1. Vital Signs
A guide to safe exercise while taking medications
University of Washington
Department of Rehabilitation
Sam Bennett, SPT
Megan Hillman, SPT
Mary Thurtle, SPT
Meg Whitney, SPT
Anne Ziegltrum, SPT

2. Questions?
• What are “vital signs”?
• Can I take my own vital signs at
home?
• Do my vital signs change when I
take medications?
• What values does my doctor want
me to have? What’s a “safe zone”?
• How should I expect my vital signs
to change during exercise?
• What should I do if my vital signs fall
outside of my safe zones?
• Why should I tell my PT about my
safe zones?

5. What is Body Temperature?1
 Body temperature tells us how warm your body is on
the inside
 Normal temperature for adults: 97.8-99°F
 What can change your temperature?
 Activity
 Food or fluid
 Time of day
 Some drugs and medications

6. Drugs and Medications…
 …that can lower your temperature:2
 Antidepressants
 Antipsychotics
 Narcotic pain medications
 Sedatives
 …that can raise your temperature:3
 Beta blockers
 Diuretics
 Antihistamines
 Tranquilizers
 Illegal drugs:
 Cocaine
 Amphetamines

7. When To Take Your
Temperature
 Take your temperature at the same time each day and
before exercising
 Avoid hot or cold food or drink immediately before
taking your temperature

8. How To Take Your
Temperature1
 Can be done in many ways:
 By mouth
 Rectally
 Underarm
 By ear
 By skin on forehead
 Using different tools:
 Glass thermometer
 Digital thermometer

9. Demonstration
 The most accurate way to take temperature is by mouth
or rectally, using a digital thermometer5
 Always read the instructions on your thermometer
 DO NOT use mercury thermometers1
http://www.clipartpanda.com/categories/cold-thermometer-clip-art-black-and-white

10. When To Contact Your Doctor
 Temperatures outside of the normal range can be
dangerous!
 Monitoring your temperature is important
 Contact your doctor if your temperature is:
 Above 103°F (fever/heat stroke)4
 Below 95°F (hypothermia)1

11. What is a Pulse?
 Heart Rate (or pulse) tells us how many times our
heart beats each minute
 Feel your heart beat:
 In blood vessels known as arteries:
 Arteries carry blood from your heart to your
body
 Every time your heart beats your arteries pulse

12. Feeling Your Pulse6
 Where:
 Temple (temporal)
 Jaw (facial)
 Neck (carotid)
 Arm (brachial)
 Wrist (radial)
 Thigh (femoral)
 Knee (popliteal)
 Ankle (tibial)
 Foot (pedal)

13. How To Take Your Pulse6
 Heart rate tells us how many times our heart beats per minute
 Feel your heart beat
 Count number of beats per minute
 60 seconds = Heart rate
 30 seconds X 2= Heart rate
 15 seconds X 4= Heart rate

14. What is “Normal”
 Normal varies
 “Normal” resting heart rate for adults: 60-100
beats/minute6

15. What Do The Numbers Mean?7
 High or low heart rate may indicate a problem
 Lower heart rate= healthy heart, greater fitness
 Higher heart rate= heart does not work as well, has
to beat more to do same job

16. What Can Change Your
Pulse?7
 These can lower your heart
rate:
 Medications: Adrenaline
(beta blockers)
 Regular moderate
exercise
 Resting
 These can raise your heart
rate:
 Medications: thyroid
medication (too much)
 Poor heart health, obesity
 Standing, activity
 Strong emotions
 Heat and humidity

17. When to Take Your Pulse6
 Before exercise
 Sit for a couple of minutes first
 During exercise
 Stop moving

18. Demonstration
 How to check your own heart rate6:
 Position yourself near a clock
 Place your hand palm-up
 Use artery at wrist (radial)
 Place two fingers on your wrist (Do not push too hard)
 Slip your fingers off-center toward your thumb
 Count the number of beats in one minute
 Write it down

