Vital Signs Reference Guide: Normal Ranges by Age
Essential vital signs reference with normal ranges, critical values, and nursing implications for all age groups
📊 Essential Vital Signs Reference
Master normal vital signs ranges for all ages to excel in clinical practice, pass the NCLEX, and provide safe patient care. This comprehensive guide includes age-specific normal ranges, critical values, and nursing implications.
💡 Pro Tip: Bookmark this page and review these ranges regularly during clinical rotations!
Blood Pressure (BP)
| Age Group | Normal Range (mmHg) | Elevated | Critical Values |
|---|---|---|---|
| Newborn (0-1 month) | 60-90/30-60 | >95/65 | >100/70 or <50/30 |
| Infant (1-12 months) | 70-100/35-65 | >105/70 | >110/75 or <60/35 |
| Toddler (1-3 years) | 80-110/40-70 | >115/75 | >120/80 or <70/40 |
| Preschool (3-6 years) | 90-115/50-75 | >120/80 | >125/85 or <80/50 |
| School-age (6-12 years) | 95-120/55-80 | >125/85 | >130/90 or <85/55 |
| Adolescent (12-18 years) | 110-135/65-85 | >140/90 | >160/100 or <90/60 |
| Adult (18-65 years) | 120/80 (Normal) 120-129/<80 (Elevated) |
130-139/80-89 (Stage 1) ≥140/90 (Stage 2) |
>180/120 or <90/60 |
| Older Adult (>65 years) | 120-140/70-90 | >150/90 | >180/120 or <100/65 |
🚨 Hypertensive Crisis
Emergency: >180/120 with symptoms (chest pain, shortness of breath, vision changes)
Urgency: >180/120 without symptoms
🩺 Nursing Considerations
- Use appropriate cuff size (2/3 of upper arm length)
- Patient should be seated with feet flat on floor for 5 minutes
- Arm should be at heart level
- Avoid caffeine, exercise, or smoking 30 minutes before measurement
- Take multiple readings and average them
Heart Rate (HR)
| Age Group | Normal Range (bpm) | Bradycardia | Tachycardia |
|---|---|---|---|
| Newborn (0-1 month) | 100-160 | <100 | >160 |
| Infant (1-12 months) | 100-150 | <100 | >150 |
| Toddler (1-3 years) | 90-140 | <90 | >140 |
| Preschool (3-6 years) | 80-120 | <80 | >120 |
| School-age (6-12 years) | 70-110 | <70 | >110 |
| Adolescent (12-18 years) | 60-100 | <60 | >100 |
| Adult (18-65 years) | 60-100 | <60 | >100 |
| Older Adult (>65 years) | 60-100 | <60 | >100 |
🚨 Critical Heart Rate Values
Adults: <40 bpm or >120 bpm at rest
Children: <70 bpm or >150 bpm (age-dependent)
🩺 Nursing Considerations
- Assess for full minute if irregular
- Note rhythm, strength, and regularity
- Consider patient's baseline and medications
- Athletes may have lower resting heart rates (40-60 bpm)
- Assess for signs of decreased cardiac output
Respiratory Rate (RR)
| Age Group | Normal Range (breaths/min) | Bradypnea | Tachypnea |
|---|---|---|---|
| Newborn (0-1 month) | 30-50 | <30 | >50 |
| Infant (1-12 months) | 25-40 | <25 | >40 |
| Toddler (1-3 years) | 20-30 | <20 | >30 |
| Preschool (3-6 years) | 18-25 | <18 | >25 |
| School-age (6-12 years) | 16-22 | <16 | >22 |
| Adolescent (12-18 years) | 12-20 | <12 | >20 |
| Adult (18-65 years) | 12-20 | <12 | >20 |
| Older Adult (>65 years) | 12-20 | <12 | >20 |
🚨 Critical Respiratory Values
Adults: <10 or >30 breaths/min
Children: <12 or >40 breaths/min (age-dependent)
🩺 Nursing Considerations
- Count for full minute, especially if irregular
- Observe chest rise and fall
- Note depth, rhythm, and effort
- Count without patient awareness (may alter breathing)
- Assess for use of accessory muscles
Temperature
| Route | Normal Range | Fever | Hypothermia |
|---|---|---|---|
| Oral | 97.6-99.6°F (36.4-37.6°C) | >100.4°F (38°C) | <95°F (35°C) |
