• A Stethoscope
• A Blood Pressure Cuff
• A Watch Displaying Seconds
• A Thermometer
• The patient should not have had alcohol, tobacco, caffeine, or performed vigorous exercise within 30 minutes of the exam.
• Ideally the patient should be sitting with feet on the floor and their back supported. The examination room should be quiet and the patient comfortable.
• History of hypertension, slow or rapid pulse, and current medications should always be obtained.
Temperature can be measured is several different ways:
• Oral with a glass, paper, or electronic thermometer (normal 98.6F/37C) 
• Axillary with a glass or electronic thermometer (normal 97.6F/36.3C)
• Rectal or “core” with a glass or electronic thermometer (normal 99.6F/37.7C)
• Aural (the ear) with an electronic thermometer (normal 99.6F/37.7C)
Of these, axillary is the least and rectal is the most accurate.
1. Best done immediately after taking the patient’s pulse. Do not announce that you are measuring respirations. [p129, p237] 
2. Without letting go of the patients wrist begin to observe the patient’s breathing. Is it normal or labored?
3. Count breaths for 15 seconds and multiply this number by 4 to yield the breaths per minute.
4. In adults, normal resting respiratory rate is between 14-20 breaths/minute. Rapid respiration is called tachypnea.