How would you treat abnormal vital signs?

TheCommuter, BSN, RN · Nov 8, 2012

My next action would be dependent upon whether the patient is symptomatic. Always remember to treat the patient and not the number on the equipment you use.

People can be bradycardic and feel just fine. Some people are tachycardic at baseline and it would be unnecessary to treat. Many people, especially the elderly and those who are hypothyroid, have low temperatures due to reduced metabolic rates and they do just fine.

High temps do not always need treatment; protocol at my workplace is to not treat low grade fevers until 101.5 or greater. Low O2 sats do not always need treatment, especially if patient has COPD and is a CO2 retainer. With these patients, a sat between 88 to 92 percent is ideal.

My point is that abnormal V/S do not always need treatment. Look at the patient first and determine if they need treatment.

TheCommuter, BSN, RN · Nov 8, 2012

Low 02 sat = sit them up and start them on oxygen

High temp = ??? Not sure... what would you do? Give antipyretics such as acetaminophen. It also helps to apply ice packs to the axillary region.

Low temp = No idea.. Warm blankets and hot fluids help.

High respiratory rate = check 02 Raise HOB to expand lungs. Give O2 if necessary.

Low respiratory rate = check 02 also? Give O2 if necessary. Check medications. Ensure patient has not overdosed on opioids.

loriangel14, RN · Nov 8, 2012

It will also depend on what orders you have. For a high temp I would give Tylenol and/or a cool cloth.Check to make sure they don't have a ton of blankets on.We have standing orders for blood cultures for temps over 38.5C/101F For a low temp I would give a warm blanket.A high resp rate would depend on the patient.If it was one of my end stage COPD or palliative patients they would get morphine if ordered.

Esme12, ASN, BSN, RN · Nov 8, 2012

I know each person and situation is different but I would like to know the common things you would do to treat abnormal vitals signs. For example, if somebody has low blood pressure, you would start them on IV fluids. And you would treat high blood pressure with antihypertensive medications..
Low 02 sat = sit them up and start them on oxygen
High temp = ??? Not sure... what would you do?
Low temp = No idea..
High respiratory rate = check 02
Low respiratory rate = check 02 also?
Low pulse = Bradycardia but what does that mean
High pulse? What would you do?
High pain levels = pain med

Welcome to An! The largest online nursing community!

We are happy to help with homework but we will not do it for you. What semester are you? LPN/RN? What class do you need this for? What do you think the treatments should be? How old is the patient? How would this pertain to your pateint?

Low 02 sat = hypoxia

High temp = hyperthermia

Low temp = hypothermia

High respiratory rate = Tachypnea/hyperventilation

Low respiratory rate = hypoventialtion (medscape requires registration but it is free)

Low pulse = Bradycardia

High pulse=Tachycardia

High pain levels = pain

treatment in many cases is dependent on underlying cause. Google is your friend.

hodgieRN · Nov 10, 2012

I know each person and situation is different but I would like to know the common things you would do to treat abnormal vitals signs. For example, if somebody has low blood pressure, you would start them on IV fluids. And you would treat high blood pressure with antihypertensive medications..
Low 02 sat = sit them up and start them on oxygen
High temp = ??? Not sure... what would you do?
Low temp = No idea..
High respiratory rate = check 02
Low respiratory rate = check 02 also?
Low pulse = Bradycardia but what does that mean
High pulse? What would you do?
High pain levels = pain med

One thing to remember is you need to assess why it's abnormal before you intervene. If someone has low oxygen levels, you will obviously intervene, but you need to be on the look out for the cause. These are just some extra add-on tips.

Low 02 sat = sit them up and start them on oxygen.

Remember to check the airway. Some pts have their tongues lay in the back of their throat. A chin lifts can help open the airway. Oxygen won't do anything without a patent airway.

High temp = ??? Not sure... what would you do?

