vital signs part 2 gnm vital signs

1. Thermometer.
Thermoreferstotemperature.
Meterrefersto the instrumentwhichisusedtomeasure anything.
Here thermometermeansthe instrumentwhichisusedtomeasure temperature.
Types ofthermometer.
1.Glass thermometer
2. digital thermometer
3.electronicthermometer
4. infraredthermometer
5. chemical thermometer.
4.Infrared thermometer.
It isalso knownas tympanicmembrane thermometer.
Infraredthermometerisinsertedintothe earCanal,
probe containaninfraredsensorthatdetects thewarmthradiatingfromtympanicmembraneandconvert
the heat intotemperature measurementinto2to 5 second.

2. 5.Chemical thermometer.
chemical thermometerislike paperorplasticstrip.
Thisplasticstripcontainschemicallytreateddotslike greenorblue.
thisplasticstripisheatsensitive ,whentemperature of the bodyRisesabove the normal level thenwhite
stripis convertedintogreencolourorblue colourthatindicatestemperature israisedorabnormal.
3.electronicthermometer
Electroneicthermometerhasheatsensible probewhichmeasures the temperature.
After measurement of the temperature the electronic device beeps that suggest or alerts the nurse to
remove the probe andreadthe display.

3. 1.Glass thermometer
Glassthermometerisalsoknownasclinical thermometer.
Glassthermometermainlyhastwoparts.
1.bulbpart
2.stempart
bulb part.
Bulbpart has liquidMercurywhichisheatsensitivemetal.
Mercury is usedin thermometerbecause
o Mercury isheat sensitive.
o Mercury isnon stickto apparatus

4. o Mercury has Shinynature.
(Otherthanthe Mercury ,alcohol pentane ,taulene ,alsousedinbulbpart)
Shape ofthe bulb.
1.cylindrical shape
2.roundshape
Cylindrical shapedbulbispresentinoral oraxillarythermometer.
Roundshapedbulbispresentinrectal thermometer.
stem part.
Stempart of the thermometerhastwoimportantcomponents.
1.Capillarytube withmeasuringscale.
2. colour coding.

5. Blue colourcodingisusedinoral thermometer.
Redcolourcodingis usedinrectal thermometer.
Measuringscales.
To measure the temperature 3unitsare used.
1.degree celsius
2.degree Farenheat
3.kelvin.
On thermometerstemdegree Celsiusanddegree fahrenheitscale isused.
Degree celsius
minrange :- 35°c
max range :- 43.3°c
degree Farenheat.
minrange :- 95 °F
max range :- 110 °F
1 Degree Celsiusisequal to10 small boxes.
1 degree Fahrenheitis equal to5 small boxes.
°C = 5/9(F-32)

6. Cleaning of thermometer before procedure
 To clean thermometerdistilledwaterisused.
 Moist guaze piece isusedtocleanthe thermometer.
 Before takingthe temperature the thermometeriswipedfrombulbtostem.
Sitesusedto take the temperature.
1.Oral
2.Auxilla
3.Rectum
4.Tympanicmembrane
5.skinsurface
skin surface :
 Speciallychemical methodisusedtomeasure temperature fromskinsurface.
 All thermometersare usedtomeasure temperature fromskinsurface.
tympanic membrane
 Infraredraysthermometerortympanicmembranethermometerisusedtomeasuretemperature
fromtympanicmembrane.
Oral site.
Oral site ismostcommonlyusedsite for clinical thermometer.
Oral site isnot used in
1. paediatric,
2.Problemrelatedtosite.
3.Mouth breather.

7. 4.Conversionforseizure patients.
5.Psychiatricill patients.
6.Those patientswhodoesnotfollowthe instruction.
 Normal temperature is 37 degree Celsiusor98.6 degree fahrenheit.
 The thermometeriskeptinthe site for2 to 3 minutes.
 From oral site infectionchancesare more.
 The thermometeriskeptinthe site of sublingual paath.
 If the patient had the cold drinks or patient is smoked then temperature is takenfrom oral site
after15 to 30 minutes.
Auxillarysite
Axillarysite whichismostcommonlyusedsite fordigital thermometer.
Error may occur in axillarysite due to
1.moisture
2. hair or
3. placementerror.
 Normal temperature of the axillarysite is97.6 degree Fahrenheitor36.4 degree Celsius.
 The thermometeriskeptinthe site at leastfor5 minutes
 if the digital thermometerisusedthenkeptforlessthan1 minute.
Rectal site.
 Rectal site ismost reliablesite tomeasure the temperature.
 Rectall site ismostcommonlyusedinpaediatric.
The thermometerisinsertedin the rectum.
 For adult1.5 inches.
 For child1 inches.
Normal temperature of the rectal site is99.6 degree Fahrenheitor37.5 degreescelsius.

