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Lessons · Nursing · vital signs: the order, and the ranges given

Vital signs: the order they are taken, and the arithmetic in them

Temperature, pulse, respirations, blood pressure, then oxygen saturation and pain. Counting for part of a minute and multiplying up is part of taking them: 15 seconds times 4, or 30 seconds times 2, gives the rate per minute.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

A set of vitals is the first thing asked for on every call to a prescriber. Taking them in the same order means none is missed, and counting respirations while the patient still thinks you are on the pulse is why the pulse comes first.

How to think about it

Work down the order and write each figure with its unit as you take it. For rates, count for 15 or 30 seconds and multiply: 15 seconds times 4, 30 seconds times 2, or count the full minute when the rhythm is not regular. Compare each figure with the reference range the unit's chart gives; the chart states the range, not you.

Worked example

Temperature 36.8 degrees C
First, because it needs no counting.
Pulse: 18 beats in 15 s, 18 × 4 = 72 beats/min
Fifteen seconds, times four.
Respirations: 8 breaths in 30 s, 8 × 2 = 16 breaths/min
Counted straight after the pulse, without announcing it.
Blood pressure 118/76 mmHg, oxygen saturation 97 percent, pain 2 out of 10
The rest of the set, each with its unit.

Your turn

You count 7 breaths in 30 seconds. Write the rate per minute.

7 × 2 =  breaths/min

The trap

Counting respirations after telling the patient you are about to. Breathing is the one vital sign a person can change on purpose, so it is counted while your hand is still on the wrist.

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