Check for sepsis as mentioned before. FYI...Many neurological pts have elevated temps due to brain injury. Some stroke pt have temps without any sign of infection. Body temp is regulated in the brain. Also, we love putting pillows all over the bed, under their arms, under their legs, between their knees, etc. All those pillows lock in the body heat b/c practically no skin is open to air. When I see a pt has an elevated temp, the first thing I do is remove all the dang pillows and blankets. Next time you are at home, put a bunch of pillows under your arms, legs, and back and cover yourself with a blanket. See how long you last before you start sweating and imagine being there for hrs and hrs. And, make sure the family isn't replacing the blanket you just removed after you leave. They love stacking it on b/c nothing says I Love You like 13 blankets. They are convinced the chills are from being cold, not b/c their temp is 103.5. It happens everyday.

Low temp = No idea..

Believe it or not, hypothermia is also a sign of sepsis. A temp of 95 will flag sepsis protocol. Pts fresh out of the recover room are often hypothermic. Elderly pts admitted for falls can be hypothermic b/c they were on the cold, hard floor for two days (at home) before anyone found them. FYI...When someone has severe hypothermia, you should warm them slowly b/c if done too fast, they are at risk for heart arrhythmias. You will need to decide whether or not to simply use warm blankets or use a heated airflow blanket.

High respiratory rate = check 02.

Find out why its high and try to fix it or address it. A change in respiratory rate is one of the first signals of a wide variety of problems. It could signal pain, anxiety, respiratory compromise, increased intracranial pressure, CO2 retention (they are trying to blow the CO2 off), hyperglycemia, infection, sepsis, a number of metabolic conditions, acidosis, etc.

Low respiratory rate = check 02 also?

Low pulse = Bradycardia but what does that mean.

There are a ton of things that cause this. Bradycardia means you have a heart rate less than 60. An athlete with a resting heart rate of 55 is technically bradycardic. But as said before, you have to see if the B/P is also affected. The bradycardic athlete will have a normal blood pressure. So, they are considered asymptomatic. Pts straining for a bowel movement can become bradycardic. They bear down and then fall. In the ER, we called it a commode code. It's a response to vagal stimulation (the vagus nerve that slows the heart rate when stimulated).

High pulse? Find out what is causing it. Is it cardiac? Respiratory? Metabolic?

High pain levels = pain med

turnforthenurse, MSN, NP · Nov 10, 2012

High temp = ??? Not sure... what would you do? Give antipyretics such as acetaminophen. It also helps to apply ice packs to the axillary region.

And take off those blankets!!! Keep a sheet on them but please please please take off those 15 blankets! And make sure the family isn't putting them back on after you leave. Educate the family and the patient on the need to keep the blankets off.

allnurses Guide · Nov 10, 2012

I tend not to jump right to antipyretics, especially for fevers of unknown origin.

nurseprnRN, BSN, RN · Nov 12, 2012

Bradycardia MEANS "slow pulse." Not sure what you're asking.

World-class athletes often have very slow resting heart rates, in the 20s even, because their hearts are so big and strong to support world-class athleticism that their resting rates don't need to be very high to support ordinary effort. So if you have a pro football player who's getting a knee done and his resting rate is in the 30s, ask him what his pulse is usually-- but also use your assessment skills. Is he awake and chatting with his buds or texting merrily, or is he kinda grey and woozy? Is his BP normal or down low?

See, just because you often see parameters for treatment expressed as numbers on specific patients doesn't mean you can skip the assessment or that parameters are the be-all, end-all of treatment decisions. They aren't. Everything has to be taken in context.

Gottawanna · Sep 14, 2014

Can I piggyback this question and ask about priority? How do you know which to address FIRST? Say you have an adult with 30 RR and 89 sats, why would you address the sats first? (Saw a question somewhere and that was the answer)

JustBeachyNurse, LPN · Sep 14, 2014

Can I piggyback this question and ask about priority? How do you know which to address FIRST? Say you have an adult with 30 RR and 89 sats, why would you address the sats first? (Saw a question somewhere and that was the answer)

The rapid respiratory rate is often due to hypoxia therefore you can treat both by administering oxygen per protocol or physician orders. Hypoxia can cause anxiety and increase respiratory rate.

Gottawanna · Sep 14, 2014

Makes so much sense, thank you.