Chapter 14Body temperatureVital signs What are Vital signs(生命体征生命体征)?)?Vital signs include persons temperature,pulse,respiration,and blood pressure.A change in vital signs can indicate a change in physiological function and pathological condition.Vital signs These signs indicate the effectiveness of respiratory,circulatory,neural,and endocrine body function.Vital signs are a quick and efficient way of monitoring clients condition or identifying problems and evaluating the clients response to intervention.Vital signs What does nurse do for clients vital signs?Measure the vital signs correctly and promptly.Understand and interpret the values.Vital signs Guidelines for vital signs measurement:1.The nurse caring for the client is responsible for vital signs measurement.2.Equipment should be functional and appropriate.3.The nurse should know the clients normal range of vital signs.4.The nurse knows the clients medical history,therapies,and medications.Vital signs 5.The nurse controls or minimizes environmental factors that may affect vital signs.6.The nurse uses a systematic method when taking vital signs.7.The nurse collaborates with the physician to decide the frequency of vital sign assessment.Vital signs 8.The nurse uses vital signs measurements to determine indication for medication administration.9.The nurse analyses the results of vital signs measurement.10.When to take vital signs Learning Objectives1.Define the following terms:fever,hyperthemia,hypothermia,continuous fever,remittent fever,intermittent fever,irregular fever.2.Discuss the normal value of body temperature and factors affect body temperature.3.Identify the classification of fever and nursing interventions for client with fever.4.Demonstrate the steps of temperature taking.ContentsPhysiologyPhysiology1Factors Affecting Body TemperatureFactors Affecting Body Temperature2Alterations in Body TemperatureAlterations in Body Temperature3Nursing Process and Nursing Process and ThermoregulationThermoregulation4Body temperature is the heat of the body,measured in heat units called degrees.Body temperature reflects the balance between the heat produced and the heat lost from the body.section 1section 1 PhysiologyTwo kinds of body temperature:Core temperature（体核温度）（体核温度）is the temperature of the deep tissues of the body.It remains relatively constant.Surface(shell)temperature（体表温度）（体表温度）is the temperature of the skin,the subcutaneous and the fat tissue.It,by contrast,rises and falls in response to the environment.Physiology1Regulation of TemperatureThe balance between heat produced and heat lost is precisely regulated by physiological and behavioral mechanism.The system that regulates body temperature has three main parts:sensors in the shell and the core（躯体和内脏（躯体和内脏感受器）感受器）an integrator in the hypothalamus（下丘脑体（下丘脑体温调节中枢）温调节中枢）an effectual system（效应系统）（效应系统）Physiology1Heat ProductionHeat is produced in the body through metabolism,which is the chemical reaction in all body cells.Heat production is through:Voluntary movements(自主运动)In voluntary shivering(不自主寒颤)Nonshivering thermogenesis(无寒颤生热)Physiology1Heat LossHeat loss by Skin（70%）、respiratory（29%）、evacuate（1%）Normal heat loss is through RadiationconductionconvectionevaporationPhysiology1Radiation It is the transfer of heat from the surface of one object to the surface of another without direct contact between the two.Radiation increases as the temperature difference between the objects increases.The clients position increases radiation heat loss.Physiology1Conduction It is the transfer of heat from one object to another with direct contact.Heat conducts through contact with solids,liquids,and gases.The nurse enhances conductive heat loss when applying an ice pack or bathing a client with cool water.The body gains heat by conduction when contact is made with materials warmer than skin temperature,such as applying a warm pack or bathing a client with warm water.Physiology1Convection It is the transfer of heat away by air movement.Heat is first conducted to air molecules directly in contact with the skin.An electric fan promotes heat loss through convection.Convective heat loss increases when moistened skin comes into contact with slightly moving air.Physiology1Evaporation It is transfer of heat energy when a liquid is changed into gas.Two ways:Insensible water loss（不感蒸发）（不感蒸发）sweating（发汗）（发汗）Evaporation is a main heat loss when environment temperature is higher than body temperature.Physiology1Bahavioral ControlHumans voluntarily act to maintain comfortable body temperature when exposed to temperature extremes.The ability of a person to control body temperature depends on:the degree of temperature extreme;the persons ability to sense feeling comfortable or uncomfortable;emotions and thought processes;the persons mobility to remove or add clothes.Physiology1Temperature Range:36 To 37.5Average oral:37Average Tympanic:37.5Average Rectal:37.5Average Axilla:36.5 section 2section 2 Factors Affecting Body Tem