CRITICAL CARE Critical care: the eight vital signs of patient monitoring Malcolm Elliott and Alysia Coventry O ne of the traditional roles of nurses involves surveillance.This might include watching patients for changes in their condition, recognising early clinical deterioration and protection from harm or errors (Rogers et al, 2008). For over 100 years, nurses have performed this surveillance using the same vital signs: temperature, pulse, blood pressure, respiratory rate and in recent years, oxygen saturation (Ahrens, 2008). Prompt detection and reporting of changes in these vital signs are essential as delays in initiating appropriate treatment can detrimentally affect the patient’s outcome (Chalfin et al, 2007). …show more content…
The nurse must be able to interpret conflicting assessment findings such as these in light of the patient’s underlying pathophysiology. When measuring body temperature, a number of factors must be considered. Not only must the measuring device be correctly calibrated, but the nurse must also be aware of the difference in the core temperature between anatomical sites. For example, a study found significant differences in the accuracy and consistency of several commonly used devices for measuring temperature – tympanic, oral disposable, oral electric and temporal artery (Frommelt et al, 2008). This highlights the importance of regular calibration, correct use, accurate documentation (site of measurement and temperature reading) and consistency (using the same site) as ways of accurately identifying trends in the patient’s core temperature. No single thermometer or measurement site is recommended as best practice, but in order to ensure accuracy Malcolm Elliott is Lecturer, Faculty of Health Science and Community Studies, Holmesglen Institute, Victoria, Australia and Alysia Coventry is Lecturer, School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Victoria, Australia Accepted for publication: March 2012 621 Table 1. Eight vital signs Vital sign Physiology Influencing factors Temperature Controlled by Age
2.7 Monitoring physiological measurements it´s important to make sure the individual health status and also necessary after surgery, as patients in intensive care units require continuous monitoring, and sometimes have medications that requires physical measurements taken. These are measurements we take to ensure that they are functioning in the way they are supposed to. When we carry out physiological measurements, such as measuring temperature, pulse and respiration, we are monitoring for signs of abnormality. Then be able to draw conclusions about the health status of the individual and any treatments they may
2. Physiological state in defined as “the condition or state of the body or bodily functions”. This can be measured when we perform our observations. By measuring a patient’s respiratory rate, oxygen saturations, peak flow (in asthma patients), pulse rate, systolic and diastolic blood pressure, core temperature, blood sugar, pupil reaction and Glasgow coma scale. All these combined measurement can give us an insight into the patient’s health or Physiological state.
Articles discussing the accurate recordings of pediatric patient’s body temperature were cited in this article. A logical sequence is followed in the literature review. It begins with a general overview of the historical importance of accurately recording a patient’s body temperature. The authors get more specific and cite studies on temperature recording techniques in children. For instance, in justifying conflicting data, the researchers cite a similar study conducted on new born babies by Polit & Beck (2008), where the recordings from the two methods were
In the first step of the Tanner (2006) model nurses use their personal knowledge and experience to notice whether the patient requires attentions based on their expectations and looking at environment of the patient. Therefore, for an experience nurse it is easier for them responding to the similar situation if she or he revisit because the knowledge is already there through experience. In the case of Mr Devi, assessment will perform using systematic assessment based on the ABCDE approach (Airway, Breathing, circulation, Disability and Exposure). The ABCDE approach is an evidence-based practice widely accepted and used by all the members of a multidisciplinary team (MDT) to assess an acutely ill patient (Harrison and Daly 2011). First, life-threatening
The anesthetist assessed the patient’s vitals by comparing the values to what is normal and what was normal for the patient when it was measured at the beginning of anesthesia. The vitals were taken every 10 minutes with a blood gas analysis performed every 30 minutes to monitor the electrolytes. These parameters would not only help to maintain the patient at a surgical plane of anesthesia but also help the anesthetist maintain the patient at a steady state physiologically and metabolically. In addition, the patient’s potassium levels were specially monitored throughout the anesthesia due to his HYPP status. An arterial catheter would also be placed in the patient’s metatarsal artery for measurement of direct blood pressure and would also be used for blood collection for IRMA blood gas
Vital observations were carried out efficiently, they were recorded every 15 minutes and a cardiac monitor was attached to continuously monitor for any deterioration. As a student nurse I assisted by recording vital observations using NEWS and assessing consciousness by using the Glasgow coma scale to ensure there were no signs of brain trauma (Le Roux, Levine and Kofke, 2013). In line with the NMC, my mentor supervised and countersigned my observations (NMC, 2011b). I promoted good patient safety as deterioration would be recognised early and appropriate care provided. Throughout the treatment process I witnessed and provided person centred care. Nursing and medical staff continuously checked patient comfort and obtained consent for treatment being provided.
According to King Lester (1968 ), a symptom is a subjective term used to describe the manifestations of a disease while, vital signs are objective evidence of a disease. Based off of this definition, Annie’s signs and symptoms include blurred vision, head ache, gasping for air, feeling weak, feeling constant fatigue, and eyestrain. These signs or symptoms can be observed throughout the time Annie spends at the swim meet. Annie leaves the locker room and notices that her blurred vision and eyestrain that she had been experiencing over the past month had returned. She continued to exhibit health issues on her way leaving the building because she had felt the need to gasp for air while walking up the stairs. This abnormal amount fatigue she had felt from walking up the stairs, concerned Annie enough to consider getting her signs and symptoms checked out. Annie continued to exhibit signs and symptoms when she got back to her dorm and had a difficult time keeping her eyes open which indicates that she is exhibiting eyestrains.
With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations:
The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT
Vital signs are a fundamental component of nursing care and indicate the body’s ability to maintain blood flow, regulate temperature and regulate oxygenate the body tissue. Taking vital signs are essential in revealing any sudden changes in the body, which could potentially indicate clinical deterioration of the patient.
This essay aims to provide a discussion of vital signs and how they are relevant to contemporary nursing practice. This is done by;
The issue of consistency is raised when discussing how to ensure assessments are comprehensive, complete and that the data is recorded using the same guidelines as other nurses. To enable consistency of assessment, the same nurse should be taking the observations of a patient for the duration of a shift (Moore, 2007). This ensure that the interpretation of results don’t differ each time the vital signs are done. It also allows the nurse to detect subtle changes in the patients state that may not have been written down. For example, in most clinical environments the respiration rate is recorded as just a number, and the rhythm, degree of effort, quality of breathing and evidence of wheezing or other abnormal breathing sounds are not recorded. The rate may stay the same over a period of time while other aspects of respiration may change, and this is something that a nurse is more likely to notice if they have assessed that patient before. During handover, a nurse should tell the next nurse looking after their patients how they took observations and detail what tools they used to ensure consistency is maintained.
The normal capillary refill time is less than 2 seconds, anything over indicates reduced skin perfusion. Ask the patient if they have any chest pain, if so begin a ECG monitoring. Take the patients temperature. The normal range for this is 36-37.5 degrees Celsius. A high temperature can be a sign of infection. The doctor may also like to re-take the patient’s Arterial Blood Gas (ABG) because previous results showed respiratory acidosis.
As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.
Vital signs are measurements of the body’s most basic functions. They are very useful in detecting and monitoring medical problems. There are five main types of vital signs which are temperature, pulse, respiration, blood pressure, and pain. They can be measured in a medical setting, at home, at the site of a medical emergency, or elsewhere.