There are a number of important differences between the vital signs of a child\u00a0and those of an adult. Note the following:<\/p>\n
a. General Information.<\/strong><\/p>\n (1) A child’s vital signs must be checked and recorded more frequently than\u00a0the vital signs of an adult.<\/p>\n (2) Your subjective impression of the child may be more important than any\u00a0one of the child’s vital signs.<\/p>\n (3) Children have incredible compensatory mechanisms that conceal\u00a0physiological insult for some time. For example, a child may have a fever (a\u00a0temperature above normal) and still behave as though he feels fine. So, a child may\u00a0have an infection and display no signs or symptoms of illness. Sometimes only after the\u00a0child’s coping mechanisms have been exhausted will you see changes in the child’s vital\u00a0signs.<\/p>\n (4) Once a child’s vital signs begin to change for the worse, the changes\u00a0occur rapidly, and the child’s condition deteriorates.<\/p>\n b. Blood Pressure.<\/p>\n (1) Younger children generally have lower blood pressures, higher pulses,\u00a0and higher respiratory rates than adults.<\/p>\n (2) A child’s blood pressure should be checked with the correctly-sized cuff.\u00a0The proper size is about two-thirds of the circumference of the child’s upper arm.<\/p>\n c. Respiration<\/strong>.<\/p>\n (1) Younger children generally have higher respiratory rates than adults.<\/p>\n (2) A child or infant’s respirations can be checked by placing your hand on\u00a0his stomach. Take the respiration rate frequently. An increase in the respiration rate\u00a0may be significant.<\/p>\n d. Shock<\/strong>.<\/p>\n (1) An early warning sign of shock in a child may be tachycardia\u00a0(abnormally fast heart beat).<\/p>\n (2) Prolonged capillary refill is another early warning sign of shock in a child.\u00a0To check capillary refill, use the blanch test. Press on the child’s nail bed until you\u00a0exert enough pressure to cause the area under the nail to show white. To be\u00a0considered normal, the color in that area should return by the time you repeat the words\u00a0“capillary refill.” That time is approximately two seconds.<\/p>\n e. Heart Beat\/Heart Rate.<\/strong><\/p>\n (1) Bradycardia (abnormally slow heart beat), a worrisome sign in children,\u00a0may be caused by pressure in the child’s skull, depressant drugs, or some\u00a0comparatively rare medical condition.<\/p>\n (2) A child’s heart rate is somewhat higher than the heart rate of an adult. A\u00a0child’s heart rate is heard more centrally in his chest than the adult’s heart rate.\u00a0Therefore, take a child’s heart rate by placing the stethoscope below the scapula on the\u00a0left side of the child’s back.<\/p>\n f. Pulse<\/strong>.<\/p>\n (1) In infants and toddlers, the carotid pulse is very difficult to feel because\u00a0the neck of an infant or a toddler is short. The most reliable pulse to check is the apical\u00a0pulse. (The apial pulse is taken by placing the stethoscope near the apex of the\u00a0sternum.)<\/p>\n (2) A child’s rapid pulse may be caused by shock, fever, or oxygen\u00a0deficiency. Fear may also cause a rapid pulse.<\/p>\n (3) The farther away from the heart a child’s peripheral pulse can be\u00a0detected, the better the child’s cardiac output.<\/p>\n g. Fever\/Temperature.<\/strong><\/p>\n (1) Each centigrade degree of fever in a child is normally accompanied by a\u00a010 percent increase in pulse and respiration rate.<\/p>\n (2) Children’s temperatures are much more important than the temperatures\u00a0of adults. A child’s temperature can change rapidly.<\/p>\n (3) An elevated body temperature in a child can produce these results:<\/p>\n (a) Dehydration:<\/p>\n 1 Nausea, vomiting, and fainting.<\/p>\n 2 Weak and rapid pulse.<\/p>\n 3 Pale skin.<\/p>\n 4 Sunken eyes.<\/p>\n 5 Shrunken tongue.<\/p>\n 6 Skin which remains “tented” after being pinched.<\/p>\n 7 Sunken fontanelle (the soft spot) in an infant.<\/p>\n (b) Convulsions. A rapid rise in body temperature may cause a child to\u00a0have convulsions.<\/p>\n (4) Lower a child’s temperature in this manner:<\/p>\n (a) Give the child fluids by mouth.<\/p>\n (b) Sponge bathe the child’s face, hands, and feet. If necessary,\u00a0undress the child and bathe him in tepid water.<\/p>\n (c) Stop bathing the child if he starts shivering.<\/p>\n (5) Low temperature in a child may be a sign of shock or other metabolic\u00a0problems; for example, near drowning or exposure.<\/p>\n","protected":false},"excerpt":{"rendered":" There are a number of important differences between the vital signs of a child\u00a0and those of an adult. Note the following: a. General Information. (1) A child’s vital signs must be checked and recorded more frequently than\u00a0the vital signs of an adult. (2) Your subjective impression of the child may be more important than any\u00a0one … Continue reading 3-20. VITAL SIGNS<\/span>