Pediatric Vital Signs: A Guide for Nurses

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A pediatric nurse holds a stethoscope to the chest of an alert baby in a caregiver’s lapFor doctors, nurses, and other health professionals who administer care to pediatric patients, knowing the basic pediatric vital signs is critical. By paying attention to these signs, they can quickly gauge whether a pediatric patient is experiencing symptoms that need to be addressed, and whether the patient’s growth and development fall within the normal range.

To properly measure and understand pediatric vital signs, nurses often use charts and other tools. By pursuing an advanced degree in nursing, pediatric nurse professionals can learn to use these tools to help ensure optimal patient outcomes.

What Is a Pediatric Vital Signs Chart?

A pediatric vital signs chart includes important data for assessing a child’s health and development. The most common vital signs recorded on each chart include heart rate, respiratory rate, blood pressure, oxygen saturation, and body temperature. These vital signs are especially useful for determining the status of very young patients, including infants, who can’t express their symptoms in words.

Health professionals, often nurses, typically measure each vital sign during a brief physical examination. These measurements supply numerical data reflecting a patient’s current status. For example, a thermometer readout might reveal that a young patient’s temperature is 99.8 degrees. This would qualify as a fever, revealing an underlying infection or illness that a young patient may be unable to express verbally.

This data can then be cross-referenced with the pediatric vital signs chart, which presents the normal range of outcomes for each category. Pediatric nurses know that the outcome ranges can change by age group. For instance, the range for a healthy resting heart rate is different for a young child than for an adult.

If a patient’s vital signs fall outside the normal range, a nurse may monitor the vital sign for fluctuation or improvement, or they may consult with the attending physician about potential diagnoses.

To better understand how these metrics can assist nurses in providing optimal pediatric care, consider each of the core measurements found on a pediatric vital signs chart.

Heart Rate

The first vital sign is heart rate, or, as it is informally known, pulse. The heart rate is the measure of how many times the heart beats in a single minute. When children are up and moving around, their heart rate will naturally be a little higher; when they sit still, the heart rate will slow.

Nurses check heart rates to ensure normal cardiovascular function or to investigate symptoms such as chest pain or difficulty breathing. A heart rate outside the normal range can suggest a medical complication. For infants, an abnormal heart rate may reveal a birth defect or a case of hypothermia. For older children, an abnormal heart rate can suggest a structural problem with the organ itself.

A child’s heart rate can be checked noninvasively, either with a small device placed on the finger or by manually counting heartbeats while holding a finger against the patient’s wrist or neck.

Respiratory Rate

A child’s respiratory rate refers to the number of breaths they take each minute. This vital sign is similar to heart rate, in that it can vary depending on the child’s level of activity. Specifically, respiratory rates tend to be elevated when the patient is nervous, excited, or experiencing pain or fever.

Respiratory rate is similar to heart rate in another way: Pediatric nurses can check it manually and without causing discomfort. Often, respiratory rates are measured by using a stethoscope to listen to the lungs and counting the number of breaths within a certain time span.

Patients who consistently show an unusually low or high respiratory rate may require further diagnostics for breathing problems, which may be caused by structural problems in the lungs.

Blood Pressure

The pediatric vital signs chart also indicates a patient’s blood pressure. This is the measure of the pressure of circulating blood against the walls of the blood vessels.

Nurses can measure a child’s blood pressure with noninvasive tools, such as blood pressure cuffs. These monitors will present blood pressure readings using two distinct measures: the systolic reading and the diastolic reading.

  • The systolic reading represents how much pressure is on the artery walls each time the heart beats.
  • The diastolic number shows how much pressure is on the artery walls between beats, in other words, when the heart is at rest.

Children may have abnormal blood pressure just as adults do, and readings that fall consistently outside the healthy range can suggest a high risk of the patient developing significant heart or kidney problems as they get older.

High blood pressure may also be a diagnostic indicator of heart defects, hormone disorders, or obesity. Low blood pressure, on the other hand, can be an indication of anemia, dehydration, poor nutrition, or complications from medication.

Oxygen Saturation

Pediatric nurses may also record the patient’s oxygen saturation level. This is a measure of how much oxygen the red blood cells carry throughout the body.

For most patients, adults and children alike, oxygen saturation isn’t something that requires regular monitoring. Generally, doctors and nurses only check blood oxygen levels if the patient has a specific problem, such as shortness of breath or pain in their chest.

