NUR 505 Module 3 Study Guide 2026 | Vital Signs, Pain Assessment, Mental
Status & Cognitive Screening Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 3 Vital Signs, Pain, and Mental Status Study Guide
Chapter 6 Vital Signs and Pain
1. Review the anatomy and physiology in your PPT and Textbook. What are some
differences between your specialty populations regarding vital signs and pain? Think
about the developmental stage and body changes that can occur in each of these
populations.
● Infants:
o Infants are more susceptible to hypothermia due to their large body surface
area for weight ratio, thinner skin, and inability to shiver and cope with cold
stress.
o Infants have a higher pulse and respiratory rate.
o Infants also gave a lower blood pressure than adults.
● Pregnancy:
o BP commonly decreases due to lowered systemic vascular resistance
beginning at about 8 weeks gestation, gradually falling until a low point is
reached at mod pregnancy.
o The diastolic value decreases more than systolic and gradually rises to
prepregnant levels by term. o HR will increase gradually throughout
pregnancy o Gestational Hypertension: 140/90 or higher o Severe HTN:
160/110 or higher (can indicate preeclampsia) o Labor Pain
o During pregnancy, some patients may experience pain due to several
physiologic processes:
• Back pain may be related to lax ligaments, weight gain, hyperlordosis, and
anterior tilt of the pelvis.
• Cramping or pressure may be signs of premature labor or Braxton Hicks
contractions (sporadic uterine contractions that start at around 6 weeks of
pregnancy).
• Pressure from the gravid uterus may cause epigastric pain.
• Round ligament pain may be due to the stretching of the ligaments by the
enlarging uterus.
• Pressure on the bladder may occur from the weight of the enlarging uterus.
● Elderly:
, o Some elderly people have an increased pain threshold or less pain tolerance
associated with peripheral neuropathies, thickened skin, or cognitive
impairment. o Heart rate may be lower due to increased vagal tone o SBP can
increase due to stiff blood vessels and increased vascular resistance o PAINAD
Pain Scale for Dementia (see next slide)
2. Know the proper steps of taking vital signs: o How do you take a pulse? What if it is an
irregular one?
▪ Count pulse for 60 seconds or (30seconds and x 2) o If an
irregular rhytm is noted you must count for 60 sec
▪ Average Pulse = 60 – 100 beats/min
▪ Tachycardia = greater than 100
▪ Bradycardia = less than 60
o How do you take respirations?
▪ Count the number of breaths (inspiration and expiration) that occur in
1 minute (or 30secs x 2)
▪ Normal RR = 12 – 20 breaths/min
▪ Normal Ratio to heart rate = 1:4
o What are normal vital signs (HR, BP, RR, Temp) in the infant,
child, and adult patient?
▪ Infant:
o Pulse – 200beats. Min
o RR – 40 – 60 breaths per minute but a rate up to 80 may be
noted and is normal. C-section babies have a rapid RR
o BP: 60-96 systolic over 30-62 diastolic.
, o Clinical Pearl for infants = A very ill baby can maintain a
“normal blood pressure” as hemodynamic instability
develops. Check the capillary refill, which is usually less than
2 seconds Capillary refill time prolonged 4 or more seconds is
an indication of poor perfusion, even when the blood
pressure seems normal. The lesson: both measurements are
needed to fully evaluate the infant.
▪ Child:
o Temp:
o Normal = 97.2 – 99.9 o Fever > 100.4 o 0-90 days old needs
immediate attention if fever o Older than 90 days with a
fever of 105 needs immediate attention
o Heart Rate:
o Less than 1 year = 128–130 o 1 year = 116–119 o 2–3 years
= 106–108 o 4–5 years = 94–97 o 6–11 years = 77–88
o 12–19 years = 72–80
o Respiratory Rate: o Newborn = 24–50 o 1 year = 20–40 o 3
years = 20–30 o 6 years = 16–22 o 10 years = 16–20 o 17
years = 12–20
o Blood Pressure:
o Blood pressure standards for children are provided by gender,
age, and height percentiles.
o Compare the reading to standards for normal blood pressure
(less than 90th percentile), prehypertension (90th to 95th
percentile), and hypertension (more than 95th percentile).
o After measuring the child’s height, determine the child’s
height percentile using the standard length or height growth
curve (see Appendix A in your book).
o Select the correct table for the child’s gender, and compare
the child’s systolic and diastolic blood pressure reading to
that expected for age and height percentile (see Appendix B
in your book). o The child’s systolic and diastolic blood
pressure values should be below the 90th percentile for age
and height percentile. o The diagnosis of HTN is made after 3
readings over several visits
Status & Cognitive Screening Exam Prep PDF | University of Alabama
The University of Alabama
Capstone College of Nursing
NUR 505 Advanced Health Assessment
Module 3 Vital Signs, Pain, and Mental Status Study Guide
Chapter 6 Vital Signs and Pain
1. Review the anatomy and physiology in your PPT and Textbook. What are some
differences between your specialty populations regarding vital signs and pain? Think
about the developmental stage and body changes that can occur in each of these
populations.
