Robin has arrived in an outpatient physical therapy clinic for evaluation of left knee pain. She plays recreational soccer in a competitive city-sponsored league and reports that three days ago she was playing in a game when she “got tangled up” with another player going for the ball. In addition to feeling a twist of the left knee, Robin states that the opposing player hit her left knee with the spikes on the shoe. Upon visual examination, the left knee looks swollen and has areas of redness where the spikes made contact with the knee. The knee feels warm to the touch. Robin is sweating mildly and reports feeling a little hot. Are measurements of vital signs indicated as part of Robin's examination? If so, which would you measure and why? Why not the others? What do you expect Robin's vital sign findings to be?
Vital signs provide critical information regarding a patient's current or changing physiological status. Because they are measures of the body's core ability to stay alive—breathing, pumping blood through the heart, and maintaining a core temperature in which the heart and brain can survive—they are often referred to as vitals. They are signs because they can be observed and/or measured by health-care professionals. A sign is an observable, objective measure that can often be quantified by using valid and reliable measurement instruments. A sign is different from a symptom, which is how a person experiences a condition. When a person reports a symptom, the description is subjective and often difficult to measure directly (see Box 5-1).
Box 5-1 Examples of Symptoms and Signs |Favorite Table|Download (.pdf) Box 5-1 Examples of Symptoms and Signs
|Symptoms ||Signs |
|“I feel nauseated.” ||Patient has vomited twice. |
|“My knee hurts.” ||Patient's right knee is swollen and warm to the touch. |
|“I feel dizzy.” ||Patient is pale, respiration rate is 24 breaths/min and labored, pulse rate is 108 bpm, and blood pressure is 80/40 mm Hg. |
Four vital signs are internationally recognized and accepted in the medical community:
Three additional measurements that are not universally considered vital signs—pulse oximetry, pain scales, and perceived exertion ratings—are discussed in this chapter because of the valuable information they contribute to the understanding of a patient's physiological status. Among some populations, particularly geriatrics, the measure of self-selected gait speed can be considered a vital sign as well.1
Although a single vital sign can be assessed, vital signs are often taken together. Each aspect of vital sign assessment is intended to provide specific information about the patient, so individual patient situations will determine which vital signs you assess and how you use that information.
We may associate vital signs with more ...