FUNDA RLE– PRELIMS
I. Vital Signs
- Traditional vital signs
a. Body temperature
b. Pulse
c. Respirations
d. Blood pressure
According to the Veterans
Administration, American Pain Society,
and the Joint Commission have Heat production- temperature rise
designated pain as the fifth vital sign. Heat loss- temperature fall
A. TEMPERATURE
- Normal temperature:
36 *C- 37.5 *C
- Fever 37.7 *C
-
- Reflects the balance between heat
produced and heat loss.
- Degrees- heat unit
2 types of temperature:
1. Core temp- Constant. (The
temperature of the deep tissues or
internal organs, such as the
abdominal and pelvic cavity, brain,
heart, liver, and blood) ● Factors that may alter core body
2. Surface temp- Body adopts that's temperature
why it changes (The temperature
of the skin, subcutaneous tissues Factors affect the body's heat
and fat.) production:
The basal metabolic rate (BMR) is the
Heat balance
rate of energy utilization in the body
- The body continually produces
heat as a by-product of required to maintain essential activities
metabolism. such as breathing.
The younger the person, the higher the
- Heat produced by the body equals BMR.
the amount of heat lost, the person
is in heat balance means its - Muscle activity and fever- ↑
constant.
increases the metabolic rate.
- ↑ Increased thyroxine.
Epinephrine, norepinephrine,
and sympathetic
stimulation/stress response. ↑
increase the rate of cellular
metabolism.
,Factors contributing to heat loss: Hypothalamic Integrator
● Radiation- Heat is transferred Controls the core temperature, located in
from the surface of one object to the preoptic area of the hypothalamus.
another surface without contact
between two objects through
• When the integrator detects heat, it
infrared radiation.
● Conduction– Heat is transferred sends out signals intended to reduce the
between objects that are in direct temperature (sweating & peripheral
contact. (one molecule to a vasodilation)
molecule of lower temp.) = ↓ heat production ↑ heat loss
● Convection- Heat is transferred
through the movement of air or • Cold sensors (shivering, &
water.
vasoconstriction)
● Evaporation- Continuous
vaporization of moisture from = ↑ heat production ↓ heat loss
respiratory tract, mouth and skin.
Factors affecting body temperature:
- Unnoticed water loss- 1. Age
“insensible water loss” 2. Diurnal variations (circadian
- Accompanying heat loss- rhythm)
“Insensible heat loss” 3. Exercise
4. Hormones
- ↑ body temp- ↑ greater heat loss 5. Stress
6. Environment
Alterations in body temperature
● Pyrexia- above usual range
(hyperthermia and fever)
● Hyperpyrexia- very high fever–
41 *C (105.8 *F)
● Febrile- has fever
● Afebrile- does not have a fever.
4 common types of fever:
1. Intermittent- regular intervals
between periods of fever and
normal.
Regulation of Body Temperature 2. Remittent- temperature fluctuates
3 Main Parts of System that regulates and increases by 2*C over 24
body temperature hours.
3. Relapsing- short febrile periods of
1. Sensors in the shell & in the core - skin
a few days are interspersed with
2. An integrator in the hypothalamus periods of 1 or 2 days or normal
3. An effector system that adjusts the temp.
production & loss of heat 4. Constant- fluctuates minimally but
always above normal.
Sensory receptors- skin. The skin has ● FEVER SPIKE- rises to fever level
more receptors for cold than warmth. rapidly following a normal
temperature and then returns to
normal within a few hours–
seizure.
, Heat exhaustion is less severe than heat 4. Rectal- most accurate
stroke.
Additional: Forehead- temporal artery
measurement, this method is the second
most accurate.
PARTS OF THERMOMETER
TYPES OF THERMOMETER
Clinical Manifestations of Fever Mercury in glass thermometers
ONSET (COLD OR CHILL PHASE) - Glass tube
The beginning of the fever. You might Electronic thermometer
experience chills, shivering, and general - Provide a reading in 2 to 60
discomfort. seconds. Consists of probe, and
base.
COURSE (PLATEAU PHASE) Chemical disposable thermometer
The duration of the fever. It's the period of - Have liquid crystal dots or bars that
time your body temperature remains change color to indicate
elevated. Depending on the cause of the temperature.
fever and how your body responds. Temperature-sensitive tape
- Obtain general indication of body
DEFERVESCENCE (FEVER surface temperature.
ABATEMENT/FLUSH PHASE) Infrared thermometer
The resolution of the fever. It's the point - Sense body heat in the form of
when your body temperature starts to infrared energy given off by heat
decrease and returns to normal. source (ear canal)
Temporal artery thermometers
HYPOTHERMIA - Scanning infrared in the temporal
• core body temperature below the lower artery of the forehead.
limit of normal
• 3 Physiologic Mechanisms: Temperature scale
1. Excessive heat loss. Fahrenheit to Celsius
2. Inadequate heat production to °C = (°F - 32) × 5/9
counteract heat loss.
3. Impaired hypothalamic Celsius to Fahrenheit
thermoregulation. °F = °C × (9/5) + 32.
B. PULSE
Site and method most appropriate for
A wave of blood created by contraction of
measurement
the left ventricle of the heart
1. Oral- most accessible
2. Tympanic membrane- ear, easy
Compliance of the arteries- is their
access.
ability to contract & expand.
