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LEARNING OBJECTIVES

LEARNING OBJECTIVES

  1. Discuss the rationale for including vital sign measures in the patient examination.

  2. Explain the relevance of vital signs data to developing a diagnosis, determining the prognosis, and establishing a plan of care.

  3. Recognize the importance of vital signs data in determining physiological response to treatment and evaluating patient progress.

  4. Describe the procedure for monitoring temperature, pulse, respiration, blood pressure, and oxygenation saturation (pulse oximetry).

  5. Differentiate between normal and abnormal values or ranges for each vital sign.

  6. Identify the normative variations in vital signs and the factors that influence these changes.

  7. Explain the rationale for using pulse oximetry in the presence of unstable oxygen saturation levels.

  8. Describe the recommended elements for documentation of vital signs data.

INTRODUCTION

Examination of body temperature, heart rate (HR), respiratory rate (RR), and blood pressure (BP) provides the physical therapist with important data about the status of the cardiovascular/pulmonary system. Owing to their importance as indicators of the body’s physiological status and response to physical activity, environmental conditions, and emotional stressors, they are collectively referred to as vital signs. Because many important clinical decisions are based in part on these measures, accuracy is essential.

The Guide to Physical Therapist Practice includes examination of vital signs (HR, RR, and BP) in the cardiovascular/pulmonary systems review and among the tests and measures used to characterize or quantify aerobic capacity/endurance, circulation (arterial, venous, lymphatic), and ventilation and respiration. Pulse oximetry is included among the tests and measures used for examination of ventilation and respiration and aerobic capacity/endurance.1 Although not considered a primary vital sign, pulse oximetry is an important related measure that provides information on arterial blood (hemoglobin) oxygen saturation levels. Pulse oximetry data allow the therapist to screen and monitor for hypoxemia—decreased oxygen concentrations of arterial blood. Hypoxemia is often associated with pulmonary disorders that impair ventilation of the lungs (e.g., pneumonia, chronic obstructive pulmonary disease [COPD], anemia, respiratory muscle weakness, and circulatory impairments).

Also referred to as cardinal signs, vital signs provide quantitative measures of the status of the cardiovascular/pulmonary system and reflect the function of internal organs. Variations in vital signs are a clear indicator that some change in the patient’s physiological status has occurred. Taken at rest and during and after exercise, these measures also provide important data on aerobic capacity and endurance. Together with other examination data, vital sign measures assist the physical therapist in making clinical judgments to do the following1:

  1. Determine the patient’s baseline status.

  2. Identify potential risk factors, suspected pathology, and impairments of body functions and structures.

  3. Develop the diagnosis, prognosis, and plan of care (POC).

  4. Periodically re-examine the patient throughout the episode of care to determine if outcome expectations are being met.

  5. Evaluate the effectiveness of interventions in achieving goals (intended impact on functioning) and outcomes (results of implementing POC that indicate the impact on functioning).

  6. Determine if ...

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