Vital signs are objective measurements that reflect the body’s basic physiological status. They help the nurse establish a baseline, detect changes in condition, recognize early deterioration, and guide nursing actions.

The major vital signs commonly assessed are temperature, pulse, respirations, blood pressure, oxygen saturation, and pain.

• Temperature: normal is about 36°C to 38°C (96.8°F to 100.4°F).
• Pulse: normal is about 60 to 100/min.
• Respirations: normal is about 12 to 20/min.
• Blood Pressure: commonly less than 120/80 mm Hg is considered normal for many adults.
• SpO₂: normal is usually about 95% to 100%, unless otherwise expected for the client.
• Pain: assessed using a self-report scale when possible.

Things to assess with the numbers:

• Trend the values against baseline, not just one isolated reading.
• Assess the client’s condition, appearance, and symptoms along with the vital signs.
• Use correct technique and equipment, including proper cuff size and patient positioning.
• Count respirations accurately rather than estimating.
• Reassess abnormal findings when needed to confirm accuracy.

The nurse interprets the vital sign pattern, not just the number by itself. Trends and related cues help determine whether the client is stable, worsening, compensating, or deteriorating.

• Fever + tachycardia may suggest infection, inflammation, or dehydration.
• Low blood pressure + increased pulse may suggest fluid volume deficit, bleeding, or shock.
• Low oxygen saturation + increased respiratory rate may suggest respiratory compromise.
• Slow respirations may occur with sedation, opioids, or decreased neurological status.
• Elevated blood pressure may relate to pain, anxiety, stress, or chronic hypertension.
• Abnormal pain findings can affect pulse, BP, respirations, and overall function.

Objective data that may help support the picture:

• CBC: WBC normal is about 5,000 to 10,000/mm³; abnormal values may support infection or inflammation.
• Hemoglobin: normal is about 12 to 18 g/dL; low values may support anemia or blood loss.
• Hematocrit: normal is about 37% to 52%; low values may support blood loss or dilution.
• CMP/BMP: helps evaluate sodium, potassium, glucose, BUN, and creatinine when fluid, perfusion, or metabolic issues are suspected.
• Sodium: normal is about 136 to 145 mEq/L.
• Potassium: normal is about 3.5 to 5.0 mEq/L.
• BUN: normal is about 10 to 20 mg/dL.
• Creatinine: normal is about 0.6 to 1.3 mg/dL.
• Glucose: fasting normal is about 70 to 110 mg/dL.
• Chest x-ray: may support respiratory findings such as pneumonia or fluid overload.
• ABGs: may be used when oxygenation or ventilation problems are suspected.

• Obtain accurate vital signs using proper technique.
• Compare the current findings to prior values and baseline.
• Reassess abnormal values when needed.
• Assess the client for symptoms that match the abnormal readings.
• Report significant changes promptly.
• Implement nursing actions based on the cause, such as oxygen, fluids, repositioning, pain control, or provider notification.
• Document the findings and the nursing response clearly.

• Measuring oral, tympanic, temporal, or axillary temperature correctly
• Counting pulse rate and assessing rhythm and strength
• Counting respirations accurately
• Taking manual and automatic blood pressure correctly
• Using pulse oximetry properly
• Assessing pain using an appropriate pain scale
• Recognizing when abnormal findings require reassessment or escalation

• Respiratory rate is often one of the earliest signs of deterioration.
• One abnormal number matters, but a worsening trend matters even more.
• Pain, anxiety, activity, and fever can all shift pulse and blood pressure.
• Wrong cuff size or poor positioning can falsely change blood pressure readings.
• Students often focus on the number and forget to assess the person.
• Vital signs are not just data collection — they drive prioritization and clinical judgment.

Vital sign charts, abnormal pattern reminders, and review materials coming soon.