8. Rectal site is not used in
1.problemrelatedtothe site or
2. cardiovascularproblem.
Cleaningthe thermometerafter the procedure.
o Afterthe procedure the thermometerisfirstcleanedwithdrycottonorguaze piece
o Afterthe procedure thermometeriswipedfromstemtobulbinrotatingmanner.
o Afterthe dry cottonwipe the thermometeriscleanedwithsoapsolution.
o Thendisinfectantsolutionisused.
The disinfectantsolutionare
1. Dettol
2.savlon
3. lysol and
4.fairnol
Most commonly Dettol solutionis used.
The Dettol solutiondisinfectantratiois1:40
it meansthat1 ml of dettol in40 ml of water.
normal temperature
from
 Oral site - 98.6°F / 37°c
 auxiliarysite - 97.6°F / 36.4°c
 Rectal site - 99.6°F / 37.5° c
Abnormal temperature with reference tooral temperature.

9.  <95°F - Hypothermia
 95 - 98°F - Subnorml temperature
 98 - 98.6 - normal
 99 - 100 - mildfever
 100 -103 -moderate fever
 103 - 105 - severfever
 >105 - Hyperpyrexia [Feverisalsoknownas - Pyrexia]
Stages of fever.
There are mainlythree stagesof fever.
1.Onsetor invasionstage.
2.FastigiumorStadiumstage
3.Defervisence ordeclinestage.
1.Onset or invasionstage.
 Bodytemperature startto rise
 Shiveringalsopresent
 patientsfeel cold
 so thisisalsocalledas coldstage
2.Fastigium or Stadium stage
 maximumtemperaturesreachesandremains
 patientsfeel heat
 so itis alsocalledhotstage
3.Defervisence ordecline stage.
 temperature starttodecline tonormal
 sweatingMaypresent
 so itis calledsweatingstage

10. Types offeverbased on its pattern.
1.ContinuousFever.
definition:
Continuousfeverisatype or patternof feverinwhichtemperature does nottouchthe baseline and
remainsabove normal throughoutthe day.
[Here temperaturestartsto rise fromits normaltemperatureand reachesits peaklevel , than the
temperaturedeclinesto normal.]
2.Intermittentfever.
definition
Intermittentfeverisatype or patternof feverinwhichthere isan interval where temperatureis
elevatedforseveral hoursfollowedbyaninterval whentemperature dropsbacktonormal.
[Here temperaturestartsto rise fromnormaltemperature.
Aftersometimethe temperaturefall down to its normal.
Again nextday at sametime the temperaturerisesto peaklevel and comesto normal.
The temperaturerise and fall occur in sameday only.]
3.Remittentfever.
definition
Remittentfeverisdefinedasfeverwithdaily fluctuationsexceeding2°C but at no time touchesnormal
[38].
[Cleartemperaturestartto rise fromits normaltemperature.

11. Then thetemperatureis called on notmore than 2 degree Celsius.
Here temperaturedoesnotmeetsthe its normaltemperature. ]
4.RelapsingFever
definition
a variable acute epidemicdisease thatismarkedbyrecurringhighfeverusuallylastingthree toseven
days
[Here temperaturerise and fall occursfor a variable perod.
2 to 3 daystemperaturerises.
Again to 2-3 dayspatientfeels normal.]
5.Inverse Fever
definition
A conditioninwhichthe bodytemperature ishigherinthe morningthaninthe evening.
[Normalpersonshavetemperature low in the morning and temperature high in theevening.
If the person havehigh temperaturein the morning and low temperaturein the evening thisis called
inverse fever.]