Reviewed November 2, 2026 by the editorial team
Normal adult values
Below 60 is bradycardia and above 100 is tachycardia. Well-trained athletes can be below 60 without symptoms.
MedlinePlus gives 12-18 at rest; in clinical practice 12-20 is used as the adult reference range.
The AHA/ACC classifies below 120/80 as normal and 120-129 with a diastolic below 80 as elevated. A single high reading does not diagnose hypertension.
It varies with time of day, activity and measurement site. Above 38 °C (100.4 °F) is considered a fever.
In patients with COPD or another chronic lung disease, the provider may set a lower target.
The American Pain Society proposed in the 1990s that pain be documented along with the vital signs. It is not a physiologic vital sign, but many facilities assess it with every set of vitals using the VAS or a numeric scale.
Vital signs by age
| Age | HR (bpm) | RR (breaths/min) | Systolic BP (mmHg) | Temperature °C (°F) |
|---|---|---|---|---|
| Newborn (0-28 days) | 100-205 | 35-55 | 67-84 | 36.1-37.7 (97.0-99.9 °F) |
| Infant (1-12 months) | 100-180 | 30-53 | 72-104 | 36.1-37.2 (97.0-99.0 °F) |
| Preschooler (3-5 years) | 80-120 | 20-29 | 89-112 | 36.1-37.0 (97.0-98.6 °F) |
| School-age (6-12 years) | 75-118 | 18-25 | 97-120 | 36.1-37.0 (97.0-98.6 °F) |
| Adolescent (13-17 years) | 60-100 | 12-20 | 110-131 | 36.0-37.0 (96.8-98.6 °F) |
| Adult | 60-100 | 12-20 | Below 120 | 36.5-37.3 (97.7-99.1 °F) |
| Older adult (65 and over) | 60-100 | 12-20 | Below 120 | 36.0-37.0 (96.8-98.6 °F) |
Toddler (1-2 years), not shown above: HR 98-140, RR 22-37, SBP 86-106 mmHg. Older adults follow the adult ranges; their baseline temperature tends to run slightly lower and they may not mount a high fever even with an infection. Source: HR, RR and systolic BP from newborn to adolescent: American Red Cross PALS 2025 reference card (AHA ranges for pediatric advanced life support). Temperature by age: Manual of vital signs in the pediatric population, Universidad de Los Lagos (Chile), 2021, citing Cobo (2011). Adult: MedlinePlus.
Blood pressure categories
| Category | Systolic (mmHg) | Diastolic (mmHg) |
|---|---|---|
| Optimal | Below 120 | Below 80 |
| Normal | 120-129 | 80-84 |
| High normal | 130-139 | 85-89 |
| Grade 1 hypertension | 140-159 | 90-99 |
| Grade 2 hypertension | 160-179 | 100-109 |
| Grade 3 hypertension | 180 or higher | 110 or higher |
| Isolated systolic hypertension | 140 or higher | Below 90 |
Source: Hypertension grading used in European guidelines (ESH) and in several national standards, such as Mexico's NOM-030-SSA2-2009 for the prevention, detection, diagnosis, treatment and control of systemic hypertension.
In the US, the AHA/ACC classification (2017 guideline, kept in the 2025 update) is the standard: normal below 120/80; elevated 120-129 with a diastolic below 80; stage 1 hypertension 130-139 or 80-89; stage 2 140 or higher or 90 or higher; severe hypertension above 180 and/or above 120. This is the classification used in US nursing courses and on the NCLEX.
How to measure each vital sign
Heart rate
- Have the patient rest for 5 minutes, sitting or lying down.
- Palpate the radial pulse with your index and middle fingers; never with your thumb, which has its own pulse.
- Count for a full minute if the rhythm is irregular; if it is regular, 30 seconds times 2 is acceptable.
- Document the rate, rhythm (regular or irregular) and strength.
- In infants and young children, auscultate the apical pulse for a full minute.
Respiratory rate
- Count without telling the patient, for example while your fingers are still on the pulse.
- Watch the chest or abdomen: each rise and fall is one breath.
- Count for a full minute, especially in children and when the pattern is irregular.
- Also note depth, rhythm, use of accessory muscles and any abnormal sounds.
Blood pressure
- Make sure the patient has not smoked, had caffeine or exercised in the previous 30 minutes and has an empty bladder.
