other
medical conditions. When checking respiration,
it is important to also note whether a person
has any difficulty breathing.
Normal
respiration rates for an adult person at rest
range from 15 to 20 breaths per minute. Respiration
rates over 25 breaths per minute or under 12 breaths
per minute (when at rest) may be considered abnormal.
Blood
pressure, measured with a blood pressure cuff
and stethoscope by a nurse or other healthcare
provider, is the force of the blood pushing against
the artery walls. Each time the heart beats, it
pumps blood into the arteries, resulting in the
highest blood pressure as the heart contracts.
One cannot take his own blood pressure unless
an electronic blood pressure monitoring device
is used. Electronic blood pressure monitors may
also measure the heart rate, or pulse.
Two
numbers are recorded when measuring blood pressure.
The higher number, or systolic pressure , refers
to the pressure inside the artery when the heart
contracts and pumps blood through the body. The
lower number, or diastolic pressure , refers to
the pressure inside the artery when the heart
is at rest and is filling with blood. Both the
systolic and diastolic pressures are recorded
as "mm Hg" (millimeters of mercury).
This recording represents how high the mercury
column is raised by the pressure of the blood.
High
blood pressure, or hypertension, directly increases
the risk of coronary heart disease (heart attack)
and stroke (brain attack). With high blood pressure,
the arteries may have an increased resistance
against the flow of blood, causing the heart to
pump harder to circulate the blood.
According
to the National Heart, Lung, and Blood Institute
(NHLBI) of the National Institutes of Health (NIH),
high blood pressure for adults is defined as:
- 140 mm Hg or greater
systolic pressure
and
- 90 mm Hg or greater
diastolic pressure
In an
update of NHLBI guidelines for hypertension in
2003, a new blood pressure category was added
called prehypertension:
- 120 mm Hg - 139 mm
Hg systolic pressure
and
- 80 mm Hg - 89 mm Hg
diastolic pressure
The
new NHLBI guidelines now define normal blood pressure
as follows:
- Less than 120 mm Hg
systolic pressure
and
- Less than 80 mm Hg
diastolic pressure
These
numbers should be used as a guide only. A single
elevated blood pressure measurement is not necessarily
an indication of a problem. Your physician will
want to see multiple blood pressure measurements
over several days or weeks before making a diagnosis
of hypertension (high blood pressure) and initiating
treatment. A person who normally runs a lower-than-usual
blood pressure may be considered hypertensive
with lower blood pressure measurements than 140/90.
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