Vital Signs: Pulse and Blood Pressure

Question 1

What do vital signs include?

Answer 1

Body temperature, pulse, respiration, and blood pressure

Question 2

Purpose of assessing vital signs

Answer 2

• They reflect the physiological function of the body
• Deviations from normaal may indicate alteration in health status

Question 3

When to assess vital signs?

Answer 3

• On admission to obtain baseline data
• Before (to alert others, consider if the surgery should be carried out) and after (may have infection/internal hemorrhage) surgery/procedure
• Before and after taking certain medication (to see if the patient is responsive to the medication)
• Client presents or reports symptoms
• Following incident or injury
• According to ward policy (e.g. more frequent in ICU, less frequent in rehab)
• Based on needs of client

Question 4

Abbreviation

Answer 4

Q15min
Q1h (x4)
Q4h (x6)
Qid (4 times/day)
TDS (3 times/day)
BD (2 times/day)
QD (1 time/day)

bp to be taken before distribution of medications

Question 5

Factors affecting the pulse

Answer 5

• Age increases –> pulse decreases
• Male –> lower pulse than female
• Fever –> pulse increases in reponse to the lowered bp resulted from peripheral vasodilation assosciated with elevated body temperature and increased metabolic rate
• Stress –> sympathetic nervous stimulation increases the overall activity of the heart
• Exercise
• Medication (Digoxin: not provided when bp<60)
• Hypovolemia

Question 6

Palpation method

Answer 6

Use finger pads (index, middle and ring fingers) to feel pulse wave and count for one full minute

Question 7

Doppler ultrasound

Answer 7

For pulses difficult to palpate (e.g. legs)

Question 8

Auscultation method

Answer 8

• Usually used for assesing apical pulse
• Press diaphragm of stethoscope firmly against chest wall until “lub-dup” sound being clearly heard

Question 9

Common sites for assessing pulse

Answer 9

• Apical pulse (at apex of heart): 5th intercostal space just medial to mid-clavicular line
• Peripheral pulse (where a large artery adjacent to a bone and close to skin surface): 8 common sites

Question 10

Common sites for assesing arterial pulse

Answer 10

Temporal (head)
Carotid (neck)
Brachial (elbow joint)
Radial (wrist)
Femoral (midway along groin)
Popliteal (behind knee)
Posterior tibial (inside of ankle)
Dorsalis pedis (upper surface of foot)

Question 11

Pulse rate