Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android



Bruce has arrived in an outpatient therapy clinic for evaluation of left knee pain. He plays recreational soccer in a competitive city-sponsored league and report that 3 days ago, while playing in a game, he “got tangled up” with another player going for the ball. In addition to feeling a twist of the left knee, Bruce states that the opposing player hit his left knee with a spiked shoe. Bruce’s biggest complaint is difficulty with stairs, getting in and out of the shower, and putting on his shoes. Upon visual examination, the left knee looks swollen and has areas of redness. The knee feels warm to the touch. Bruce is sweating mildly and reports feeling a little hot.

Are measurements of vital signs indicated as part of Bruce’s examination?

If so, which would you measure and why?

What do you expect Bruce’s vital sign findings to be?

Are there vital signs you do not need to measure? If so, why not?

Assessing a patient’s physiological responses to activity, or lack of activity, is a critical part of promoting patient mobility. Physiological assessments provide information about patients’ overall health, their ability to tolerate the demands of increased mobility, and the effects of prolonged immobility.

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 or measured. 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 may be difficult to measure directly (see Box 5-1).

Box 5-1 Examples of Symptoms and Signs

|Download (.pdf)|Print



“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 (BP) is 80/40 mm Hg.

Four vital signs are internationally recognized and accepted in the healthcare community:

  • Pulse or heart rate (HR)

  • Blood pressure (BP)

  • Respiration

  • Temperature

Four additional measurements that are not universally considered vital signs—pulse oximetry, pain ratings, perceived exertion ratings, and gait speed—are also discussed in this chapter because of the valuable information they contribute to the understanding of a patient’s physiological status.

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 ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.