| Rectal | 98.6-100.6°F (37-38.1°C) | >101.4°F (38.6°C) | <96°F (35.6°C) |
| Axillary | 96.6-98.6°F (35.9-37°C) | >99.4°F (37.4°C) | <94°F (34.4°C) |
| Tympanic | 97.6-99.6°F (36.4-37.6°C) | >100.4°F (38°C) | <95°F (35°C) |
| Temporal | 97.6-99.6°F (36.4-37.6°C) | >100.4°F (38°C) | <95°F (35°C) |
🚨 Critical Temperature Values
High Fever: >104°F (>40°C) - Risk of seizures/organ damage
Severe Hypothermia: <90°F (<32.2°C) - Life-threatening
🩺 Nursing Considerations
- Rectal most accurate for core temperature
- Oral: Wait 15 minutes after eating/drinking
- Consider patient's normal baseline
- Factor in diurnal variation (lowest in early morning)
- Age affects temperature regulation
Oxygen Saturation (SpO₂)
| Age Group | Normal Range (%) | Mild Hypoxemia | Severe Hypoxemia |
|---|---|---|---|
| All Ages | 95-100% | 90-94% | <90% |
| COPD Patients* | 88-92% | 85-87% | <85% |
🚨 Critical Oxygen Saturation Values
Adults: <88% - Immediate intervention required
COPD: <85% or sudden drop >4% from baseline
*COPD SpO₂ targets (88-92%) should be individualized per provider orders. Always verify with current care plan.
🩺 Nursing Considerations
- Ensure proper sensor placement and circulation
- Remove nail polish/artificial nails
- Consider skin pigmentation effects
- Validate with ABG if questionable reading
- Monitor trends, not just single values
📚 Study Tips for Mastering Vital Signs
Use Memory Devices
Create acronyms or mnemonics for age-specific ranges. Remember: "Young hearts beat fast, old hearts beat steady."
Practice with Real Patients
Take vital signs on family and friends to build confidence. Notice how ranges vary by individual baseline.
Focus on Critical Values
Memorize the "call the doctor" values first. These are your safety priorities in clinical practice.
Understand the "Why"
Learn why vital signs change with age. Infants have higher heart rates due to smaller heart size and higher metabolic needs.
Make Flashcards
Create cards with age group on front, normal ranges on back. Review daily during nursing school.
Link to Pathophysiology
Connect vital signs to disease processes. Understanding why they change helps with assessment and interventions.
📚 Clinical References & Standards
Primary Sources: American Heart Association Guidelines for Blood Pressure Measurement (2017),
American Academy of Pediatrics Clinical Practice Guidelines, and Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8).
Additional Standards: Normal values compiled from current nursing textbooks including
Fundamentals of Nursing (Potter & Perry, 2021) and Pediatric Nursing (Hockenberry & Wilson, 2019).
Critical Values: Based on widely accepted emergency medicine protocols, ACLS guidelines,
and institutional standards. Critical temperature and oxygen saturation thresholds represent general
guidelines - specific facility protocols may vary and should always take precedence.
⚠️ Important Clinical Disclaimer
This reference guide is for educational purposes only and should not replace clinical judgment, facility protocols, or provider orders. Normal ranges may vary by institution and patient population. Always verify critical values and follow your facility's policies for reporting abnormal vital signs.
Individual patient factors including medications, chronic conditions, and baseline values should always be considered when interpreting vital signs. When in doubt, consult with experienced nurses or healthcare providers.