● Infants:
o Infants are more susceptible to hypothermia due to their large body surface
area for weight ratio, thinner skin, and inability to shiver and cope with cold
stress.
o Infants have a higher pulse and respiratory rate.
o Infants also gave a lower blood pressure than adults.
● Pregnancy:
o BP commonly decreases due to lowered systemic vascular resistance
beginning at about 8 weeks gestation, gradually falling until a low point is
reached at mod pregnancy.
o The diastolic value decreases more than systolic and gradually rises to
prepregnant levels by term. o HR will increase gradually throughout
pregnancy o Gestational Hypertension: 140/90 or higher o Severe HTN:
160/110 or higher (can indicate preeclampsia) o Labor Pain
o During pregnancy, some patients may experience pain due to several
physiologic processes:
• Back pain may be related to lax ligaments, weight gain, hyperlordosis, and
anterior tilt of the pelvis.
• Cramping or pressure may be signs of premature labor or Braxton Hicks
contractions (sporadic uterine contractions that start at around 6 weeks of
pregnancy).
• Pressure from the gravid uterus may cause epigastric pain.
• Round ligament pain may be due to the stretching of the ligaments by the
enlarging uterus.
• Pressure on the bladder may occur from the weight of the enlarging uterus.
● Elderly:
, o Some elderly people have an increased pain threshold or less pain tolerance
associated with peripheral neuropathies, thickened skin, or cognitive
impairment. o Heart rate may be lower due to increased vagal tone o SBP can
increase due to stiff blood vessels and increased vascular resistance o PAINAD
Pain Scale for Dementia (see next slide)
2. Know the proper steps of taking vital signs: o How do you take a pulse? What if it is an
irregular one?
▪ Count pulse for 60 seconds or (30seconds and x 2) o If an
irregular rhytm is noted you must count for 60 sec
▪ Average Pulse = 60 – 100 beats/min
▪ Tachycardia = greater than 100
▪ Bradycardia = less than 60
o How do you take respirations?
▪ Count the number of breaths (inspiration and expiration) that occur in
1 minute (or 30secs x 2)
▪ Normal RR = 12 – 20 breaths/min
▪ Normal Ratio to heart rate = 1:4
o What are normal vital signs (HR, BP, RR, Temp) in the infant,
child, and adult patient?
▪ Infant:
o Pulse – 200beats. Min
o RR – 40 – 60 breaths per minute but a rate up to 80 may be
noted and is normal. C-section babies have a rapid RR
o BP: 60-96 systolic over 30-62 diastolic.
, o Clinical Pearl for infants = A very ill baby can maintain a
“normal blood pressure” as hemodynamic instability
develops. Check the capillary refill, which is usually less than
2 seconds Capillary refill time prolonged 4 or more seconds is
an indication of poor perfusion, even when the blood
pressure seems normal. The lesson: both measurements are
needed to fully evaluate the infant.
▪ Child:
o Temp:
o Normal = 97.2 – 99.9 o Fever > 100.4 o 0-90 days old needs
immediate attention if fever o Older than 90 days with a
fever of 105 needs immediate attention
o Heart Rate:
o Less than 1 year = 128–130 o 1 year = 116–119 o 2–3 years
= 106–108 o 4–5 years = 94–97 o 6–11 years = 77–88
o 12–19 years = 72–80
o Respiratory Rate: o Newborn = 24–50 o 1 year = 20–40 o 3
years = 20–30 o 6 years = 16–22 o 10 years = 16–20 o 17
years = 12–20
o Blood Pressure:
o Blood pressure standards for children are provided by gender,
age, and height percentiles.
o Compare the reading to standards for normal blood pressure
(less than 90th percentile), prehypertension (90th to 95th
percentile), and hypertension (more than 95th percentile).
o After measuring the child’s height, determine the child’s
height percentile using the standard length or height growth
curve (see Appendix A in your book).
o Select the correct table for the child’s gender, and compare
the child’s systolic and diastolic blood pressure reading to
that expected for age and height percentile (see Appendix B
in your book). o The child’s systolic and diastolic blood
pressure values should be below the 90th percentile for age
and height percentile. o The diagnosis of HTN is made after 3
readings over several visits
