BHOPAL (M.P.
SUBJECT: - NURSING EDUCATION
LESSION PLAN
ON
Vital signs
SUBMITTED TO: SUBMITTED BY:
Mrs. C. Gomthi Mrs. Geeta Chaudhary
Professor M.Sc. Nursing Ist yr
hod of psychiatric nursing
S.NO TIME SPECIFIC CONTENT TEACHING LEARNIN A/V ELVALVATI
. OBJECTIVE ACTIVITY G AIDS ON
ACTINITY
1. 2 min To introduce self My self geeta msc nursing first yr students
to the students.
2. 2min To explain Assessment of newborn: Explanation Listening OHP
aseessment of Immediate assessment – Apgar scoring and Define vitals?
newborn Transitional asseement questioning.
To enumerate the PUROSE AND INDICATION:-
purpose and The purposes for assessment of vital signs are :-
3. 5 min indication of vitals 1. To assess the normal functioning of vital organs. Discussion Discussion.
to the students. 2. To assess the condition and progress made by the and LCD Enumerate the
patient. explanation. indications of
3. To help in formulation of diagnosis and vitals?
assessment of deviations in the physiological
adaptation like –blood depletion, over and under
consumption of oxygen.
4. To assess the emotional status of the patient.
The indications of vital signs are as fallows:-
1. On admission.
2. Any deviation in the health status.
3. Before and after surgical procedure.
4. Before and after invasive diagnostic procedure.
5. Before and after administration of any drug.
6. As a routine procedure to assess the health status of
the admitted patient.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNIN A/V ELVALVA
. OBJECTIVE ACTIVITY G AIDS TION
ACTINITY
4. 2 min To teach TEMPERATURE. Discussion Listening Can anyone
temperature in and and please
Temperature may be defined as the degree of
detail. explanation questioning. explain
heat maintained in the body.
about
temperature
TYPES OF TEMPERATURE.
5. 5 min To explain about ?
types of
CORE TEMPERATURE- it is the temperature of
temperature.
the deep tissues of the body. E.g. cranium thorax,
abdominal and pelvic cavity. It is 37 degree c.
SURFACE TEMPERATURE-it is the temperature
of the skin, subcutaneous tissue and fat it can vary
according to environmental temperature.
6. 8 min To explain about REGULATION OF BODY TEMPERATURE- it is Discussion Listening LCD and
regulation of regulated due to three phenomena. and and black
temperature. I. Neural control- hypothalamus is the main organ explanation questioning. board. Who can
which controls body temperature. Impulses from explain
hypothalamus cause vaso dilatation and vaso about
constriction. This can also be explained by regulation of
following sub points. body
i) Thermo genesis – it means chemical regulation temperature
by production of heat in following ways ?
a. Oxidation of food.
b. Muscles activity.
c. Hormonal effect.
d. Sympathetic stimulation.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNIN A/V ELVALVA
. OBJECTIVE ACTIVITY G AIDS TION
ACTINITY
ii) Thermolysis – it means regulation of body
temperature by heat loss .the heat is lost from
the body in following ways.
a) Radiation.
b) Conduction.
c) Convection.
d) Evaporation.
e) Some amount of heat is also lost from the
body through lungs, kidney and bowels.
II. Behavioral control- it involves the various act
which a person uses to maintain a comfortable body
temperature.e.g. Changing clothing, sitting with
arms folded, turning of the fan, taking cold showers
etc.
7. 10 min To explain about Lecture Listening LCD Explain
normal NORMAL TEMPERATURE- about
temperature. In a healthy individual the body temperature may normal
vary between 97-99 degree f. the temperature may temperature.
slightly vary according to the site from where it is
taken.
Oral temperature- 98.6of
Rectal temperature- 99.6of
To enumerate the Axillary temperature- 97.6of
factors affecting
the body Various factors which affect the body temperature are as
temperature. fallows:-
1. Age.
2. Exercise.
3. Hormonal level.
4. Circadian rhythms.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNIN A/V ELVALV
. OBJECTIVE ACTIVITY G AIDS ATION
ACTINITY
8. 8 min To explain about ADVANTAGES- Lecture Listening LCD and What is the
advantages, Most reliable. black contraindic
disadvantages and DISADVANTAGE- board. ations
contraindication Needs privacy. rectum as a
when temperature Needs lubrication. site for
is taken from False if rectum is loaded. taking
rectum. In newborns it may lead to ulceration or perforation. temperatur
Not recommended by WHO as it causes damage and e?
ulceration to rectal mucus membrane.