For those who do have abnormal oxygen saturation levels, it may point to underlying conditions such as asthma or a structural malformation of the heart.

Body Temperature

A pediatric vital signs chart may also denote the patient’s body temperature. Temperature may be measured with either an oral or rectal thermometer. While rectal thermometers are slightly more accurate, oral thermometers are much more commonly employed, as they are less invasive.

The main thing nurses are checking when they check temperature is whether the patient has a fever. If so, this typically means the body is fighting an infection. A high temperature can be an important diagnostic indicator.

How to Use a Pediatric Vital Signs Chart

By studying a pediatric vital signs chart, and comparing a patient’s measurements to the “normal” range, nurses are able to assess their patient’s growth and development while also uncovering any serious health issues that require clinical intervention.

Tracking Growth and Development

A patient’s vital signs are measured over time and compared with the normal range for their age group. This allows pediatric health care providers to ensure that the child is growing the way they should.

As an example, consider one of the core measurements included on a pediatric vital signs chart: heart rate. Heart rate is usually higher in infants than older children. It drops as the individual reaches early childhood and then adolescence. A healthy heart rate for a newborn baby can be anywhere from 100 to 160 beats per minute, while a normal range for preteens and teens is anywhere from 60 to 100. By monitoring heart rate over time, nurses can verify that their patient is developing in a normal, healthy way.

Identifying Health Issues

By comparing a patient’s vital signs to those in the normal range, nurses can also spot red flags for disease or physiological abnormalities. Consider how vital signs are used as diagnostic tools:

  • When a child has low blood pressure, it may reveal an underlying infection or even undiagnosed internal bleeding. When alerted to these issues, the medical team can implement potentially life-saving interventions.
  • Children who have especially low respiratory rates may be experiencing neurological damage. Again, abnormal vital signs may help caregivers detect an otherwise invisible issue.
  • A heightened temperature is one of the clearest indicators that a child’s body is fighting off infection, and can often verify a diagnosis of influenza or other illness.

By understanding the normal ranges for each vital sign, nurses can quantify exactly how much of a deviation their patient is experiencing. This can help classify the severity of an illness, and may be an important metric that health care providers use to decide to monitor a situation more closely or begin immediate treatment.

Normal Pediatric Vital Signs

Vital signs provide important information about how well a pediatric patient’s organs and bodily systems are functioning. When a patient falls within the range of normal pediatric vital signs, that suggests that the organs are all working optimally, and that important bodily processes are being carried out efficiently. A deviation from normal pediatric vital signs raises a red flag that something may be wrong.

In some instances, a drastic deviation from the range of normal pediatric vital signs alerts nurses and other health care providers to critical concerns. For example, a heart rate that is significantly faster than normal may indicate a structural defect in the patient’s heart, potentially requiring corrective surgery.

The normal vital sign range shifts as a patient ages: What’s considered normal and healthy for a newborn differs from that of an infant, toddler, preteen, or adult. Consider the following vital sign ranges by age.

Infant Vital Signs

To begin, consider the normal range for infant vital signs:

  • Infant heart rate. The normal range for heart rate is 100 to 160 beats per minute.
  • Respiratory rates, birth to 6 months. Respiratory rates for those from birth to 6 months old should be between 30 and 60 breaths per minute.
  • Respiratory rates, 6 to 12 months. Respiratory rates for patients 6 to 12 months should fall between 24 and 30 breaths per minute.
  • Blood pressure, birth to 6 months. Blood pressure for patients from birth to 6 months old should be 65 to 90/45 to 65 millimeters of mercury (mm Hg).
  • Blood pressure, 6 to 12 months. Blood pressure for patients 6 to 12 months should be 80 to 100/55 to 65 mm Hg.
  • The ideal temperature for all ages is 98.6 degrees Fahrenheit. For infants, anything between 97.4 and 99.6 is considered to be healthy.
  • Oxygen level. Ideally, an infant’s blood oxygen range will be somewhere between 90% and 100%.

Using pediatric vital sign charts, nurses and other health professionals can gauge whether an infant is deviating from the normal range, and, if so, by how much. When vital signs trend positive or negative over multiple screenings, that can sometimes be used to diagnose an underlying issue. In some situations, nurses may use this information to take preventive action.

