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5 Basic Comprehension of Lab Values and Vital Signs

Understanding normal values for vital signs is helpful when determining if a patient is medically stable for therapy. Abnormal resting vital signs may indicate modifying or deferring intervention on a given day.

Vital Signs Guidelines

Resting Values:

  • Heart Rate: (HR) 50-120 bpm
  • Systolic Blood Pressure (SBP): 80-180
  • Diastolic Blood Pressure (DBP): 40-110 mmhg
  • SpO2: > 90%
  • Respiratory Rate: 12-20bpm

 

If you mobilize a patient whose vital signs fall outside of the “normal” parameters, treatment should be terminated if any of the following symptoms are observed:

  • Dizziness not resolved within 60 seconds of obtaining an upright posture
  • Increase in patient’s HR of 30bpm over baseline
  • A change in the patient’s systolic blood pressure of 30mmHg or a change in the diastolic blood pressure of 10mmHg
  • Blurred vision
  • Dilated pupils
  • Anginal pain
  • Shortness of breath

Consider the following:

  • What is the trend in vitals over the last 24 hrs?
  • Is the patient asymptomatic?
  • Are there other factors involved, like pain, low hemoglobin, sepsis, or medications?
  • Could interventions provided by nursing help with evaluation and treatment (i.e pain meds, BP meds, suctioning, position change, anti-anxiety meds)?
  • Is the patient’s BP indicating Orthostatic Hypotension?
    • Defined as a decrease in SBP of 20mmHg or more; DBP of 10 mmHg or more within 3 minutes of standing up
    • Measure HR and BP with 2-3 min between positional changes: Supine, Sitting, Standing

 

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