00:00
Hello. Welcome to the series on vital signs. This is a really important fundamental topic
for us as nursing students and nurses. This helps give us a really great baseline idea of our
patient's condition, so let's take a further look. So when we talk about vital signs, we're
going to look at these 5 main areas. Number 1 being our temperature. Just know, depending
on the area of the body that you take the temperature, it's going to vary slightly. And
we'll discuss this later. And number 2 is our pulse otherwise known as our heart rate. Number
3 is our respiratory rate and how fast we breathe. Four will be our blood pressure. And 5 is
our oxygen saturation. So these big 5 components is what we call a full set of vital signs. As
you can see, these are hitting many different areas of the body and our body systems,
so it's going to give us a really great indication of how well your patient's doing. Now, let's
take a look at one more vital sign. We call this the 6th vital sign, otherwise known as pain.
01:08
Now, realistically, this is not a vital sign. However, this is really important information to
collect on your patient because if a patient's actually in pretty severe pain, it can indeed
affect some of these other vital signs such as how fast you breathe, your pulse, or even your
blood pressure for example. So this is also a great baseline condition to make sure you
assess on your patient. So why do we even take vital signs? Again, it's a great
determination of a patient's baseline health status. Now, with these vital signs, we can
identify some potential problems that may arise and hopefully implement interventions
early. Then we can evaluate those interventions and see if they were effective for our
patients. And again, this is going to give us a more accurate understanding of our patient's
baseline health. So one thing to know is many times as a nurse when you go in and assess
the patient visually, we may see some indicators with the patient that, you know, they may
not quite seem right but maybe nothing too alarming. Well, vital signs are a good tip off that
there could be some changes with your patient's hemodynamic status or their baseline
health. So again, another great assessment piece when you're taking care of your client.
02:24
Let's discuss guidelines for measuring vital signs for our client. There's a lot of important
points to consider but we'll talk through each one. So first and foremost, making sure your
equipment is functional is very important. And we also need to consider it's appropriate for
the size and the age of the client. An example of this is there's pediatric cuff when we're
obtaining blood pressure for our client, for a pediatric patient. Also know that the size of the
cuff matters in regards to the accuracy of the reading. So if I have a really small cuff for a
patient's arm, this can give us an abnormally and false high reading. The same is true if the
cuff is far too large, we can have a false low reading. So this is important in regards to the
size of our equipment and considering the age of the client. And don't forget about
delegation. Vital signs is something we can typically delegate to a licensed personnel, but
it's also important to note that there are occasions where it's not appropriate, so as a
nurse we need to use our judgment. We also want to be able to understand and interpret
those values we obtained. If we have a set of vital signs, we need to know what they mean.
03:43
Right? Otherwise, we're just looking at numbers. The same is true as knowing the client's
usual range of vital signs. This becomes important because some patient's blood pressure,
what we called trend, and normally runs lower than maybe the 120/80 that's a normal blood
pressure range. The same can be true as well when we're talking about heart rate. Some
patient's heart rate may run a little bit lower and that's normal for them. We also want to
determine the client's medical history, the therapies they are getting, and the prescribed
medications can all affect their vital signs. We also want to control or minimize
environmental factors that affect vital signs. Here is a great example of that. In healthcare,
you may hear something called white coat syndrome or you may have this yourself. All we
really mean by that is, I will tell you when I used to work in a cardiology clinic, patients would
come in to the office and their blood pressure and heart rate would be really high. It really
just had to do with the doctor made them nervous so their blood pressure and their heart
rate were elevated everytime they came in. But they would give us readings of blood
pressures at home and they were much lower and much better results. Keep this in mind
that there are different factors that can affect patient's vital signs. We also want to
consider using an organized, systematic approach when we take their vital signs. When we
get a set of vitals, we want to take a full set of those meaning all the temperature, the
respiratory rate, the blood pressure, the pulse. All of those pieces matter, so we want to
do it in organized and systematic way, that way we make sure we're accurate and we obtain
all the results we need. You want to consider as a nurse the acceptable ranges for
medication administration. Many times we have to use vital sign measurements to determine
indications for meds. Sometimes we got to give medications to lower that blood pressure
for example or even to increase a blood pressure. Whatever findings that you get for vital
signs, we need to be sure to communicate those which may mean that we are accurate in
our documentation. There are occasional instances where we've got to communicate
abnormal findings to a healthcare provider because they could mean a decline in a patient's
status. And of course, always analyze those results of vital sign measurement because
analyzing this is going to matter in regards to the patient's condition and their treatment.
06:20
And don't forget to instruct the client or their family or the caregiver in vital sign
assessment. This is really important because if they're monitoring these at home, they need
to know "Is this a significant finding? Do I need to call my doctor or not?" We talked about
many guidelines for measuring vital signs. This helps emphasize health promotion and activity
that helps support our health. So again, you may need to teach a client and their families
to assess and record their vital signs. Also stress that these vital signs need to be taken
at the same time everyday. There are different times throughout the day that our vital
signs are naturally going to change. So stress when you're doing education with your family
members or your patient that they take them at the exact same time everyday, if at all
possible. In regards to recording vital signs, let's talk about 4 points to keep in mind. We
want to make sure we record the values on either electronic health record or the paper
graphic, whatever your facility is using at the time. We also want to record in our nurse's
notes if there are any accompanying or precipitating symptoms of a patient's vital signs.
07:35
This could be key information for the healthcare provider later. And of course, there are
times when interventions are needed for abnormal vital signs. It's important that we
document those interventions and to follow up. And if a vital sign is outside anticipated
ranges, this is a point where we may need to consider contacting the healthcare provider.
07:58
So let's take a look at some guidelines when we're talking about safety and performing vital
signs. It's really important to communicate clearly with members of the healthcare team.
08:08
This could mean that we had to discuss precipitating symptoms of an abnormal vital sign or
maybe clear and accurate documentation in the record. Also of course, make sure you
assess and incorporate the client's priorities of their care and their preferences, and
always use best evidence when making decision about your client's care. Let's talk about a
few more safety guidelines when we're measuring vital signs for our patient to ensure safe
individual clients and their care. Now a really important point is to clean your devices
between client uses. This is going to help decrease the risk of infection. So here's another
really important point to know. Many times your patient's going to be in special precautions
that are ordered by the physician such as contact precautions, airborne precautions for
example. Now, there's certain agency protocols on how we clean that equipment so make
sure you check your agency's policy. Also make sure you rotate your sites when you're
doing repeated measurements of vital signs like blood pressure or pulse ox, for example.
09:16
This can decrease the risk of our skin breakdown. Also, it can actually give us an inaccurate
measurement. Here's what I mean by that. If I take a blood pressure on my arm, I take one
really quickly and pump up a cuff and then maybe wait 30 seconds to do it again and to do it
another 30 seconds. That could give us an inaccurate reading. So make sure you rotate
sites if you have to repeat measurements. And of course, make sure you analyze those
trends for vital signs and report any abnormal findings. Just keep in mind that each patient
has a little bit different baseline on their blood pressure, for example, or their heart rate.
09:55
If there's something abnormal here, make sure you report this to the healthcare provider.
10:00
And of course, determine the appropriate frequency of measuring those vital signs based
on the client's condition. Here's a great example of that. If a patient is in the intensive
care unit, for example, many times a patient's pretty ill so we may have to do these vital
signs very frequently, for example, much more frequently than maybe a patient on a medical
surgical unit. However, many times you're going to have a physician order for that that's
appropriate for your patient. Thanks for watching.