FUNDA-LEC
TOPIC: VITAL SIGNS
Time to Assess Vital Signs:
1. Upon admission.
2. Change in health status of the client.
3. Before and after surgery or an
invasive procedure.
4. Before and or after the administration
of a medication.
5. Before and after any nursing
intervention that could affect the vital
signs.
I. ASSESSING BODY TEMPERATURE
- Body temperature is the difference
between the amount of heat produced
by the body and the amount of heat
lost to the environment, measured in
degrees. There are individual variations
of these temperatures as well as
normal changes during the day, with
core body temperatures being lowest in
the early morning and highest in the
late afternoon (Porth & Matfin, 2009).
Core Body vs Surface Body Temperature
Factors Affecting heat production:
1. Basal Metabolic Rate (BMR)
2. Muscle Activity
3. Thyroxine output
4. Epinephrine and sympathetic
stimulation
5. Fever
Heat Loss
1. Radiation - Transfer of heat from the
surface of one object to the surface of
another without contact between the
two objects.
2. Conduction - Transfer of heat from one
molecule to a molecule of lower
temperature.
3. Convection - Dispersion of heat by air
currents
4. Evaporation - Continuous vaporization
of moisture from the respiratory tract
and from the mucosa of the mouth and
from the skin.
Regulation of Body Temperature
1. Shivering increases heat production.
2. Sweating is inhibited to decrease heat
loss.
3. Vasoconstriction decreases heat loss.
Factors Affecting Body Temperature
1. Age
2. Gender
3. Diurnal variation
4. Exercise
5. Stress
6. Environment
Alterations in Body Temperature
- Pyrexia: A body temperature above the
usual range is called pyrexia,
hyperthermia, or (in lay terms) fever.
- A very high temperature, e.g. 41C° (105
°F) is called hyperpyrexia.
Common Types of Fever
1. Intermittent - During this type of fever,
the body temperature alternates at
regular intervals between periods of
fever and periods of normal
temperatures.
2. Remittent - During this type of fever, a
wide range of temperature fluctuations
occurs over the 24 hour period, all of
which are above normal.
3. Relapsing - In a relapsing fever, short
febrile periods of a few days are
interspersed with periods of 1 or 2 days
of normal temperature.
4. Constant - constant fever, the body
temperature fluctuates minimally but
always remains elevated.
Clinical Manifestation of Fever
1. Onset
2. Course (Plateau Phase)
3. Defervescence (Fever Abatement/Flush
Phase)
