Vital Signs Taking

RESPIRATION AND BLOOD PRESSURE

RESPIRATION– act of breathing

• 3 Processes
• Ventilation - movement of gases in and
out of the lung
• Diffusion - exchange of gases from an
area of higher pressure to an area of lower
pressure
• Perfusion - the availability and
movement of blood for transport of gases,
nutrients and metabolic waste products.
• 
Two Types Of Breathing:
• Costal (thoracic) – involves
movement of the chest.
• Diaphragmatic (Abdominal)
– involves movement
Respiratory Centers:
• Medulla Oblongata – primary center
• Pneumotaxic center – responsible
for the rhythmic quality of
breathing.
• Apneustic Center – responsible for
deep, prolonged inspiration
• 
Assessing respiration
• Procedure
• Position client.
• Place client’s arm in relaxed position across
abdomen or lower chest, or place hand directly
over client’s upper abdomen
• Observe complete respiratory cycle.
• After cycle is observed, look at watch’s hand
and begin to count
TAKE NOTE!
• Rate – normal:16-20 cycles/min
• (adult); 30-60 cycles per min (newborn)
• If BP is elevated – the RR becomes slow
• If BP is decreased – RR becomes rapid
• Depth – observe the movement of the chest
• may be normal, deep or shallow
• Rhythm – observe for regularity of
exhalations and inhalations
• Quality or character – refers to
respiratory effort and sound of breathing
• 
Major Factors Affecting RR:

A. Exercise – increases RR
B. Stress – increases RR
C. Environment – increase temp. –
decreases RR
D. decreased temperature –
increases RR
E. Increased altitude – increases RR
TERMINOLOGIES:
• Eupnea- normal respiration that is quiet,
rhythmic, effortless
• Tachypnea- rapid respiration marked by
quick, shallow breaths.
• Bradypnea -slow breathing
• Hyperventilation- prolonged and deep
breaths . carbon dioxide is excessively exhaled.
• Hypoventilation- slow shallow respiration.
• Dyspnea- difficult and labored breathing.
• Orthopnea- ability to breath only in upright
position.
• 
BLOOD PRESSURE:
is a measure of the pressure exerted by the blood as it
pulsates through the arteries.

• Systolic pressure – pressure of blood as a

result of contraction of the ventricles
• Diastolic pressure- the pressure when
the ventricles are at rest (60-90 mmHg)
• Pulse pressure – the difference between
systolic and diastolic pressure (normal: 30-
40 mmHg)
Factors affecting BP:

• Age – older people have higher BP due to decreased

elasticity of blood vessels.
• Exercise – increases cardiac output, hence the BP.
• Stress – Sympathetic nervous system
• Race – hypertension is one of the 10 leading causes of
death among Filipinos.
• Obesity – BP is generally elevated among overweight and
obese people.
• Sex/Gender
• Medications – some medications can increase or decrease
BP.
• Diurnal variations – BP is lowest in the morning and
highest in the late afternoon or early evening.
• Disease Process – DM, renal failure, hyperthyroidism
cause increase in BP.
Assessing BP

• Procedure:
1. Ensure the client is rested
2. Allow 30 minutes to pass if the client had smoked or
ingested caffeine before taking the BP
3. Use appropriate size of BP cuff
4. Position the patient in sitting or supine position
5. Apply BP cuff snugly, 1 inch (2.5 cm) above the
antecubital space
6. Use the bell shaped diaphragm of the stethoscope
since the BP is a low-frequency sound
7. Inflate deflate the cuff slowly, 2-3 mmHg at a time
8. Wait 1-2 mins before making further determinations
9. Document readings.
Classification of blood pressure for adults

Blood Pressure SBP DPB

Classification mmHg mmHg

Hypotension <90 <60

Normal 90- 120 Less than 80

Elevated 120–129 Less than 80

Stage 1 130-139 80-89

Hypertension
Stage 2 ≥140 ≥90
Hypertension
Hypertensive Crisis >180 >120
Teacher’s Insight
• Vital signs reflect essential body functions,
including your heartbeat, breathing rate,
temperature, and blood pressure. Your health
care provider may watch, measure, or monitor
your vital signs to check your level of physical
functioning. Vital signs are useful in detecting
or monitoring medical problems. Vital signs
can be measured in a medical setting, at home,
at the site of a medical emergency, or
elsewhere.
• Recommended by American Heart Association
• Flipped Classroom: For additional
reference, you can click the actual video for
vital signs
monitoring.Https://Www.Youtube.Com/
Watch?V=Guwj-6nl5-8