Part of Unit: Vital Signs
Lesson Plan Overview / Details
In this unit students will learn what vital signs are. How to measure temperature, pulse, respirations and blood pressure and normal ranges for each. Why accurate measurements are important.
4 class periods (90 minute class)
- 180 Minutes
- Pulse and Respirations
- 90 Minutes
- Blood Pressure
- 90 Minutes
California Career and Technical Education Standards
- HSMT.B.B2.2 Know the process for evaluating and appraising the appropriateness of information.
- HSMT.B.B2.4 Use appropriate documentation to report information about patients and clients.
- HSMT.B.B4.1 Know how to assess the ability of patients and clients to comprehend procedures ...
- HSMT.B.B4.2 Use active listening skills (e.g., reflection, restatement, and clarification te...
- HSMT.FS.5.3 Use critical thinking skills to make informed decisions and solve problems.
- HSMT.FS.6.3 Understand the importance and use of Standard Precautions and Infection Control,...
California Academic Content Standards (Reinforced)
- ELA.9-10.R.CAGT.2.5 Extend ideas presented in primary or secondary sources through original analysis...3
- ELA.9-10.R.CAGT.2.6 Demonstrate use of sophisticated learning tools by following technical direction...2
Objectives and Goals
- Spell and define key terms.
- Define vital signs and explain why accurate measurements are important.
- Accurately measure the patient's temperature, pulse, respirations and blood pressure.
- Identify abnormal vital signs.
- Accurately record vital signs.
Activities in this Lesson
- What is meant by vital signs? - Hooks / Set
Show video clip of show Gray's Anatomy where critically ill patient is on a heart monitor and cardiac arrest occurs several times.
Explain the purpose for measuring vital signs and importance of accurate measurements.
Pair students up, explain to them they will each take turns being the patient and Medical Assistant (M.A.) as we cover each vital sign.
Pass out vocabulary handout. Have students keep vocabulary terms on desk- terms will be covered as each vital sign is covered
- Vital Signs Overview - Lecture
Ask students: What are the four vital signs and what does each measure?
As students volunteer answers - write the four vital signs and what they measure on the board in the order they will be learned
- Methods used to measure temperature - Lecture
Ask students-What are all the different places on the body you can measure temperature using a thermometer. As students give different routes list them on the white board along with the correct medical term.
Oral - mouth (under tongue)
- normal range: 96.0F - 100.0F
- most common for adults and older children
- thermometer is placed under tongue
- if patient has recently had anything to eat or drink , need to wait 10 - 20 minutes
- patient must keep mouth closed entire time
- should not be used on a patient who is having difficulty breathing
Axillary - armpit
- least accurate way to measure temperature
- usually is one degree less than a person's oral temperature
Example: If oral is 98.6F, axillary will be 97.6F
Rectal - rectum
- measures core body temperature
- most accurate way to measure temperature
- usually is one degree higher than a person's oral temperature
Example: If oral is 98.6F, rectal will be 99.6F
Tympanic - ear
- also called aural
- quickest way to take temperature
Ask students: How would the following situations effect an individual's body temperature?
Certain drugs such as stimulants or depressants?
Discuss other factors that can cause a temperature to vary.
- Mercury Thermometers - Demo / Modeling
Reading a mercury thermometer
Draw a picture of a mercury thermometer on the whiteboard showing the degree and two-tenth degree markings.
- Explain to students each long line is one degree, each short line is two-tenths of a degree, or 0.2
- To read the thermometer hold it at eye level by the stem.
- Rotate it slowly between your thumb and index finger until you can see the mercury column.
- The mercury will show up between the numbers and the degree lines.
- Read the mercury to the nearest two-tenths degree
- If mercury ends between two lines - round up
Draw the mercury on the thermometer diagram on the whiteboard and ask students what the temperature is. Repeat this several times.
Pass out mercury thermometers to students and have them read the thermometer and write down their findings.Check their results and assist as needed.
Pass out worksheet "How do you feel?". This is an exercise on reading mercury thermometers. Have students complete, then review with class.
Show video on how to use a mercury thermometer.
Before using a mercury thermometer complete the following steps:
- Wash your hands
- Check thermometer for any chips or cracks
- Wash thermometer in cold, soapy water or alcohol swabs (hot water will break thermometer)
- Shake the mercury down until it is below 96.0F (demomstrate this to students)
- Cover with a disposable sheath
Have students perform the above steps with their mercury thermometer and take their own oral temperatures. Explain to students mercury thermometer must stay under tongue for minimum of 5 minutes. When time is up, take disposable sheath off thermometer and read the thermometer, write down the results. Wash your hands.
Ask students what oral temperature readings they obtained.
Have students plot their reading on a graph.
- Other types of thermometers - Demo / Modeling
Demonstrate the use of the following types of thermometers:
- electronic thermometer
- digital thermometer
- disposable (plastic thermometer)
- tympanic thermometer (refer to transparency - Inserting a tympanic thermometer)
Explain to students when each type would most likely be used.
Allow time for students to practice using each type of thermometer.
- Inserting a tympanic thermometer.pdf [ Download ]
- Pulse - Lecture
Pulse measures how fast the heart is beating.
Always measured in beats per minute (bpm)
Measured while patient is at rest unless otherwise ordered by doctor.
