LESSON 4
VITAL SIGNS
4-1.
INTRODUCTION
Soon after a patient arrives on the nursing unit you should begin your nursing
assessment. You should take several measurements to establish a baseline for further
observations of that patient. Among these measurements are height, weight, and vital
signs. The vital signs are the body temperature, the pulse or rate of heartbeats, the
respiration or rate of breathing, and the blood pressure. The vital signs are abbreviated
TPR and BP for temperature, pulse, respirations and blood pressure. These readings
are called vital signs because they all must be present for life to continue.
4-2.
HEIGHT AND WEIGHT
The patient's height and weight are recorded on admission for several reasons.
a. Diet Management. The patient's ideal weight may be determined. The
health care team will also be able to monitor weight loss or gain.
b. Observation of Medical Status. Taking the patient's height and weight may
indicate that the patient is overweight, underweight, or is retaining fluids (edema). The
health care team can observe changes in weight caused by specific disease processes
and determine the effectiveness of nutrition supplements prescribed to maintain weight.
c. Calculation of Medication Dosages. Drug dosage is often prescribed in
relation to a patient's weight when a specific blood concentration of the drug is desired.
Larger doses may be required in a heavier person.
4-3.
MEASURING HEIGHT AND WEIGHING THE PATIENT
a. To measure height, have the patient stand on the scale with the back to the
measuring bar.
b. Ask the patient to stand straight. Lower the bar so that it lightly touches the
top of the patient's head.
c. Record the height in inches or centimeters in accordance with local policy.
d. If the patient cannot stand, obtain an approximate height in bed.
(1)
Have the patient lie on his back and stretch as much as possible.
MD0906
4-3