Blood pressure: appropriate cuff size (bladder encircling about 80% of the arm), arm supported at heart level, patient seated with feet flat and back supported, after a 5-minute rest with no caffeine, nicotine, or exertion in the prior 30 minutes; document arm and position; repeat after 1–2 minutes if elevated and record the average.
Pulse: palpate the radial pulse 30–60 seconds; if irregular, auscultate the apical pulse for one full minute and note any apical–radial deficit.
Respirations: count for a full minute, ideally without the patient's awareness, observing pattern and effort; note irregular patterns (Cheyne-Stokes, Kussmaul).
Temperature: use a consistent route and account for the route when interpreting; note recent intake or activity that may affect an oral reading.
Oxygen saturation: ensure an adequate waveform and perfusion; document room-air value and, if on oxygen, the device and flow.
Weight: same scale, same time of day, similar clothing; compare to the prior weight and to target; thresholds commonly > 2–3 lb in a day or > 5 lb in a week for at-risk patients.
Orthostatic vital signs: measure blood pressure and heart rate supine after 5 minutes, then standing at 1 and 3 minutes; a drop of ≥ 20 mmHg systolic or ≥ 10 mmHg diastolic, or reproduction of symptoms, is positive.
