The document outlines the measurement and significance of vital signs: temperature, pulse, and respiration (TPR). It details how to measure each vital sign, their normal ranges, and classifications of abnormal findings. Additionally, it includes a procedure for taking vital signs and provides a case study example of vital sign monitoring.

1. TEMPERATURE, PULSE,
RESPIRATION (TPR)
EDGAR A. ULEP, RM, LPT, MSPH.
College of Midwifery
QSU Cabarroguis

2. TEMPERATURE
• The measurement of core body heat
• Heat is produced in the body by the muscles and glands
• Heat is lost from the body by respiration, perspiration and excretion

3. TEMPERATURE
• If the body temperature is within a normal range, it is afebrile.
• If the temperature is elevated, usually considered one degree over the
patient’s norm, it is febrile
• Temperature below normal, is called hypothermia
• Temperature above normal is called pyrexia

4. FEVER
• FEVER is not an illness. Actually, it is an important part of the body’s
defense against infection

5. ABNORMAL TEMPERATURES
• Fever – is greater than 37.5C
• High fever – anything over 39C
• Moderate Fever – 37.5C – 39C
• Hypothermia is subnormal temperature. This can be equally problematic for
a person. Anything under 35C

6. ROUTES/SITE TO MEASURE
TEMPERATURE
• ORAL – Mouth
• RECTAL – Rectum
• AXILLA – Armpit
• AURAL/TYMPANIC – Ear
• TEMPORAL - Forehead

7. TYPES OF THERMOMETERS
• DIGITAL ELECTRONIC – used fro oral, rectal and axilla
• THERMOSCAN-DIGITAL – used for tympanic & temporal
• MERCURY – used for oral, rectal and axilla

8. RULES TO FOLLOW
• Always hold the thermometer in place while measuring temperatures
• Red covering for rectal and blue for oral/axillary
• Always use lubricant with rectal temperatures
• Always remove clothing around axilla

9. PULSE
• The wave of blood created by the pumping, that travels along the arteries
• The pulse is caused by the pressure of the blood pushing against the wall of an
artery as the heart contracts and relaxes
• It is the throbbing of an artery as the human heart beats
• The pulse rate is an important vital signs because it indicates how well the blood is
circulating through the body
• When you check the pulse rate , you count the number of beats in 1 full minute
called BEATS PER MINUTE (bpm)

10. FINDING A PULSE
• At points where the artery is between finger tips and a bony area
• Called pulse points
• Felt with 2-3 fingers, but never the thumb

11. HOW TO MEASURE?
• Measured in beats per minute
• Count the waves for 1 full minute

12. QUALITY OF PULSE
• RHYTHM – regular or irregular
• RATE – within the normal limits
• STRENGTH – strong, bounding, thready

13. NORMS
• Normal pulse rate 60-100bpm
• TACHYCARDIA – faster than 100bpm
• BRADYCARDIA – slower than 60bpm
• ARRHYTHMIA – irregular pulse rate

14. PULSE RATE
• Pulse rate generally increases with exercise, emotional excitement,
hemorrhage, or elevated temperature
• Drugs can increase or decrease the heart rate

15. AFFECTING PULSE RATE AND QUALITY
• Fever
• Emotions
• Exercise
• Drugs
• Hypovolemia(blood loss)
• Age

16. RADIAL PULSE
Is the most common site for counting the pulse rate
Do not use your thumb to count a pulse because you have a pulse in your
thums

17. APICAL PULSE
• Pulse is counted at the APEX (pointed end) of the heart
• Count the apical heartbeat by placing stethoscope

18. RESPIRATION
• The mechanical act of breathing in air (inspiration) and expelling air (expiration) from
the body
• Is the process of taking oxygen into the body and expelling carbon dioxide from the
body
• One inspiration (breathing in) and one expiration (breathing out) are considered as one
respiration
• When you count a patient’s respiration, you do not want the patient to be aware of what
you are doing. If the patient realizes that you are counting respiration, he or she may not
breathe normally

19. RESPIRATION
• Measured in cycle per minute
• Normal range is 16-20cpm(Adult) / 40-40cpm(Infant)
• TACHYPNEA – above 20cpm
• BRADYPNEA – below 16cpm

20. RESPIRATION TERMS
• EUPNEA – normal breathing
• DYSPNEA – difficulty of breathing
• APNEA – absence of breathing
• HYPERPNEA – fast & deep breathing
• ORTHOPNEA – shortness of breath occurs while lying flat and is relieved
by sitting or standing

21. TPR CHART
a procedure of recording
Temperature, Pulse and
Respiration.

22. TPR
• Is a procedure to check temperature, pulse and respiration of a patient. It is
also known as checking vital signs when we include checking of blood
pressure in the procedure.

23. PREPARATION
• TPR tray should contain;
• thermometers
• Antiseptic solution
• Cotton
• Kidney basin
• Paper and TPR chart

24. PROCEDURES
• Explain the procedure to the patient or relative of the patient
• The patient should be in comfortable position preferably in lie down position
• Wash hands before starting the procedure
• Take out a thermometer and clean the thermometer from bulb to stem with cotton swab in circular motion
• Discard the swab in kidney tray
• Place the patient hand into her/his abdomen and count the radial pulse for one full minute
• While holding the radial pulse start counting respiratory rate in one (1) full minute
• After 2 minutes. Remove the thermometer and clean from stem to bulb
• Wash hands and record the temperature, pulse and respiration in patient’s TPR chart

25. EXERCISES

26. EXERCISE 1
• A 24 years old was admitted in the hospital due to labor pain. Upon
admission, assessment was done with BP- 110/80, PR- 88 bpm, RR- 21 cpm,
and a body temperature of 36.7°C at 01:58 am.
• At 6 am, vital signs were gathered with; BP-100/70, PR- 71bpm, RR-19 cpm,
and a body temperature of 37.2 degree Celsius.
• 10 am, VS done with: BP-110/70, PR- 79 bpm, RR-20 cpm, and a body
temperature of 36.2 degree Celsius.

27. EXERCISE 1
• 2 pm, VS done with: BP-100/70, PR- 87 bpm, RR-18 cpm, and a body
temperature of 37 degree Celsius.
• 6 pm, VS were gathered and are as follows: BP-100/70, PR- 92 bpm, RR-21
cpm, and a body temperature of 37.8 degree Celsius. Paracetamol given.
• 10 pm, VS are: BP 110/70 mmHg, PR-82 bpm, RR-20 cpm and a body
temperature of 37.2 degree Celsius.
• At 2 am, BP-100/70, PR- 73 bpm, RR-18 cpm, and a body temperature of
36.4 degree Celsius.

28. THANK YOU