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TEMPERATURE, PULSE
AND RESPIRARTION

By- Ashish Noel
M.Sc. Nursing ( Paed)

The purposes for assessment of vital signs are :-
To assess the normal functioning of vital organs.
To assess the condition and progress made by the
patient.
To help in formulation of diagnosis, and assessment of
deviations in the physiological adaptation like –blood
depletion, over and under consumption of oxygen.
To assess the emotional status of the patient

The indications of vital signs are as fallows:-
 On admission.
 Any deviation in the health status.
 Before and after surgical procedure.
 Before and after invasive diagnostic procedure.
 Before and after administration of any drug.
 As a routine procedure to assess the health status of
the admitted patient

TYPES OF TEMPERATURE
 CORE TEMPERATURE- it is the temperature of the
deep tissues of the body. E.g. cranium
thorax, abdominal and pelvic cavity. It is 37 degree c.

 SURFACE TEMPERATURE-it is the temperature of the
skin, subcutaneous tissue and fat it can vary according
to environmental temperature

REGULATION OF BODY
TEMPERATURE
It is regulated due to three phenomena.
 Neural control- hypothalamus is the main organ which
controls body temperature. impulses from hypothalamus
causes vaso dilatation and vaso constriction. This can also
be explained by following sub points.
 Thermo genesis – it means chemical regulation
by production of heat in following ways

• Oxidation of food.
• Muscles activity.
• Hormonal effect.
• Sympathetic stimulation.

 Thermolysis – it means regulation of body
temperature by heat loss .the heat is lost from the
body in following ways.
 Radiation.
 Conduction.
 Convection.
 Evaporation.
 Some amount of heat is also lost from the
body through lungs, kidney and bowels.

 Behavioral control- it involves the various act which
a person uses to maintain a comfortable body
temperature.e.g. changing clothing , sitting with arms
folded, turning of the fan , taking cold showers etc.

 NORMAL TEMPERATURE-
In an healthy individual the body temperature
may vary between 97-99 degree f. the temperature
may slightly vary according to the site from where
it is taken.
 Oral temperature- 98.6of
 Rectal temperature- 99.6of
 Axillary temperature- 97.6of

Factors affecting temperature
variation.
1.Age.
2.Exercise.
3.Hormonal level.
4.Circadian rhythms.

PYREX IA
PYREXIA CAN BE DEFINED AS
RISE IN BODY TEMPERATURE
ABOVE NORMAL(99.6-99 o F).

STAGES OF PYREXIA
1. ONSET OR INVASION.
2. FASTIGIUM OR
STADIUM.
3. DEFERVESCENCE OR
DECLINE.

TYPRS OF FEVER OR PYREXIA.
INTERMITTENT.
REMITTENT.
CONSTANT.
RELAPSING.
CRISIS.
LYSIS.

RANGES OF PYREXIA.
1. HYPOTHERMIA- BELOW95 0 F.
2. SUBNORMAL TEMPERATURE_ 95-98 0 F.
3. LOW PYREXIA –N 99-100 o F.
4. MODERATE PYREXIA – 100-103 o F.
5. HIGH PYREXIA- 103-105 o F.
6. HYPER PYREXIA – 105 o F AND ABOVE.

A DVA N TA G E S -
 Most reliable.

D I S A DVA N TA G E -
 Needs privacy.
 Needs lubrication.
 False if rectum is loaded.
 In newborns it may lead to ulceration or perforation.
 Not recommended by WHO as it causes damage and ulceration
to rectal mucus membrane.

C O N T R A I N D I C AT I O N S -
 Rectal surgery, hemorrhoids.
 Tumor and infection.
 Traction patient.
 WHO recommendations.

CONVERSION
To convert Fahrenheit in to Celsius:
C = (F-32) X 5/9

To convert Celsius to Fahrenheit:
F = (C X 9/5) + 32

PULSE
PULSE- pulse can be defined
as the alternate expansion
and recoil of the arteries due
to activity of the left
ventricles

CHARACTERISTICS
Pulse may have characteristics of:-
 Rate ,
 Rhythm,
 Volume,
 Tension and
Equality.

RATE
Rate is the number of beats per minute. it can range
from 70-80 beats per minute.
Common variation are:-
 Tachycardia- pulse rate above 100 beats/ min.
 Bradycardia- pulse rate below 60 beats / min.

 Age, Sex , Exercise.
 Pain, Anxiety.
 Medication, Metabolism.
 Hemorrhage.
 Position.

RHYTHM
It is the pattern of pulse and pause between
them.

The variation due to rhythm are:-
 Intermittent- occasionally missed pulse.
 Irregular- variation in frequency.
 Extra systole- premature contraction.
 Sinus arrhythmia - pulse is rapid during inspiration
and slow during expiration.
 Dicrotic pulse – sensation of double beat.

VOLUME
It refers to fullness of artery which
reflects the force of ventricular
contraction.
The variations due to volume are as fallows:-
 Absent pulse- no pulsation is felt extreme pressure.
 Water hammer pulse – it is a full volume pulse which
rapidly collapses due to aortic regurgitation.
 Bounding – strong pulsation which does not disappear
with moderate pressure.

 Thready – pulsation is not easily felt and
slightly pressure causes it to disappear.
 Weak pulse – it is stronger than thready
pulse .
 Pulses alternans – it has a regular rhythm
but with alternate , strong and weak volume.
 Bigeminal pulse – it is an irregular in which
every other beat comes early.
 Paradoxial pulse – pulse volume becomes
weak during inspiration.

TENSION AND EQUALITY
 Tension –
It is the degree of compressibility of
an artery.
 Equality –
Pulse on both sides should be
assessed , and compared the
characteristics of each side for equality.

SITES OF PULSE
The nine common sites of taking pulse are.
 Temporal.
 Carotid.
 Apical.
 Brachial.
 Radial.
 Femoral.
 Poplitial.
 Posterior tibial artery.
 Dorsalis pedis.

RESPIRATION
Respiration can be
defined as the act of
breathing.

CHARACTERISTICS OF RESPIRATION
 Rate – it is the number of full respiration per
minute.
 Depth of respiration – it can be assessed by
observing the movement in the chest wall in
informal respiration a person in hales about 500
ml of air and the diaphragm moves about 1 cm
down and ribs retract up wards about 1.2 to 2.5
cms.
 Rhythm – normal breathing is irregular and in
interrupted.

COMMON TERMS
 Bradypnea- rate of breathing less than 10 breaths/
min.
 Tachypnea- rate of breathing greater than 20/ min.
 Hyperpnea – inspiration are increased in depth
and rate.
 Apnoea – respiration ceases for several seconds.
 Hyperventilation – rate and depth of respiration
increases.
 Hypo ventilation – rate and depth decreases.

 Cheyne stroke respiration – respiration is irregular
, characterized by alternate periods of apnoea and
hyperventilation.
 Kussmaul’s respiration – respirations are abnormally
deep but regular, rate is increased.
 Dyspnoea – breathing is difficult and characterized by
increased effort ot exale and inhale.
 Orthopnea – patient has difficulty in breathing unless
in upright position.
 Biot’s respiration – condition of the central nervous
system causes shallow breathing interrupted by an
irregular period of apnea.

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