Copyright Goodheart-Willcox Co., Inc. Chapter 18 Vital Signs, Height, and Weight 455 The process of taking vital signs is essentially the same for children and adults however, the preferred method and normal ranges are different. For example, you may use a rectal thermometer to measure a newborn’s temperature, but an oral thermometer to measure the temperature of an adult. It can be challenging to keep children still long enough to obtain an accurate measurement. Vital signs are usually taken in a doctor’s office during an exam, during admission to a healthcare facility, or once a day in long-term care facilities (more frequently when necessary). A patient who is very ill in the hospital or who has had surgery may have vital signs taken hourly, often using vital sign machines. Vital signs may also be taken if a patient complains of dizziness, if a patient has nausea or pain, after a patient has an emergency, or before and after a patient takes certain medications. For each vital sign, well-established guidelines help nursing assistants determine whether adults and children are in a normal range. Facility guidelines impact how vital signs are recorded. Some facilities use paper forms for all residents on a shift and then transfer the measurements to each resident’s chart or EMR. Other facilities use a specific form for each resident or enter vital signs into a resident’s electronic record immediately. How Is Temperature Measured and Recorded? When you take a resident’s temperature, you are measuring body heat, including how much body heat is produced and lost. Temperature is recorded in degrees (°) and is measured using either the Fahrenheit or the Celsius scale. The Fahrenheit (F) scale is used mostly in the United States. In the Fahrenheit scale, water freezes at 32° and boils at 212°. The Celsius (C), or centigrade, scale is used in other parts of the world. In the Celsius scale, water freezes at 0° and boils at 100° (Figure 18.1). While a resident’s body temperature can change over the course of a day due to the dilation and expansion of blood vessels, pyrexia, or fever, is caused by the body heating up to protect itself. Pyrexia can signal an infection, some other disease process, an injury, or a possible reaction to a medication. Age can also affect temperature. An older person may not adjust as quickly to changes in temperature and may often express feelings of being cold. Body temperature is regulated by the hypo- thalamus, which is located in the brain. The hypo- thalamus is the body’s internal thermostat. It resets the body to a higher temperature when an infection or illness is present. As you learned in chapter 14, the heat generated defends the body against toxins, causing infection or illness. Culture Cues Anxiety About Vital Signs Taking vital signs may be a new or upsetting activity for some residents. Residents from different cultures or generations may feel frightened and wonder what is happening. They may also be worried about the outcome of the vital sign. When taking vital signs, be sure to move slowly and patiently. Provide thorough and accurate explanations about what you are doing. If the resident does not speak your language, ask someone to interpret, if possible. Apply It 1. When taking vital signs, what can you do to ensure you move slowly and patiently? 2. What communication skills can you use to provide thorough and accurate explanations for concerned or confused residents? catshila/Shutterstock.com Figure 18.1 Both the Celsius and Fahrenheit scales are shown on this thermometer.