Module 10: Vital Signs

Statement of Purpose: The purpose of this unit is to prepare students to know how, when and why vital signs are taken and how to report and chart these procedures. Students will learn the correct procedure for measuring temperature, pulse, respirations, and blood pressure. They will learn to recognize and report normal and abnormal findings.

Module 10 Vocabulary Study Tool: https://claude.ai/public/artifacts/c84c1002-a95b-4af6-b531-88e8aedb8b3e

Performance Standards (Objectives): Define key terminology:

TERMINOLOGY:

Temperature

1. Afebrile

2. Axilla

3. Celsius

4. Fahrenheit

5. Febrile

6. Metabolism

7. Mucosa

8. Pyrexia

9. Tympanic

Blood Pressure

10. Aneroid manometer

11. Bell

12. Diaphragm

13. Diastolic

14. Hypertension

15. Hypotension

16. Orthostatic hypotension

17. Pre-hypertension

18. Pulse pressure

19. Sphygmomanometer

20. Stethoscope

21. Systolic

Pulse

22. Apical

23. Arrhythmia

24. Bounding

25. Brachial

26. Bradycardia

27. Carotid

28. Pulse deficit

29. Radial

30. Rhythm

31. Thready

32. Tachycardia

Respiration

33. Abdominal respirations

34. Apnea

35. Bradypnea

36. Cheyne-Stokes

37. Cyanosis

38. Diaphragm

39. Dyspnea

40. Labored respiration

41. Orthopnea

42. Shallow respiration

43. Stertorous

44. Tachypnea

45. Temperature, Pulse, Respiration (TPR)

Pain (effects on vital signs)

46. Acute pain

47. Chronic pain

48. Phantom pain

49. Pain scales

Patient, resident, and client are synonymous terms referring to the person receiving care

CNA Module 10 Vocabulary Practice Sentences

Temperature

1. The patient was afebrile, which means he had no fever or elevated temperature.
2. The nurse assistant measured the temperature in the patient’s axilla (armpit) using a digital thermometer.
3. In most hospitals, temperatures are recorded in Celsius, where normal body temperature is 37 degrees.
4. Some facilities still use Fahrenheit to measure temperature, where normal body temperature is 98.6 degrees.
5. The febrile patient had an elevated body temperature and needed close monitoring.
6. Good nutrition helps maintain healthy metabolism, which is how the body uses nutrients for all body activities.
7. The doctor examined the mucosa (mucous membrane) inside the patient’s mouth for signs of dehydration.
8. Pyrexia is the medical term for when the body temperature becomes abnormally high.
9. The tympanic thermometer measures core body temperature by placing the probe in the ear canal.

Blood Pressure

10. The aneroid manometer has a calibrated dial that shows blood pressure readings.
11. The nurse used the bell part of the stethoscope to listen for faint heart sounds.
12. Place the diaphragm of the stethoscope over the brachial artery to hear blood pressure sounds clearly.
13. The diastolic pressure measures the pressure in arteries when the heart muscle is relaxed.
14. Hypertension means the patient has sustained high blood pressure, usually above 140/90 mm Hg.
15. Hypotension occurs when blood pressure drops below normal, usually below 80/50 mm Hg.
16. Orthostatic hypotension happens when blood pressure suddenly falls as a person stands up.
17. A reading of 130/85 indicates pre-hypertension, meaning the patient is at risk for developing high blood pressure.
18. Pulse pressure is the difference between the systolic and diastolic blood pressure numbers.
19. The sphygmomanometer is the instrument used to measure blood pressure.
20. Use a stethoscope to listen to sounds in the body, such as heartbeat and breathing.
21. Systolic pressure measures the pressure in blood vessels when the heart contracts.

Pulse

22. To take an apical pulse, place the stethoscope over the apex of the heart.
23. Arrhythmia means the patient has an irregular heartbeat that should be reported immediately.
24. A bounding pulse feels strong and hard under your fingertips.
25. Find the brachial pulse on the inner aspect of the arm at the bend of the elbow.
26. Bradycardia is a slow heartbeat with a pulse rate below 60 beats per minute.
27. Check the carotid pulse by feeling gently at the side of the person’s neck.
28. Pulse deficit is the difference between heartbeats counted at the heart and at the wrist.
29. The radial pulse is felt at the person’s wrist on the thumb side over the radial artery.
30. A normal pulse has a regular rhythm with beats occurring at consistent intervals.
31. A thready pulse feels weak and is difficult to feel or count.
32. Tachycardia is a fast heartbeat with a pulse rate above 100 beats per minute in adults.

Respiration

33. Abdominal respirations use abdominal muscles when breathing and may indicate respiratory distress.
34. Apnea is the temporary absence of breathing that must be reported immediately.
35. Bradypnea means slow breathing with fewer than 10 respirations per minute.
36. Cheyne-Stokes respirations show an abnormal pattern of shallow breathing followed by deeper breathing, then stopping.
37. Cyanosis appears as bluish discoloration of skin, lips, and nails due to lack of oxygen.
38. The diaphragm is the muscle that separates the lungs from the abdominal cavity.
39. Dyspnea means the patient has difficult, labored breathing.
40. Labored respiration shows that the patient is having difficulty breathing normally.
41. Orthopnea means the patient can only breathe when sitting or standing upright.
42. Shallow respiration shows decreased depth of breathing that may not provide enough oxygen.
43. Stertorous respirations are characterized by deep snoring sounds during breathing.
44. Tachypnea means rapid breathing, usually more than 24 respirations per minute.
45. TPR stands for Temperature, Pulse, and Respiration – the basic vital signs measured together.

