Vital Signs Reference
Normal adult ranges, abnormal thresholds, and when to escalate.
| Vital | Normal Adult Range |
|---|---|
| Temperature | 36.5–37.5 °C (97.7–99.5 °F) oral |
| Heart Rate | 60–100 bpm, regular |
| Respiratory Rate | 12–20 breaths/min, quiet and unlabored |
| Blood Pressure | Roughly 90/60 to 120/80 mmHg |
| Oxygen Saturation (SpO₂) | 95–100% on room air |
| Pain | Patient-reported goal (commonly ≤ 3–4/10) |
Temperature
36.5–37.5 °C (97.7–99.5 °F) oralAbnormal: Fever ≥ 38.0 °C (100.4 °F) · Hypothermia < 35.0 °C (95.0 °F)
Route matters — rectal and temporal read higher than oral; axillary reads lower. A single fever in a neutropenic or post-op patient is never dismissed.
Escalate: Fever with rigors, hypotension, or altered mentation — think sepsis screening.
Heart Rate
60–100 bpm, regularAbnormal: Bradycardia < 60 · Tachycardia > 100
Interpret against baseline and context: athletes run lower; pain, fever, hypovolemia, and anxiety all raise rate. New irregularity warrants an apical pulse and often an EKG.
Escalate: Symptomatic bradycardia, sustained tachycardia > 130, or a new irregular rhythm.
Respiratory Rate
12–20 breaths/min, quiet and unlaboredAbnormal: Bradypnea < 12 · Tachypnea > 20
The most sensitive early indicator of deterioration — and the most commonly miscounted. Count a full 30–60 seconds while the patient is unaware.
Escalate: RR > 24–28 or rising trend, accessory muscle use, or inability to speak full sentences.
Blood Pressure
Roughly 90/60 to 120/80 mmHgAbnormal: Hypotension SBP < 90 or MAP < 65 · Hypertensive crisis ≥ 180/120
Cuff size and position change readings — a too-small cuff reads high. Compare to the patient's documented baseline, not just the textbook range.
Escalate: SBP < 90 with symptoms, MAP < 65, or ≥ 180/120 with headache, chest pain, or vision changes.
Oxygen Saturation (SpO₂)
95–100% on room airAbnormal: Hypoxemia < 90–92% (88–92% target in chronic CO₂ retention)
Poor perfusion, cold extremities, nail polish, and motion all degrade the waveform — confirm a good pleth before treating the number.
Escalate: SpO₂ below the ordered target despite supplemental oxygen, or rising O₂ requirement.
Pain
Patient-reported goal (commonly ≤ 3–4/10)Abnormal: Above the patient's stated goal or functional tolerance
Self-report is the standard — use NRS for most adults, FLACC or CPOT when the patient cannot self-report. Reassess after every intervention.
Escalate: New, severe, or character-changed pain — especially chest, calf, or post-op surgical site.
Educational use only. Normal ranges vary by source, population, and patient baseline; use the parameters and escalation criteria in your facility’s policies and the patient’s orders. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.