Unit 12

Numbers at Work: Saying and Hearing Measurements

Workplace English for Nursing Assistants

Meet Herman

Watch the video about Herman. Watch what happens.

Case Study Video — Herman

Herman — Emergency Vital Signs

Talk about it

  1. Was Herman's pulse normal? What is the normal range? What is a fast pulse called?
  2. Were Herman's respirations normal? What is the normal range?
  3. Was Herman's blood pressure normal? What is normal, and what do we call a reading this high?
Five tiles show the normal adult ranges for temperature, pulse, respiration, blood pressure, and oxygen saturation.
Figure 12.1 — Learn these five ranges first. Everything abnormal is above or below them.

The Normal Ranges

Vital signs give important information about a client’s health. Healthcare workers must know the normal ranges for temperature, pulse, respiration, blood pressure, and oxygen level. They also need to measure each vital sign carefully, repeat unusual results, and report abnormal numbers to the nurse right away. Clear speaking and careful number checking help prevent mistakes.

Normal Ranges — Adult

Temperature: 97.6–99.6°F (oral average 98.6°F). Over 100°F = fever.

Pulse (heart rate): 60–100 beats per minute.

Respiration: 12–20 breaths per minute.

Blood pressure: less than 120/80 mmHg.

Oxygen saturation (O₂ sat): 95–100%.

Practice 1

1.1 The Normal Ranges

Fill in the normal adult range for each vital sign.

  1. Temperature (oral average): about °F (fever is over °F).
  2. Pulse: to beats per minute.
  3. Respiration: to breaths per minute.
  4. Blood pressure: less than / mmHg.
  5. Oxygen saturation: to 100% (report below %).

Medical Root Words (Word-Building)

Chattybot · FlashcardsScan to drill these words out loud. Chattybot · FlashcardsScan to drill these words out loud.

Medical roots are the main parts of medical terms. They usually identify a body part or function. For example, cardi means heart, derm means skin, and osteo means bone.

Roots
RootMeaning
brady-slow / low
tachy-fast / high
hyper-high / too much
hypo-low / too little
-cardiaheart (rate)
-pneabreathing
Terms built from the parts
TermBuilt fromMeaning
Bradycardiabrady + cardiaSlow heart rate (under 60 bpm)
Tachycardiatachy + cardiaFast heart rate (over 100 bpm)
Bradypneabrady + pneaSlow breathing (under 12/min)
Tachypneatachy + pneaFast breathing (over 20/min)
Hypertensionhyper + tensionHigh blood pressure (over 140/90)
Hypotensionhypo + tensionLow blood pressure (under 90/60)

Practice 2

2.1 Medical Terminology

Match each term to its meaning.

  • 1. Bradycardia
  • 2. Tachypnea
  • 3. Bradypnea
  • 4. Hypertension
  • 5. Tachycardia
  • 6. Hypotension
  • A. Blood pressure that is too high (over 140/90 mmHg)
  • B. Breathing that is too fast (over 20 breaths per minute)
  • C. A high heart rate
  • D. Slow breathing (under 12 breaths per minute)
  • F. A low heart rate
  • G. Blood pressure that is too low (under 90/60 mmHg)

2.2 Word-building

Write what each part means:

brady- =   tachy- =   hyper- =   hypo- =

Measuring Accurately

Chattybot · FlashcardsScan to drill these words out loud.

Temperature — by route

Temperature routes
RouteNotes
Oral (98.6°)No food/drink/gum 15–20 min before; under the tongue.
Axillary (97.6°)Under the arm; best for dementia (safer — no biting).
Rectal (99.6°)Most accurate but most invasive/dangerous; NEVER for dementia.
Tympanic (97.6°)In the ear; least accurate. Adult: pull ear UP and back. Child: DOWN and back.
Temporal artery (99.6°)Swipe across the forehead; least invasive AND very accurate.
NCIT (99.6°)No contact at all; no sunlight, no draft.
A figure of a client with labeled markers showing oral, axillary, rectal, tympanic, temporal, and no-contact temperature routes.
Figure 12.2 — Where to Take a Temperature: Six temperature routes. The safest for dementia is under the arm.

Pulse & respiration

A close-up shows two fingers placed on the thumb side of a client's wrist, with the thumb crossed out as a no.
Figure 12.3 — Taking a Radial Pulse: Index and middle fingers on the thumb-side wrist. Count for 60 seconds.

Practice 3

3.1 True or False

  1. You should tell the client when you are about to count their respirations.
  2. Count a pulse for a full 60 seconds.
  3. The axillary route is safer than the oral route for a client with dementia.
  4. You may take an oxygen reading over blue nail beds or nail polish.
  5. Clean vital-sign equipment with alcohol after each use.
  6. An abnormal reading should be repeated before you report it.