19. When to Contact Your Doctor6
 Outside of safe zone
 Resting and active are different
 Important:
 Feeling faint
 heart does not beat in a steady rhythm

20. What is Breathing Rate?6
 How many breaths you take each minute

21. What is Happening When You
Breathe?6
 Your brain controls breathing!
 Brain signals travel down your spine to your muscles.
 This happens automatically without you needing to be aware.
 Why is this important to know?
 Noting any changes in your breathing is important to catching any
concerns early
 What is the normal range?
 12-20 breaths per minute

22. What Can Change Breathing
Rate?6
 You can control it
 Emotions
 Activity level
 Condition of
air/environment
 Medications/drugs

23. How To Check Your Breathing
Rate8
 What you will need to check your breathing rate at
home:
 Someone to help
 A clock
 Find someone to help with these steps:
1. Sit comfortably and have your helper stand next to you.
2. Instruct them to count each time they see your chest rise in a
minute.
 If no one is available to help, try these steps on your
own.

24. Demonstration8
 Additional Tips
 Remove bulky clothing
 Have your helper place their hand on your back
and feel for each breath

25. When To Contact Your
Doctor8
 If breathing rate falls outside of your safe zone (See
brochure)
 You or your helper notices you make noises when breathing
like grunting or wheezing
 You feel dizzy or light headed
 Call 911 if:
 You or your helper notices that you are experiencing difficulty
breathing or are unable to breathe

26. What Is Blood
Pressure?9
 Blood Pressure = Systolic / Diastolic
 Systolic: the pressure in your arteries when
your heart is contracting
 Diastolic: the pressure in your arteries between
heart beats (relaxed)

27. What is “Normal”?9
Blood Pressure Category Systolic (upper
number) mmHG
Diastolic (lower
number)
mmHG
Normal <120 and <80
Prehypertension 120-139 or 80-89
High Blood Pressure
(Hypertension) Stage 1
140-159 or 90-99
High Blood Pressure
(Hypertension) Stage 2
>160 or >100
Hypertensive Crisis >180 or >110

28. Why do I need to take my
blood pressure?12
 High blood pressure often causes no symptoms
 High blood pressure increase your risk for heart
disease and stroke
 The best way to monitor blood pressure is by checking
it often.

29. Types of Monitors
 There are many different types of home monitors but
the most commonly used are:
 Upper arm monitor
 Wrist monitor
 Make sure you buy the right size monitor11
 Have your doctor check your monitor to make sure it is
working properly
 Check the tubing frequently to make sure the cuff is in
good condition

30. Demonstration
 Make sure:
 your monitor is placed in the appropriate position
 you are sitting down with feet flat on the floor
 your arm is supported on a table or other flat surface
at the level of the heart
 Additional tips
 Avoid caffeine, cigarettes, and exercise for at least 30
minutes prior to the test10
 Monitor your blood pressure at the same time every
day on the same arm
 Keep a journal to monitor your results

31. When To Contact Your Doctor
 If, while monitoring your blood pressure, you get13:
 A systolic reading of 180 mmHg or higher OR
 A diastolic reading of 110 mmHg or higher…
 …wait a couple of minutes and take it again
 If the reading is still at or above that level, you should
seek immediate emergency medical treatment.
 Also, seek medical attention if you feel faint, dizzy, or
lose consciousness.

32. Meet Bob…
 Bob is a patient taking beta-blockers to control his high
blood pressure. He loves to run, but has knee pain, so he
is seeing a PT to rehabilitate. He wants to know if he is
safe to exercise at PT today. He is currently at rest when
his vital signs are assessed.
 Temperature: 99.2
 (safe zone 98.6 to 99.5)
 Pulse: 56
 (safe zone 55-100)
 Breathing Rate: 10
 (safe zone 8-20)
 BP: 130/90
 (safe zone 120/80 to
135/95)

33. More about Bob…
 What do we need to consider if Bob had taken
these vital signs while on the treadmill at PT?
 What if Bob was feeling dizzy? Is that a worry?

34. ?