CONTRAINDICATIONS-
Rectal surgery, hemorrhoids.
Tumor and infection.
Traction patient.
To teach the WHO recommendations.
9. 10 min students
conversion of
temperature Lecture questioning
readings To convert Fahrenheit in to Celsius:
C = (F-32) X 5/9 LCD
How to
To convert Celsius to Fahrenheit: convert to
F = (C X 9/5) + 32 F?
To explain pulse.
10. 5 min
PULSE- pulse can be defined as the alternate expansion and
recoil of the arteries due to activity of the left ventricles.
S.NO. TIME SPECIFIC CONTENT TEACHING LEARNIN A/V ELVALV
OBJECTIVE ACTIVITY G AIDS ATION
ACTINITY
11. 5 min To teach the Pulse may have characteristics of rate, rhythm, volume, tension Lecture. learning LCD What is
characteristics and quality. normal
of pulse. pulse rate.
1. Rate-
Rate is the number of beats per minute. it can range
from 70-80 beats per minute.
Common variation are:-
a) Tachycardia- pulse rate above 100 beats/ min.
b) Bradycardia- pulse rate below 60 beats / min.
12. 5 mins To enumerate Age, Sex, Exercise.
the factors of Pain, Anxiety.
causing Medication, Metabolism.
variation in Hemorrhage.
pulse rate. Position.
2. Rhythm-
It is the pattern of pulse and pause between them.
The variation due to rhythm are:-
a) Intermittent- occasionally missed pulse.
b) Irregular- variation in frequency.
c) Extra systole- premature contraction.
d) Sinus arrhythmia - pulse is rapid during inspiration and
slow during expiration.
e) Dicrotic pulse – sensation of double beat.
S.NO. TIME SPECIFIC CONTENT TEACHING LEARNING A/V ELVALVATION
OBJECTIVE ACTIVITY ACTINITY AIDS
13. 3. Volume – Explanation. Learning. What is water
It refers to fullness of artery which reflects the hammer pulse?
force of ventricular contraction.
The variations due to volume are as fallows:-
a) Absent pulse- no pulsation is felt extreme pressure.
b) Water hammer pulse – it is a full volume pulse which
rapidly collapses due to aortic regurgitation.
c) Bounding – strong pulsation which does not
disappear with moderate pressure.
d) Thready – pulsation is not easily felt and slightly
pressure causes it to disappear.
e) Weak pulse – it is stronger than thready pulse.
f) Pulses alternans – it has a regular rhythm but with
alternate, strong and weak volume.
g) Bigeminal pulse – it is an irregular in which every
other beat comes early.
h) Paradoxial pulse – pulse volume becomes weak
during inspiration.
4. Tension –
It is the degree of compressibility of an artery.
5. Equality –
Pulse on both sides should be assessed, and
compared the characteristics of each side for equality.
S.NO TIM SPECIFIC CONTENT TEACHIN LEARNIN A/V ELVALVATION
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ACTIVITY ACTINITY
14. 4min To enumerate The nine common sites of taking pulse are. Explanation. Questioning. LCD Enumerate the
the sites of 1. Temporal. sites for taking
taking pulse. 2. Carotid. pulse.
3. Apical.
4. Brachial.
5. Radial.
6. Femoral.
7. Poplitial.
8. Posterior tibial artery.
9. Dorsalis pedis.
15. 10 To explain RESPIRATION – respiration can be defined as the act of Lecture listening LCD What is
min respiration in breathing. tachypnoea?
detail.
Characteristics of respiration.
1) Rate – it is the number of full respiration per
minute.
2) Depth of respiration – it can be assessed by
observing the movement in the chest wall in
informal respiration a person in hales about 500 ml
of air and the diaphragm moves about 1 cm down
16. 10 To teach the and ribs retract up wards about 1.2 to 2.5 cms.
min terms related to 3) Rhythm – normal breathing is irregular and in
respiration. interrupted.
1) Bradypnea- rate of breathing less than 10 breaths/
min.
2) Tachypnea- rate of breathing greater than 20/ min.