3.2 Fill in the blank

  1. To take a pulse, use the artery on the thumb side of the wrist.
  2. For a client in isolation, keep vital-sign equipment (in the room / at the desk).
  3. The least invasive route (no contact at all) is the thermometer.

Blood Pressure

Chattybot · FlashcardsScan to drill these words out loud.

Blood pressure is written as systolic over diastolic in mmHg. Systolic (top number) = the heart contracting. Diastolic (bottom number) = the heart at rest.

Blood pressure categories
Category Reading
Normal Under 120 / under 80
Elevated 120–129 / under 80
High — Stage 1 130–139 or 80–89
High — Stage 2 140+ or 90+
Hypertensive CRISIS 180+ and/or 120+ — EMERGENCY, tell the nurse now
A vertical scale shows blood pressure categories from normal at the bottom to hypertensive crisis at the top.
Figure 12.4 — Blood pressure rises through five categories. The top one is an emergency.
⚠ Safety — Which Arm?

Never take a blood pressure on the same-side arm as a mastectomy (it can cause lymphedema), or on an arm with an IV. Use the other arm.

Two crossed-out panels show a cuff on a mastectomy-side arm and on an arm with an IV; a checked panel shows the correct other arm.
Figure 12.5 — Which Arm for the Cuff?: Never cuff the mastectomy side or an arm with an IV. Use the other arm.

Good technique: client seated and quiet, legs uncrossed, arm bare and supported at heart level, palm up. Cuff the right size (one finger fits under it) over the brachial artery. First beat heard = systolic; last beat = diastolic. Unsure or out of range? Rest the arm 5 minutes and repeat, or ask the nurse.

A labeled diagram shows a seated client with a blood pressure cuff over the brachial artery, a stethoscope, and a sample reading marking systolic and diastolic.
Figure 12.6 — The Blood Pressure Setup: Cuff over the brachial artery, arm supported at heart level, palm up.

Practice 4

4.1 Fill in the blank

  1. The (top / bottom) number is systolic; it is the heart contracting.
  2. Never take a blood pressure on the same arm as a or an IV.
  3. A reading of 180+ / 120+ is a hypertensive — an emergency.
  4. The first beat you hear is the pressure; the last beat is the diastolic.

4.2 Fill in the blank (word bank)

Use a word from the word bank. Each is used once.

sixty · bradypnea · hypertension · hypotension · tachypnea · tachycardia · painful · stethoscope · pulse oximetry · non-contact infrared thermometer

  1. Bradycardia is a heart rate less than beats per minute.
  2. is slow breathing, less than 12 breaths per minute.
  3. Blood pressure that is too high is called .
  4. A blood pressure reading less than 90/60 is called .
  5. The is the least invasive way to take a temperature (no contact).
  6. Lymphedema is a swelling of the arm.
  7. Breathing that is too fast and shallow is called .
  8. The Korotkoff sound is heartbeats heard through a .
  9. A heart rate greater than 100 bpm is called .
  10. measures oxygen levels in the blood.

Saying and Hearing Numbers

⚠ Teens and Tens

These pairs sound alike:

13 / 30   14 / 40   15 / 50   16 / 60   17 / 70   18 / 80   19 / 90

Native speakers mishear these too, in noisy corridors, in a hurry…

🗣 Speaking Toolbox: Reading a number back
Language Focus: how nurses actually say numbers

Blood pressure: 190/98 = "one-ninety over ninety-eight." 118/76 = "one-eighteen over seventy-six."

Pulse: 108 = "one-oh-eight" (not "one hundred and eight").

Temperature: 99.9 = "ninety-nine point nine" — and always say the ROUTE: "axillary."

O₂ sat: 94% = "ninety-four percent" or just "ninety-four on room air."

Practice 5

5.1 Say it the safe way

Write each number the way you would SAY it out loud — whole number, then digit by digit.

Example: 15 → "Fifteen. One-five."

  1. 50 →

    __________________________________

  2. 18 →

    ___________________________________

  3. 90 →

    ___________________________________

  4. 60 →

    ___________________________________

5.2 Say the reading

Write how a nurse would say each one out loud.