Pain

46. Acute pain is severe pain that comes on suddenly and needs immediate attention.
47. Chronic pain lasts for a long time and affects the patient’s daily activities.
48. Phantom pain occurs where a limb or body part has been removed but the patient still feels pain there.
49. Pain scales help patients rate their pain level from 0 (no pain) to 10 (worst possible pain).

Module 10: 5 CNA Dialogues for English Learners

Practice conversations highlighting vital signs terminology

Dialogue 1: Taking Temperature

Setting: CNA Maria is checking on Mr. Johnson, who feels unwell

Maria: Good morning, Mr. Johnson. How are you feeling today?

Mr. Johnson: Not so good. I think I have a fever.

Maria: Let me check your temperature. I’m going to use a tympanic thermometer in your ear. This will only take a few seconds.

Mr. Johnson: Okay.

Maria: Your temperature is 101.2 degrees Fahrenheit. That means you’re febrile – you do have a fever. Normal body temperature is around 98.6°F, so you’re running a bit high.

Mr. Johnson: Is that bad?

Maria: It shows your body is fighting something, but it’s not dangerously high. When you’re afebrile again – that means without fever – you’ll feel much better. I need to report this to the nurse and chart it in your medical record.

Key Terms Used: tympanic, Fahrenheit, febrile, afebrile

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Dialogue 2: Checking Blood Pressure

Setting: CNA David is taking vital signs for Mrs. Chen during her routine check

David: Mrs. Chen, I need to check your blood pressure now. May I use your left arm?

Mrs. Chen: Of course. Is my blood pressure okay usually?

David: Let me check today’s reading first. I’m placing this sphygmomanometer cuff around your arm. You’ll feel some pressure as it inflates.

Mrs. Chen: I can feel it getting tight.

David: Perfect. Now I’m using my stethoscope to listen. I place the diaphragm here on your arm over the brachial artery… Your systolic pressure is 118 and your diastolic is 76.

Mrs. Chen: What does that mean?

David: That’s 118 over 76 – very good! You don’t have hypertension or hypotension. Your blood pressure is in the normal range. The systolic number is when your heart beats, and the diastolic is when it rests between beats.

Key Terms Used: sphygmomanometer, stethoscope, diaphragm, brachial, systolic, diastolic, hypertension, hypotension

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Dialogue 3: Monitoring Pulse

Setting: CNA Sarah is training new assistant Tom on how to check pulse

Sarah: Tom, I’m going to show you how to check a patient’s pulse. First, find the radial pulse on the wrist, like this.

Tom: I think I feel it, but it seems really fast.

Sarah: Count the beats for 15 seconds, then multiply by four. If it’s over 100 beats per minute, that’s called tachycardia. Under 60 is bradycardia.

Tom: This patient has 110 beats per minute. So that’s tachycardia?

Sarah: Exactly. Also notice the rhythm – is it regular or irregular? An irregular rhythm is called an arrhythmia. How does the pulse feel – is it strong and bounding, or weak and thready?

Tom: It feels strong but very fast.

Sarah: Good observation. Sometimes we also need to check the apical pulse by listening to the heart directly with a stethoscope. If there’s a difference between the apical and radial pulse, that’s called a pulse deficit.

Key Terms Used: radial, tachycardia, bradycardia, rhythm, arrhythmia, bounding, thready, apical, pulse deficit

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Dialogue 4: Observing Respiration

Setting: CNA Jennifer is concerned about patient Mr. Garcia’s breathing

Jennifer: Doctor, I’m worried about Mr. Garcia in room 204. His respirations seem abnormal.

Doctor: What did you observe?

Jennifer: His breathing rate is 28 per minute – that’s tachypnea, right? Also, he’s having dyspnea and seems to have labored respirations. He can only breathe comfortably when sitting up.

Doctor: That sitting position you mentioned – that’s orthopnea. Any other symptoms?

Jennifer: Yes, I noticed some cyanosis around his lips, and his breathing seems shallow. Sometimes he has periods where he stops breathing completely for a few seconds.

Doctor: Those periods without breathing are called apnea. The shallow breathing and cyanosis are concerning. Let’s get him on oxygen immediately.

Jennifer: Should I continue monitoring for bradypnea too?

Doctor: Yes, watch for any changes in his breathing pattern. Good assessment, Jennifer.

Key Terms Used: tachypnea, dyspnea, labored respirations, orthopnea, cyanosis, shallow respiration, apnea, bradypnea

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Dialogue 5: Pain Assessment and Vital Signs

Setting: CNA Roberto is doing rounds and checking on Ms. Williams who had surgery

Roberto: Good afternoon, Ms. Williams. I need to take your vital signs. How is your pain level today?

Ms. Williams: It’s much worse than yesterday. Maybe an 8 out of 10 on those pain scales you use.

Roberto: I’m sorry you’re in such discomfort. That sounds like acute pain from your surgery. Let me check your TPR – that’s temperature, pulse, and respiration.

Ms. Williams: Why do you check all those when I’m just having pain?

Roberto: Pain affects all your vital signs. Your pulse is 95 – a bit elevated, probably from the acute pain. Your breathing is also slightly faster at 22 per minute. Temperature is normal at 98.4°F, so you’re afebrile.

Ms. Williams: Will chronic pain affect my vital signs too?

Roberto: It can, but usually not as much as acute pain. I’ll let the nurse know about your pain level so we can help you feel more comfortable. Some patients even experience phantom pain after surgery, which can also affect how you feel overall.

Key Terms Used: pain scales, acute pain, TPR (Temperature, Pulse, Respiration), afebrile, chronic pain, phantom pain

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Practice Notes for Students:

• Vital signs include temperature, pulse, respirations, and blood pressure
• Always report abnormal findings to the supervising nurse
• Chart everything accurately in the patient’s medical record
• Normal ranges vary by age and individual patient
• Communication with patients should be clear and reassuring