How to Check Vital Signs | Checking Vitals Nursing Assessment

Summary

In this educational video, Sarah from registernurseRN.com demonstrates how to check the six vital signs: pain, oxygen saturation, temperature, heart rate, respirations, and blood pressure. She emphasizes the importance of hand hygiene, patient privacy, and clear communication. Sarah explains the process of assessing pain, measuring temperature using an oral thermometer, checking oxygen saturation with a pulse oximeter, and counting heart rate and respirations together for accuracy. She also covers the proper technique for manually measuring blood pressure using a sphygmomanometer and stethoscope, ensuring the correct cuff size and placement. The video concludes with a reminder to inform patients of their vital signs and maintain hygiene.

Takeaways

• 🧼 Start with hand hygiene and ensure patient privacy.
• 🌡️ Pain assessment is the first vital sign to check, using a scale of 0-10.
• 🔍 Ask about the quality and location of pain if present.
• 🌡️ Temperature can be measured in various ways, with oral being common for adults.
• 🩺 Be aware of temperature variations depending on the measurement site.
• 🫁 Oxygen saturation is measured using a device on the fingernail bed, with normal levels being 95% to 100%.
• ❤️ Heart rate and respirations are typically counted together for accuracy.
• 🔊 Use the radial artery to count the pulse, and count for 30 seconds if regular, or 1 minute if irregular.
• 🩸 Blood pressure is measured using a cuff, with the correct size and placement being crucial.
• 📊 Listen for the first and last Korotkoff sounds to determine systolic and diastolic pressures.
• 🗣️ Inform the patient of their vital signs after measurement and maintain hygiene practices.

Q & A

What are the six vital signs that Sarah discusses in the video?

The six vital signs Sarah discusses are pain, oxygen saturation, temperature, heart rate, respirations, and blood pressure.

How does Sarah instruct to assess a patient's pain level?

Sarah instructs to ask the patient to rate their pain on a scale of zero to 10, with zero being no pain and 10 being the worst pain they've ever experienced. She also asks about the quality and location of the pain.

What is the normal temperature range for an adult according to the video?

The normal temperature range for an adult is about 97°F to 99°F.

What are the different methods Sarah mentions for taking a patient's temperature?

Sarah mentions several methods for taking a temperature: orally, axillary, temporally, in the ear (tympanic), and rectally.

How does Sarah demonstrate measuring oxygen saturation and what is the normal range?

Sarah demonstrates measuring oxygen saturation by placing a device on the nail bed of the finger. The normal oxygen saturation range is 95% to 100%.

What is the normal pulse rate for an adult as stated in the video?

The normal pulse rate for an adult is 60 to 100 beats per minute.

How does Sarah suggest counting the heart rate and respirations together?

Sarah suggests counting the heart rate for 30 seconds if it's regular, and then counting the respirations for the next 30 seconds by observing the rise and fall of the chest.

What is the correct placement for the blood pressure cuff according to the video?

The blood pressure cuff should be placed with the arrow about 1 to 2 inches above the brachial artery, which is located in the bend of the arm.

How does Sarah describe the process of manually obtaining blood pressure?

Sarah describes the process of manually obtaining blood pressure by palpating the brachial artery, inflating the cuff to 180 to 200 mmHg, and then slowly releasing the pressure while listening for the first and last sounds with a stethoscope.

What is the normal blood pressure reading Sarah gets for the patient in the video?

The normal blood pressure reading Sarah gets for the patient is 114 over 65.

What is the importance of hand hygiene and privacy as mentioned by Sarah before starting the vital signs check?

Sarah emphasizes the importance of hand hygiene to prevent infection and providing privacy to the patient to ensure their comfort and respect their personal space before starting the vital signs check.