3. Axillary- easy access
I. Vital Signs
- Traditional vital signs
a. Body temperature
b. Pulse
c. Respirations
d. Blood pressure
According to the Veterans
Administration, American Pain Society,
and the Joint Commission have Heat production- temperature rise
designated pain as the fifth vital sign. Heat loss- temperature fall
A. TEMPERATURE
- Normal temperature:
36 *C- 37.5 *C
- Fever 37.7 *C
-
- Reflects the balance between heat
produced and heat loss.
- Degrees- heat unit
2 types of temperature:
1. Core temp- Constant. (The
temperature of the deep tissues or
internal organs, such as the
abdominal and pelvic cavity, brain,
heart, liver, and blood) ● Factors that may alter core body
2. Surface temp- Body adopts that's temperature
why it changes (The temperature
of the skin, subcutaneous tissues Factors affect the body's heat
and fat.) production:
The basal metabolic rate (BMR) is the
Heat balance
rate of energy utilization in the body
- The body continually produces
heat as a by-product of required to maintain essential activities
metabolism. such as breathing.
The younger the person, the higher the
- Heat produced by the body equals BMR.
the amount of heat lost, the person
is in heat balance means its - Muscle activity and fever- ↑
constant.
increases the metabolic rate.
- ↑ Increased thyroxine.
Epinephrine, norepinephrine,
and sympathetic
stimulation/stress response. ↑
increase the rate of cellular
metabolism.
,Factors contributing to heat loss: Hypothalamic Integrator
● Radiation- Heat is transferred Controls the core temperature, located in
from the surface of one object to the preoptic area of the hypothalamus.
another surface without contact
between two objects through
• When the integrator detects heat, it
infrared radiation.
● Conduction– Heat is transferred sends out signals intended to reduce the
between objects that are in direct temperature (sweating & peripheral
contact. (one molecule to a vasodilation)
molecule of lower temp.) = ↓ heat production ↑ heat loss
● Convection- Heat is transferred
through the movement of air or • Cold sensors (shivering, &
water.
vasoconstriction)
● Evaporation- Continuous
vaporization of moisture from = ↑ heat production ↓ heat loss
respiratory tract, mouth and skin.
Factors affecting body temperature:
- Unnoticed water loss- 1. Age
“insensible water loss” 2. Diurnal variations (circadian
- Accompanying heat loss- rhythm)
“Insensible heat loss” 3. Exercise
4. Hormones
- ↑ body temp- ↑ greater heat loss 5. Stress
6. Environment
Alterations in body temperature
● Pyrexia- above usual range
(hyperthermia and fever)
● Hyperpyrexia- very high fever–
41 *C (105.8 *F)
● Febrile- has fever
● Afebrile- does not have a fever.
4 common types of fever:
1. Intermittent- regular intervals
between periods of fever and
normal.
Regulation of Body Temperature 2. Remittent- temperature fluctuates
3 Main Parts of System that regulates and increases by 2*C over 24
body temperature hours.
3. Relapsing- short febrile periods of
1. Sensors in the shell & in the core - skin
a few days are interspersed with
2. An integrator in the hypothalamus periods of 1 or 2 days or normal
3. An effector system that adjusts the temp.
production & loss of heat 4. Constant- fluctuates minimally but
always above normal.
Sensory receptors- skin. The skin has ● FEVER SPIKE- rises to fever level
more receptors for cold than warmth. rapidly following a normal
temperature and then returns to
normal within a few hours–
seizure.
, Heat exhaustion is less severe than heat 4. Rectal- most accurate
stroke.
Additional: Forehead- temporal artery
measurement, this method is the second
most accurate.
PARTS OF THERMOMETER
TYPES OF THERMOMETER
Clinical Manifestations of Fever Mercury in glass thermometers
ONSET (COLD OR CHILL PHASE) - Glass tube
The beginning of the fever. You might Electronic thermometer
experience chills, shivering, and general - Provide a reading in 2 to 60
discomfort. seconds. Consists of probe, and
base.
COURSE (PLATEAU PHASE) Chemical disposable thermometer
The duration of the fever. It's the period of - Have liquid crystal dots or bars that
time your body temperature remains change color to indicate
elevated. Depending on the cause of the temperature.
fever and how your body responds. Temperature-sensitive tape
- Obtain general indication of body
DEFERVESCENCE (FEVER surface temperature.
ABATEMENT/FLUSH PHASE) Infrared thermometer
The resolution of the fever. It's the point - Sense body heat in the form of
when your body temperature starts to infrared energy given off by heat
decrease and returns to normal. source (ear canal)
Temporal artery thermometers
HYPOTHERMIA - Scanning infrared in the temporal
• core body temperature below the lower artery of the forehead.
limit of normal
• 3 Physiologic Mechanisms: Temperature scale
1. Excessive heat loss. Fahrenheit to Celsius
2. Inadequate heat production to °C = (°F - 32) × 5/9
counteract heat loss.
3. Impaired hypothalamic Celsius to Fahrenheit
thermoregulation. °F = °C × (9/5) + 32.
B. PULSE
Site and method most appropriate for
A wave of blood created by contraction of
measurement
the left ventricle of the heart
1. Oral- most accessible
2. Tympanic membrane- ear, easy
Compliance of the arteries- is their
access.
ability to contract & expand.
3. Axillary- easy access