  1. BP 118/76 →

    ___________________________________

  2. Pulse 108 →

    ____________________________________

  3. Temp 99.9 axillary →

    ____________________________________

  4. BP 180/120 →

    ____________________________________

Check Your Knowledge Chattybot · Check Your KnowledgeScan to answer these questions out loud.
  1. Say all five normal ranges from memory.
  2. A temperature of 100.4°F — normal or fever?
  3. You get an abnormal reading. Name the two things you do, in order.
  4. Build the word: slow + breathing = ? Fast + heart = ?
  5. Which is high blood pressure — hyper- or hypo-tension?
  6. A pulse of 52. Normal? What is the word?
  7. Which temperature route is best for a client with dementia? Which is never used?
  8. How long do you count a pulse? What if you lose it?
  9. Why do you not tell a client you are counting their breathing?
  10. Say "15" and "50" the safe way.
  11. Say this out loud: BP 180/120, pulse 60, temp 99.9 axillary.

Dialogue Practice

Read these dialogues out loud with a partner.

Two people having a scripted workplace dialogue.

Dialogue 1 —Sixty or sixteen?

Chattybot · DialogueScan to read this script out loud.

Busy corridor, a floor buffer running nearby. You report Mr. Adeyemi's vitals to the nurse, who is writing as you speak.

You: Mr. Adeyemi — pulse sixty, respirations eighteen.

Supervisor: (writing) Sixteen, eighteen...

You: Sorry — sixty. Six-zero. And respirations eighteen. One-eight.

Supervisor: Sixty and eighteen. Let me fix that. Good catch — sixteen would have had me in there with a doctor.

You: It's this floor buffer. I'll say the digits from now on.

Later, the nurse gives the student an instruction across the same corridor.

Supervisor: — and take it again in fifteen minutes.

You: Sorry — was that fifteen or fifty?

Supervisor: Fifteen. One-five.

You: Fifteen minutes — one-five — is that right?

Supervisor: That's right.



Two people having a scripted workplace dialogue.

Dialogue 2 —Reporting a full set

Chattybot · DialogueScan to read this script out loud.

You have taken vitals on Mr. Whitcombe, who fell yesterday. BP 190/98, pulse 108, respirations 14, temp 99.9 axillary, O₂ sat 96%.

You: Have you got a second? Mr. Whitcombe's vitals — one of them I don't like.

Supervisor: Go ahead.

You: In summary, BP one-ninety over ninety-eight, pulse one-oh-eight, respirations fourteen, temp ninety-nine point nine axillary, sat ninety-six.

Supervisor: Which one don't you like?

You: The blood pressure. One-nine-zero over nine-eight. And the pulse is up too — one-oh-eight, that's tachycardia.

Supervisor: Did you repeat the BP?

You: Twice, five minutes apart, right arm, large cuff. One-ninety over ninety-eight both times.

Supervisor: Any symptoms?

You: No headache, no chest pain, no vision change. He does say he feels "off", but he can't say how.

Supervisor: Right. I'm coming now. Take it again in ten minutes and don't walk him.

You: Again in ten — one-zero — minutes, and no walking. Is that right?

Supervisor: Correct.

Roleplays

Work with a partner.

An older man having his blood pressure taken.

Roleplay 1 —The impossible reading

Chattybot · RoleplayScan to rehearse this roleplay out loud.

Situation

An automatic cuff gives you 58/32 on Mr. Kowalczyk, twice. He is sitting up, talking normally, warm and pink, and says he feels fine. Decide what to do.

Your Goals:

  1. Look at the CLIENT before you act on the number.
  2. Ask about symptoms that would go with that reading.
  3. Repeat the measurement properly before reporting.
  4. Ask for a manual re-check and say WHY you doubt it.
  5. Do not chart the number as fact before it is confirmed.
An incoming nurse at handover.

Roleplay 2 —The noisy handover

Chattybot · RoleplayScan to rehearse this roleplay out loud.

Situation

Shift change in a busy corridor. You must report three clients' vitals to the incoming nurse, and she must give you two instructions back. Neither of you can hear well.

Your Goals:

  1. Say every number whole, then digit by digit.
  2. Notice when the nurse writes a wrong number and correct it immediately. -- Correct the FACT, not the person.
  3. Use a Repetition Request when you don't catch something — naming both options.
  4. Read back both instructions with a question at the end.

Cumulative Review

Multiple Choice

1. Height is usually measured

  1. when a client is admitted
  2. once a year on the admission date
  3. each time weight is taken on bath day

2. The client MOST likely to have vital signs taken often is a

  1. client who fell a week ago
  2. client just admitted to the hospital with pneumonia
  3. assisted-living client with dementia

3. A client in contact isolation should have a full set of vital-sign equipment kept

  1. in the client's room
  2. right outside the door
  3. at the nurse's desk

4. To prevent the spread of infection, vital-sign equipment must be

  1. cleaned with alcohol after each use
  2. used once and discarded
  3. washed with soap and water before each use

5. The average temperature taken with a tympanic thermometer is

  1. 98.6°F
  2. 99.6°F
  3. 97.6°F

6. The route that is least invasive AND most accurate is

  1. axillary
  2. temporal artery
  3. oral

7. The normal range for an adult pulse is

  1. 40–60 bpm
  2. 60–100 bpm
  3. 100–120 bpm

8. A respiratory rate of 26 breaths per minute is called

  1. bradypnea
  2. tachypnea
  3. normal

9. The SAFEST way to say a pulse of 50 out loud is

  1. "Fifty."
  2. "Fifty. Five-zero."
  3. "Five oh."

