6.1 Vital Signs: Ranges & Technique
Key Takeaways
- Normal adult ranges: temperature ~97.8–99.1°F oral, pulse 60–100 bpm, respirations 12–20 per minute, blood pressure roughly 90–140 systolic / 60–90 diastolic.
- Count respirations without telling the resident, because awareness changes the breathing pattern.
- Use the radial site with two or three fingers (never the thumb) for routine pulse; count a full 60 seconds for an irregular pulse.
- Place the blood-pressure cuff on the bare upper arm; never use an arm with an IV, dialysis access, injury, or mastectomy on that side.
- The Florida CNA collects and records vital signs accurately and reports abnormal values immediately — the CNA does not diagnose.
Vital Signs Are the Most Tested Skill Set
Basic Nursing Care is 26% of the Florida written exam — the single largest domain — and vital signs are its core. Vital signs are measurements that show how the body's basic functions are working. The CNA's job is to measure accurately, record immediately, and report abnormal results to the nurse. CNAs do not interpret or diagnose.
Normal Adult Reference Ranges
| Vital Sign | Normal Adult Range |
|---|---|
| Temperature (oral) | About 97.8–99.1°F (36.5–37.3°C); rectal runs ~1° higher, axillary ~1° lower |
| Pulse (P) | 60–100 beats per minute |
| Respirations (R) | 12–20 breaths per minute |
| Blood pressure (BP) | Roughly 90–140 systolic / 60–90 diastolic mmHg |
| Oxygen saturation (SpO2) | Follow facility range and nurse direction (commonly ≥95%) |
One respiration equals one full inhalation plus one exhalation.
When to Measure
Measure on admission, at the start of the shift, before and after activity or certain procedures, after a fall, when the resident feels unwell or has a change in condition, and whenever the nurse or care plan directs.
Correct Technique and What to Report
Temperature
Match the route to the resident. Do not take an oral temperature within 15–30 minutes of hot or cold fluids, eating, or smoking, on residents who are unconscious, confused, or on oxygen by mask. Report fever, low temperature, or a sudden change, along with chills, sweating, flushing, or confusion.
Pulse
Use the radial site for routine measurement: place two or three fingers (never the thumb — it has its own pulse) on the thumb side of the wrist. Count 30 seconds × 2 for a regular pulse, or a full 60 seconds for an irregular one. Note rate, rhythm, and strength. Report a very fast, very slow, weak, bounding, or irregular pulse.
Respirations
Count respirations without telling the resident — keep your fingers on the wrist as if still taking the pulse, because a resident who knows can change the pattern. Count the rise and fall of the chest. Report labored, noisy, or shallow breathing, bluish color, or inability to speak in full sentences.
Blood Pressure
Place the cuff on the bare upper arm with the arm supported and relaxed. Never use an arm with an IV line, dialysis access (fistula/graft), injury or cast, or on the side of a mastectomy. Use the correct cuff size; a too-small cuff gives a falsely high reading.
Report Immediately When
| Vital Sign | Report If |
|---|---|
| Temperature | Above ~101°F or below ~97°F, or sudden change |
| Pulse | Above 100 or below 60 (unless that is the resident's baseline) |
| Respirations | Above 24 or below 12, or labored/noisy |
| Blood pressure | Systolic above ~160 or below ~90; diastolic above ~100 or below ~60 |
| Oxygen saturation | Below the facility's threshold or the resident's baseline |
A value that is normal-range but a big change from the resident's baseline is still reportable. Some residents have a baseline outside the textbook range that is normal for them.
Exam Tip
Vital-sign questions usually combine a measurement with a judgment. The correct CNA action is almost always: measure accurately, record it, and report the abnormal finding to the nurse — not act on it independently.
Why should the CNA count respirations without telling the resident?
A resident has a dialysis fistula in the left arm and an IV in the right forearm. Where should the CNA take the blood pressure?