3) Hyperpnea – inspiration are increased in depth and
rate.
4) Apnoea – respiration ceases for several seconds.
5) Hyperventilation – rate and depth of respiration
increases.
6) Hypo ventilation – rate and depth decreases.
S.NO TIM SPECIFIC CONTENT TEACHING LEARNING A/V ELVALVATION
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7) Cheyne stroke respiration – respiration is
irregular, characterized by alternate periods of
apnoea and hyperventilation.
8) Kussmaul’s respiration – respirations are
abnormally deep but regular, rate is increased.
9) Dyspnoea – breathing is difficult and
characterized by increased effort ot exale and
inhale.
10) Orthopnea – patient has difficulty in breathing
unless in upright position.
11) Biot’s respiration – condition of the central
nervous system causes shallow breathing
interrupted by an irregular period of apnea.
17. 10 To teach the Demonstra- observation Articles. Explain the
min. procedure of PROCEDURE OF TAKING TPR. tion purpose of the
taking TPR. PREPARATION OF THE PATIENT :- articles.
a) Provide comfortable position.
b) Explain the procedure to the patient.
c) Check the contraindications.
ARTICLES REQUIRED:-
1) Clinical thermometer- to take temperature.
2) A bottle containing lotion- to disinfect the
thermometer.
Dettol 1:40
Savlon 1:20
Fairgenol 1:40
3) A bottle containing plain water- to rinse the
thermometer.
4) Cotton swab wet- to clean the thermometer.
5) Soapy swab- to clean the thermometer.
6) Dry swab- to dry the thermometer.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING A/V ELVALVATION
. OBJECTIVE ACTIVITY ACTINITY AIDS
7) A kidney tray and paper bag- to discard soiled Demonstration observation and
swabs. redemonstration
8) A feeding cup with water – to wash the
thermometer after use.
9) T.P.R. sheet blue and red and black pen – to record
the TPR.
EXTRA ARTICLES USED IN AXILLA AND
RECTUM ARE:-
10) Gauze pieces – to separate the buttocks.
11) Clean gloves – to protect the hand of nurse.
12) Vaseline – to lubricate the thermometer.
13) Screen – to provide privacy.
18. 30 min To teach the 14) A mackintosh – to protect bed from soiling.
steps of 15) A small towel or gauze piece in bowl – preparation
taking TPR. of axilla.
STEPES OF TAKING TPR.-
1) Prepare the tray and explain the procedure to the
patient to gain the confidence of the patient and to
avoid fear of unknown.
2) Wash hands and wear gloves if taking temperature
from rectum – to prevent cross infection.
3) Remove the thermometer from the antiseptic lotion
and rinse in cool water solution and wipe the
thermometer with dry swab from stem to bulb- to
remove the disinfectant and for maintaining the
asepsis of the bulb.
4) Shake down the thermometer if mercury level is
above 35 degree c or 95 degree f.- to record the
temperature correctly.
5) ORAL TEMPERATURE-
Place the thermometer at the base of the tongue
to the right or left of the frenuclum, ask the patient.
S.NO. SPECIFIC CONTENT TEACHIN LEARNING A/V ELVALVATION
OBJECTIVE G ACTINITY AIDS
ACTIVITY
This position for 2 mins.-heats from superficial blood vessels in
sublingual pocket produces temperature reading.
6) AXILLA-
Place the thermometer in axilla after wiping the axilla
with towel for 5 min- for correct recording of the
temperature.
7) RECTUM-
Screen the patient and place the patient in side lying
position, now place the lubricated thermometer in rectum-
lubrication promotes the easy insertion of thermometer and
causes less chances for injury.
8) For taking pulse place your first ,second and third fingers
along the client’s radial artery and press by putting the
thumb on the either side of the wrist- since the thumb
reading is in correct.
9) Count it for one full min.
10) For respiration after recording of pulse count the rise and
fall of client’s chest wall- a complete cycle is inspiration,
expiration and pause.
11) Count the respiration for one min.
12) Remove the thermometer from site and wipe in rotatory
motion from stem to bulb- wiping from least
contamination to more contamination.
13) Hold the thermometer at eye level and record the findings.
14) Make the patient comfortable.
15) Inform the patient if he asks.
16) Clean the thermometer with soapy swab and rinse in
water.
17) Shake the mercury level down.