- Seat the patient for 5 minutes with the back supported, feet flat on the floor and the bare arm at heart level.
- Use the right cuff size: a cuff that is too small gives falsely high readings.
- Place the cuff 2-3 cm above the antecubital fossa, with no talking during the measurement.
- Take at least two readings 1-2 minutes apart and document the average and the arm used.
Temperature
- Use a digital thermometer; mercury thermometers are no longer recommended.
- Axillary: dry the axilla, place the tip in the center and keep the arm against the body for as long as the device indicates.
- Oral: wait 15-30 minutes if the patient has eaten, drunk or smoked; the tip goes under the tongue with the mouth closed.
- Document the reading and the site: axillary readings usually run lower than oral or rectal ones.
Oxygen saturation
- Choose a warm, clean finger; remove dark nail polish or artificial nails.
- Ask the patient to keep the hand still and relaxed.
- Wait for a stable pulse waveform before reading the number.
- Check that the pulse rate on the oximeter matches the pulse you palpate.
- Document whether the patient is on room air or receiving oxygen, and how much.
Adult red-flag values
- Respiratory rate of 8 or less, or 25 or more per minute. Scores 3 on NEWS2. Check the airway, level of consciousness and oxygen saturation, and notify the provider immediately.
- SpO2 of 91% or less. In a patient without chronic lung disease this indicates significant hypoxemia. Notify the provider and follow the oxygen therapy protocol.
- Systolic BP of 90 mmHg or less. Possible hypotension or shock, especially with cool skin, confusion or low urine output. Notify the provider right away.
- BP of 180/110 mmHg or higher. Grade 3 hypertension (the AHA/ACC defines severe hypertension as above 180/120). With chest pain, shortness of breath, or visual or neurologic changes it may be a hypertensive emergency.
- Heart rate of 40 or less, or 131 or more per minute. Scores 3 on NEWS2. Take an apical pulse, look for symptoms and notify the provider.
- Temperature of 35.0 °C (95.0 °F) or less. Hypothermia; scores 3 on NEWS2. Warm the patient, repeat the measurement and notify the provider.
- Temperature of 39.1 °C (102.4 °F) or more. High fever. Together with tachycardia, tachypnea or hypotension it may point to sepsis.
Thresholds from the National Early Warning Score 2 (NEWS2), Royal College of Physicians, 2017; blood pressure grades from the classification table above. Always follow your facility's protocol.
Related NANDA nursing diagnoses
Frequently asked questions
What are normal vital signs for an adult?
At rest: heart rate 60-100 per minute, respiratory rate 12-20 per minute, blood pressure below 120/80 mmHg, temperature 36.5-37.3 °C (97.7-99.1 °F) and oxygen saturation 95-100%.
What are the 5 vital signs?
Heart rate, respiratory rate, blood pressure and temperature are the four classic vital signs. Oxygen saturation was added with the widespread use of pulse oximetry. Some facilities count pain as the fifth vital sign instead of oxygen saturation.
Why do children have a faster pulse and breathing rate?
Their metabolism is higher and their heart and lungs are smaller, so they compensate with more beats and breaths per minute. A newborn can have a heart rate of 100-205 beats per minute and be normal.
What blood pressure is considered high?
Under the AHA/ACC guideline used in the US, stage 1 hypertension starts at 130/80 mmHg and stage 2 at 140/90 mmHg. Other guidelines set the threshold at 140/90 and call 130-139/85-89 high normal. The diagnosis is confirmed with repeated readings on different days.
What temperature counts as a fever?
In general, a temperature above 38 °C (100.4 °F) is considered a fever. Axillary readings usually run a few tenths lower than oral or rectal readings, so always document the site.
What oxygen saturation level is dangerous?
Anything below 95% is already outside the normal range. At 92% or less you should notify the provider, and at 88% or less the patient needs immediate attention, unless the provider has set a different target because of chronic lung disease.
Nursing assessment scales
Sources: American Red Cross. PALS 2025: Pediatric Systematic Assessment card · NOM-030-SSA2-2009, systemic hypertension (DOF, in Spanish) · American Heart Association. Understanding Blood Pressure Readings · MedlinePlus. Vital signs (Spanish edition) · MedlinePlus. Pulse Oximetry. Reviewed November 2, 2026.