Basic Nursing Skills and Vital Signs
What you measure and why
Vital signs are temperature, pulse, respirations, blood pressure, and pain, often called the fifth vital sign; pulse oximetry and weight are also routine. Trends matter more than single numbers - report changes and anything outside the range your facility uses.
Typical adult ranges: oral temperature about 97.6–99.6 °F; pulse 60–100 beats per minute; respirations 12–20 per minute; blood pressure below 120/80 is normal, with many facilities flagging 140/90 or higher. Report a pulse under 60 or over 100, respirations under 12 or over 20, and any rapid change.
Technique that gets tested
- Oral temperature: wait 15–30 minutes after a hot or cold drink, smoking, or gum. Do not use an oral route with a confused resident who may bite down.
- Radial pulse: use two fingers, never your thumb; count 30 seconds and multiply by two, or a full minute if irregular.
- Respirations: count without telling the resident - keep your fingers on the wrist as if still counting the pulse. Count a full minute if abnormal.
- Blood pressure: correct cuff size, arm supported at heart level, avoid an arm with an IV, dialysis fistula, or on the side of a mastectomy.
- Orthostatic blood pressure: lying, sitting, standing; report a drop of 20 mmHg systolic or 10 mmHg diastolic.
Traps
- Announcing that you are counting respirations, which changes the rate.
- Using your thumb to take a pulse.
- Taking a rectal temperature on a resident with diarrhea or recent rectal surgery.
- Recording a number you did not actually measure.
Rule of thumb
Measure, then compare with the resident's normal and the last reading - report changes, not just numbers.