10. The nurse says a number and you are not sure you heard it. You should

  1. write down your best guess
  2. ask "Was that fifteen or fifty?"
  3. ask someone else later

11. You get an abnormal blood pressure. Before you report it, you should

  1. chart it immediately
  2. repeat the measurement to confirm
  3. wait and take it again next shift

12. A coworker is about to take a BP on the arm with an IV. The BEST thing to say is

  1. "You can't do that!"
  2. "Sorry — don't you mean the other arm? She's got an IV in that one."
  3. "I'll report you to the nurse."

Case Study: Herman

Read the case. Use the normal ranges to answer.

The Case: Herman

You work in an assisted-living facility. While walking with Herman, they pass out and fall. You call 911 and take vital signs to report to the emergency team: temperature 99.9°F (axillary), pulse 108, respirations 14, blood pressure 190/98.

1. Was this an appropriate time to take vital signs? Why?

______________________________________________________________

2. What must you do with the vital-sign equipment after using it on Herman?

______________________________________________________________

3. Was Herman's pulse normal? What is the normal range? What is a fast pulse called?

______________________________________________________________

4. Were Herman's respirations normal? What is the normal range?

______________________________________________________________

5. Was Herman's blood pressure normal? What is normal, and what do we call a reading this high?

______________________________________________________________

6. Write out EXACTLY how you would say this whole set out loud to the paramedics.

______________________________________________________________

For the instructor — not part of the student pages

Instructor Answer Key

Unit 12 — Numbers at Work: Saying and Hearing Measurements

This unit develops the clinical vocabulary and number communication needed when taking vital signs. Learners study normal ranges for temperature, pulse, respirations, blood pressure, and oxygen level, along with medical roots, measurement techniques, equipment safety, and abnormal readings. A case study about Herman shows how a misheard number can become a patient-safety problem. Through illustrated readings, flashcards, knowledge checks, dialogues, and role-plays, learners practice distinguishing similar-sounding numbers, saying measurements twice and digit by digit, confirming unusual results, requesting a repeat, using read-back, and reporting a complete set of vital signs clearly.

Practice 1–5 and Review

Practice 1.1 (ranges): 1. ~98.6°F (fever over 100°) 2. 60–100 3. 12–20 4. 120/80 5. 95–100% (report below 90%).

Practice 2.1 (match): 1-F, 2-B, 3-H, 4-D, 5-A, 6-C, 7-G, 8-E. Practice 2.2: brady- = slow, tachy- = fast, hyper- = high, hypo- = low.

Practice 3.1: 1. False 2. True 3. True 4. False 5. True 6. True. Practice 3.2: 1. radial 2. in the room 3. non-contact infrared (NCIT).

Practice 4.1: 1. top 2. mastectomy 3. crisis 4. systolic. Practice 4.2: 1. sixty 2. bradypnea 3. hypertension 4. hypotension 5. non-contact infrared thermometer 6. painful 7. tachypnea 8. stethoscope 9. tachycardia 10. pulse oximetry.

Practice 5.1: 1. "Fifty. Five-zero." 2. "Eighteen. One-eight." 3. "Ninety. Nine-zero." 4. "Sixty. Six-zero." Practice 5.2: 1. "one-eighteen over seventy-six" 2. "one-oh-eight" 3. "ninety-nine point nine, axillary" 4. "one-eighty over one-twenty" (then digits).

Multiple Choice: 1-a, 2-b, 3-a, 4-a, 5-c, 6-b, 7-b, 8-b, 9-b, 10-b, 11-b, 12-b.

Back to Herman Best Response: 1-b (confirm, report abnormal immediately, then continue). 2-a (an impossible reading + a client who feels fine points to equipment error — have the nurse verify manually). 3-b (correct it immediately, with digits — a charted number is very hard to un-believe later).

Suggested drill — the noisy number drill

Play loud noise. Students sit back to back in pairs. One reads a card with a vital-sign set; the other writes it down. Then compare. Try it once saying the whole number only, then again saying the whole number, then digits. For example, “fifty. five zero.”