Normal Vital Signs for Children

Next, consider the normal vital signs for children, which includes any patient between 1 and 11 years old.

Normal vital signs for children are as follows:

  • Heart rate. The normal heart rate should be 70 to 120 beats per minute.
  • Respiratory rate, 1 to 5. Respiratory rate for patients between ages 1 and 5 should be 20 to 30 breaths per minute.
  • Respiratory rate, 6 to 11. For patients 6 through 11, respiratory rates should fall somewhere between 12 and 20 breaths per minute.
  • Blood pressure. Blood pressure for patients in this age range should be 90 to 110/55 to 75 mm Hg.
  • As with infants, children should have a temperature of around 98.6 degrees. Anything from 97.4 to 99.6 is considered to be in the range of normal vital signs for children.
  • Oxygen saturation. In a healthy child, oxygen saturation levels are typically somewhere between 97% and 99%.

It’s important to note that some of these vital sign ranges evolve once children reach adolescence. For example, preteens and teens typically have slower breathing rates than younger children (usually just 12 to 18 breaths per minute), and lower heart rates (60 to 100 beats per minute).

Another crucial distinction is that these vital signs correspond not just with age but also with benchmarks in weight and height. Pediatric nurses may determine that a patient’s slightly abnormal vital signs are acceptable if the patient is also unusually short, heavy, etc.

How to Take Pediatric Vital Signs

Knowing how to take pediatric vital signs is an important skill for nurses.

Checking Heart Rate

The easiest way to measure the heart rate of a child in any age group is to place a finger on the child’s wrist, applying slight pressure until their pulse can be felt. Count the number of pulses for a period of 15 seconds, and then multiply that number by four to obtain the overall heart rate.

Assessing Respiratory Rate

Similarly, respiratory rate can be assessed through observation. Set a timer for 30 seconds, and count the number of times the child’s chest rises. Multiply the number by two to get the respiratory rate.

Measuring Blood Pressure

Simple blood pressure cuffs can be used on patients of all ages. All air must be eliminated from the cuffs before placing them around the patient’s arm. Cuffs should fit snugly. For infants and smaller children, specially sized cuffs may be needed to ensure a snug fit.

Monitoring Oxygen Saturation

Health professionals measure blood oxygen levels with sensors placed on the patient’s finger or toe. If blood oxygen levels are lower than the normal range, this usually means oxygen therapy must be started immediately.

Taking Temperature

Most pediatric nurses prefer to use a digital thermometer placed under the patient’s tongue, though rectal thermometers may sometimes be used for infants. In the latter case, the thermometer only needs to be inserted about half an inch into the rectum to get an accurate reading.

In addition to taking pediatric vital signs, nurses may also use screening tools to evaluate a child’s transition into different demographic categories. These screening tools consider multiple vital signs in tandem, rather than in isolation, to get a full sense of the child’s health and well-being, and may alert nurses that their patient is reaching a new stage of development either earlier or later than is typical.

The Building Blocks of Patient Health

By taking pediatric vital signs, nurses can effectively monitor their pediatric patients’ overall health as they grow and transition into new stages of development. Additionally, vital signs can provide clues as to underlying health abnormalities, potentially opening the door to early clinical interventions.

Nurses who are interested in strengthening their physical assessment skills can consider enrolling in an advanced degree program, such as Ohio University’s online Master of Science in Nursing (MSN). This program equips nurses with the academic knowledge and clinical experience they need to take vital signs and interpret them accurately. Learn more about how this program helps nurses hone their patient care fundamentals.

Recommended Readings

Healthy Exercise and Nutrition Guide for Nurses

Nurse Burnout Prevention Strategies for Nurse Leaders

Personal Protective Equipment in Nursing: Its Purpose and Importance


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Frontiers in Pediatrics, “Pediatric Vital Sign Distribution Derived from a Multi-Centered Emergency Department Database”

Healthline, “Is My Blood Oxygen Level Normal?”

Medical News Today, “What to Know About Pediatric Vital Signs”

MedlinePlus, Children’s Health

Pediatric Research, “Continuous Vital Sign Analysis for Predicting and Preventing Neonatal Diseases in the Twenty-First Century: Big Data to the Forefront”

U.S. Department of Health and Human Services, Child Health & Development

WebMD, Pediatric Vital Signs