Temperature, Pulse, and Respiration

Lesson Plan and Speaking Notes
Temperature, Pulse, and Respiration

Vital Signs
The three main vital signs we monitor are:
Temperature
Pulse rate
Respiration rate

Temperature

Normal body temperature can ranges from 97.8° F to 99° F, and varies depending on recent activity and food and fluid consumption.

Take the patients temperature at least ten minutes after:
Strenuous activity
Consumption of cold or warm beverages or food
Smoking

Fever

Fever is a temperature that is higher than normal for each individual. It is important to know the patient's normal or baseline temperature, so a comparison can be made.

Fever generally indicates infection or illness. Any degree of fever should be reported, since some illnesses may cause a low-grade fever.

A fever is considered when the following temperatures are recorded:
99.5° or higher measured orally
99° or higher measured axillary
100.4° or higher rectally

Types of Thermometers

Because of the risk of breaking, glass thermometers are no longer recommended because of concerns about possible mercury exposure. Mercury is a toxic substance.

A digital thermometer is more accurate than the plastic strip types.

Most digital thermometers have thermometer covers, and these should be used to prevent cross-infection.

Oral Temperature

Insert the thermometer under the tongue. Wait for the thermometer to beep.

When would an oral temperature be unsafe or unreliable?

Unable to hold thermometer in mouth

Danger of clamping teeth down on glass thermometer (confusion, uncontrolled body movements, seizures)

Mouth breather

Rectal Temperature

0.5-0.7° higher than oral

Cover the tip of the digital thermometer with Vaseline.

Gently insert the thermometer to about 1 inch.

Stop if any resistance is felt.

Keep the thermometer in place by holding it between the fingers.

When the thermometer beeps, gently remove it.

Axillary Temperature

0.3-0.4° lower than oral

Place the thermometer in the armpit.

Fold the arm down to cover the thermometer.

Have the students take each others' temperatures with an oral digital thermometer. Observe for and correct any mistakes in technique.

Pulse Rate
The pulse rate measures the number of times the heart beats per minute.
The heart pushes blood through the arteries, which expand and contract with the flow of blood.
The normal pulse rate for adults ranges from 60-100 beats per minute.
The pulse rate may vary with exercise, illness, and stress.

Take the pulse by placing your first and second fingertips, firmly but gently on the artery located on the outside of the patient's wrist on the thumb side.

Demonstrate this. Ask the class to follow by taking their own pulses.

Can everyone feel the pulse?

Count the pulse by using a watch with a second hand.
When the second hand is on 12, count the pulse for a full 60 seconds until the second hand reaches 12 again.
Also observe for any irregularities of rhythm and the strength of the pulse.

Have the students take each others' pulse rates.
Observe for and correct any mistakes in technique.

Respiration Rate

The respiration rate is the number of breaths a person takes per minute.

Normal respiration rates for an adult ranges from 15-20 breaths per minute.

Respiration rates over 25 breaths per minute or under 12 breaths per minute are abnormal.

The respiration rate should be measured when the patient is at rest in a chair or in bed.

Count the number of breaths for one minute by counting how many times the chest rises.

Respiration rates may increase with fever, illness, activity, or stress.

Also observe for shortness of breath, cough, and difficulty breathing.

Have the students take each others' respiratory rates.
Observe for and correct any mistakes in technique.