Vital Signs
Normal adult values
- Temperature: 36.5–37.5 °C (oral); axillary about 0.5 °C lower; rectal 0.5 °C higher.
- Pulse: 60–100 beats/min, regular, good volume.
- Respiration: 12–20 breaths/min, regular, quiet.
- Blood pressure: around 120/80 mmHg; below 120/80 is normal, 140/90 and above needs reporting.
- SpO₂: 95 % or above on room air.
- Pain is the fifth vital sign – ask and score it.
How to measure correctly
Pulse: two fingers on the radial artery, count for a full minute, note rate, rhythm and volume; never use your thumb. Respiration: count for one minute without telling the patient, ideally while still holding the wrist. Temperature: clean the thermometer, leave in place for the required time, document the site. BP: patient rested five minutes, seated, back supported, arm at heart level, cuff 2.5 cm above the antecubital fossa, inflate about 30 mmHg above the point where the pulse disappears, deflate slowly. Confirm any abnormal reading before reporting.
Worked example
A patient who has just walked in from the corridor has BP 150/96 mmHg. Reasoning: activity, anxiety and a full bladder raise BP. Let the patient rest five minutes, empty the bladder, recheck in the correct position. If the repeat is still 140/90 or above, record both readings and report to the nurse; do not simply record the lower one.
Traps
- Counting pulse for 15 seconds and multiplying without noting irregularity.
- Announcing “take a deep breath” before counting respirations.
- Using a cuff that is too small, which falsely raises the reading.
- Recording a value you did not actually measure.