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Figure 7.1 Measurement of blood pressure is done by a trained medical professional using a stethoscope and sphygmomanometer, or with an automated blood pressure machine. Accurately performing, effectively analyzing, and routinely monitoring a patient’s vital signs are key components of nursing care. (credit: “Blood Pressure Monitoring” by NIH Clinical Center/Flickr, CC BY 2.0)

Introduction

Vital signs are gathered during an initial encounter with a patient to establish a baseline, and routinely thereafter, according to condition, to assess disease progression or resolution. When vital signs are abnormal, a patient’s plan of care is typically altered. When vital signs are taken routinely, the healthcare team can analyze them to observe the response to treatments or disease progression. The combination of multiple vital sign measurements over a period of time also provides the typical and normal range for an individual patient. These individualized ranges are called vital sign trends. Vital signs provide a snapshot of the circulatory, respiratory, and neurological status of the patient.

At the same time, vital signs are only one piece of the patient’s health. While there is a normal and abnormal range for each vital sign, there is some variability between individual peoples’ baseline vital signs. For example, an athletic patient with a heart rate of 58 beats per minute and a blood pressure of 90/54 mm Hg may be numerically concerning; however, the reading may be normal for that patient, since the cardiovascular system of an athlete is more efficient than that of a person who is not as physically active. Conversely, a patient who lives a largely sedentary life who presents with this heart rate and blood pressure may not have as efficient a cardiovascular system and may feel symptomatic (presenting with dizziness, lightheadedness, weakness, and/or confusion); therefore, the lower numbers must be addressed.

This chapter discusses each vital sign and its relationship to the overall homeostatic balance of our bodies, how to measure each vital sign accurately, and how to identify ways to teach patients to assess and analyze their own vital signs.

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