Begin a discussion on why a patient’s vital signs might differ at various times during the day. (Stress, excitement, illness, and environmental factors may all affect blood pressure.) Most physicians’ offices have the medical assistant take and record the patient’s vital signs and measurements before the physician sees the patient. Ask: Why do you think this is? (It saves the physician time. In addition, patients may be less nervous with the medical assistant than they would be with the physician, because of white-coat syndrome. If any result, other than the temperature is elevated, by the time the physician sees the patient the falsely high reading may also have dropped, because patients tend to become more at ease with time.)

Vital signs are the essential body functions in the person such as heartbeat ,breathing rate, temperature, blood pressure. These are based on age ,time ,gender, medication and environmental factors.

Vital signs may differ at various time during the day due to various physiologic and pathologic processes which affecting these sets of measurements. So the vital signs should be monitored every 2 hours in a monitoring patient. Also some conditions such as full bladder, stress ,cold temperature and certain medications also affects the vital signs in the patient.

Vital sign such as blood pressure continue to rise during the day before wake up ,it is more in the mid day. Normally the blood pressure drops in the late afternoon and evening and lowers at night while sleeping.

The impact on blood pressure include

Stress, excitement, illness and environmental factors

Person having any illness like infection or fever our body's immune response and the amount of inflammation in the body is greater which can lead to increased in the high blood pressure. Once the illness overs the blood pressure comes to its normal range .

Environmental factors such as climate ,temperature and time of the day also causes blood pressure changes. Usually blood pressure is higher in winter and lower in the summer . As low temperature causes narrowing of the blood vessels, it increases the blood pressure due to more force is required to push the blood in narrow veins and arteries. In this way the stress ,excitement, illness and environmental factors affects the blood pressure.

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