Four students. Four sets of vital signs. One of them is probably actually sick. Which one?
Case type: Vital Signs · Difficulty: Rookie Detective · You will need: the case worksheet and everything you learned in Activity 1.1.
It is Tuesday, August 25 — a hot summer evening at Westbrook Middle School. Afterschool sports just ended, and within half an hour four students walk into the health office, one after another.
All four feel a little off. All four just came from sports. The nurse takes each one's vital signs and fills out an intake form.
Your job, detective: the nurse can only call one family first. Read the evidence and decide which patient is most probable to be truly sick.
Probable means more likely to be true than not. The most probable answer is the one your evidence supports best. It is a strong, educated guess — not a promise.
Detectives live on this ladder. A real nurse almost never gets to "certain" from one visit — they decide who is probable enough to act on first. That is exactly what you will do today.
| Vital sign | Average low | Average high |
|---|---|---|
| Pulse | 60 bpm | 100 bpm |
| Temperature | 97.8 °F | 99.1 °F |
| Respiratory rate | 12 breaths/min | 18 breaths/min |
| Blood pressure | 90/60 mm Hg | 120/80 mm Hg |
Hard exercise changes vitals. Right after sports, a healthy pulse and breathing rate can be above the range for a while, and temperature can run a little warm. They drift back to normal with rest.
It is 6 p.m. Body temperature naturally peaks in the late afternoon and evening — remember the daily curve. An evening reading runs a little higher than a morning one, even in a healthy body.
Rookie mistake: picking the patient with the most circles. Count which circles exercise cannot explain — that is where the case cracks open.
Feels dizzy, feels hot, and is very thirsty.
Heart is beating fast, hands are shaking, feels a little dizzy.
Feels cold (kept her hoodie on in the warm gym), feels dizzy, and is thirsty even though she has been drinking water all game.
Feels thirsty and a little dizzy.
| Vital sign | Normal range | P1 Marcus | P2 Aaliyah | P3 Sofia | P4 Ethan |
|---|---|---|---|---|---|
| Activity | — | Football | Soccer (played) | Watched game | Soccer (played) |
| Pulse (bpm) | 60–100 | 92 | 116 | 110 | 98 |
| Temperature (°F) | 97.8–99.1 | 100.2 | 98.9 | 101.6 | 99.0 |
| Resp. rate (/min) | 12–18 | 17 | 24 | 16 | 21 |
| Blood pressure | 90/60–120/80 | 94/62 | 118/76 | 86/54 | 119/79 |
Copy these onto Case 1 Worksheet — Part A and circle every number outside its range. Then the real detective work starts.
On Case 1 Worksheet — Parts D and E, name the patient who is most probable to be sick. Then argue both sides like a real detective:
Why argue against yourself? If your pick survives its own counter-argument, it is probable. If it does not, you just solved the case a different way.
A real school nurse would not diagnose anyone from one visit. With a probable patient identified, the next moves are:
Turn in your worksheet, detective. We compare verdicts — and re-examine the evidence — together in class. One reading is never a diagnosis.
Tap a word for the full card.