Show transparency (or use as handout) Arterial and Venous Systems
Explain - each time the heart beats, the arteries in the body expand and contract, forcing blood through the system
- Arterial and Venous Systems.pdf [ Download ]
- Pulse Sites - Lecture
Areas of the body where the artery is closer to the surface of the skin. By pressing down on these areas, you can feel a pulse and count how fast the heart is beating.
Display transparency - Pulse Sites
Go through common pulse sites:
- radial - thumb side of wrist, most commonly used
- brachial - used for obtaining pulse in infants; taking blood pressures
- apical - obtained by using a stethoscope and listening to the heart beat
- carotid - both sides of neck, used for CPR
- popliteal - behind the knee
- femoral - deep inside the upper thigh
- pedal pulses - used to assess circulation in the lower extremities
Have students find the following pulse sites on their partner:
Assist students as needed.
- Pulse Sites.pdf [ Download ]
- What is a normal pulse rate? - Lecture
Pulse rate varies for each age group.
Display handout on normal ranges for pulse.
Discuss ranges for age.
Ask students the following questions:
- What factors cause the pulse rate to increase? (fever, younger age, disease processes, medication)
- What factors cause the pulse rate to decrease? (health status, disease processes, medication)
Give students several minutes to write down as many factors as they can think of. Discuss.
The adult pulse rate is between 60-100 beats per minute
tachycardia - rapid heart rate, over 100 beats per minute
bradycardia - slow heart rate, less than 60 beats per minute
Rhythm and force of the pulse
rhythm - time interval between each beat. Rhythm should be regular.
irregular pulse - beats are not evenly spaced or when beats are skipped
force - relates to pulse strength
- Resting Pulse Rates.docx [ Download ]
- Taking a Radial Pulse - Group Work
- The radial pulse is used for routine vital signs.
- It is felt by placing the first two or three fingers of one hand against the radial artery.
- Count the pulse for one minute.
Demonstrate the procedure for taking a radial pulse. Have each student practice taling a radial pulse on their partner for one full minute. Have students plot their results on a graph.
Ask students to discuss the experience.
- Taking an apical pulse - Group Work
- The apical pulse is taken using a stethoscope. ( Explain to students how to clean a stethoscope before use and how to use it to hear sounds produced by the body.)
- The apical pulse is on the left side of the chest below the nipple. (Display transparency - location of heart in chest cavity)
- The heart beat normally sounds as a lub-dub.
- Each lub-dub is counted as one beat.
- Count the apical pulse for one minute.
Demonstrate the procedure for taking an apical pulse. Have each student practice taking an apical pulse on their partner. Have students plot their results on a graph and compare it to their partner's radial pulse reading.
Ask students to discuss the experience.
Students are to take the pulse rate of three individuals. Subjects should be in different age groups. For example: toddler, adolescent and elderly
- Location of heart in chest cavity.pdf [ Download ]
- Respirations - Lecture
Show transparency on the Respiratory System.
Explain the role and function of the respiratory system
Respiration means breathing air into (inhalation) and out of ( exhalation) the lungs.
Normal respiratory rates:
Adult 12 - 20 respirations per minute
Children 18 - 28 respirations per minute
Infants 24 - 35 respirations per minute
Count respirations when the patient is at rest.
- The patient should not know you are counting respirations
- To count respirations watch the chest rise and fall
- Respirations are counted right after taking a pulse
Show video on how to obtain respirations on a patient
Have students practice taking respirations on their partner. Discuss results
Explain respiratory terms on vital signs vocabulary handout:
- What does blood pressure mean? - Lecture
Blood Pressure (b/p) - the amount of force exerted against the walls of the artery by the blood
- Blood pressure is measured in millimeters of mercury (mm/Hg )
- Blood pressure is written as a fraction ex: 120/80
Explain to students on how the actions of the heart effect the pressure in the arteries.
- heart is contracting
- pressure in the arteries is highest
- top # of b/p reading
- normal range (adult) 90 - 140
- heart is relaxed - filling with blood
- pressure in the arteries is lowest
- bottom # of b/p reading
- normal range (adult) 60 - 90
Infants and children have lower blood pressures than adults:
- newborn 70/55 mmHg
- 1 year old 90/55 mmHg
Blood Pressure continues to increase as child grows older
Adult blood pressure levels reached between 14 - 18 years old
Instruct on terms:
- What effects an individual's blood pressure - Group Work
Have students work with their partner to answer the following questions:
- What factors will increase a person's blood pressure?
- What factors will decrease a person's blood pressure?
Have students write down answers in their notebook. Discuss.
- What equipment do you need? - Demo / Modeling
A stethoscope and sphygmomanometer are used to measure blood pressure.
Give each pair of students a stethoscope and B/P cuff.
Explain parts of B/P cuff:
- how to open and close valve
- inflate and deflate cuff
- how to read guage on B/P cuff
Pass out worksheet: Reading the B/P Guage. Have students complete. Review.
- reading the blood pressure gauge worksheet.pdf [ Download ]
- How to take a patient's blood pressure - Demo / Modeling
Show video: How to take a patient's blood pressure.
Demonstrate on a student how to take a B/P emphasizing what sounds to listen for as the cuff is deflating slowly
Have students practice taking a blood pressure on their partner. Have them write down the reading
Supervise students technique and correct as needed.
Discuss the experience.