Vital SignsA guide to safe exercise while taking medications

University of WashingtonDepartment of Rehabilitation

Sam Bennett, SPTMegan Hillman, SPTMary Thurtle, SPTMeg Whitney, SPT

Anne Ziegltrum, SPT

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?

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?ActivityFood or fluidTime of daySome drugs and medications

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:

CocaineAmphetamines

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

How To Take Your Temperature1

Can be done in many ways:By mouthRectallyUnderarmBy earBy skin on forehead

Using different tools:Glass thermometerDigital thermometer

DemonstrationThe 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

When To Contact Your DoctorTemperatures 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

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

Feeling Your Pulse6

Where:Temple

(temporal) Jaw (facial)Neck (carotid)Arm (brachial)Wrist (radial)Thigh (femoral)Knee (popliteal)Ankle (tibial)Foot (pedal)

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 rate30 seconds X 2= Heart rate15 seconds X 4= Heart rate

What is “Normal”Normal varies

“Normal” resting heart rate for adults: 60-100 beats/minute6

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

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,

obesityStanding, activityStrong emotionsHeat and humidity

When to Take Your Pulse6

Before exerciseSit for a couple of minutes first

During exerciseStop moving

DemonstrationHow to check your own heart rate6:

Position yourself near a clockPlace 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 thumbCount the number of beats in one minute Write it down

When to Contact Your Doctor6

Outside of safe zoneResting and active are different

Important: Feeling faint heart does not beat in a steady rhythm

What is Breathing Rate?6

How many breaths you take each minute

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

What Can Change Breathing Rate?6

You can control it

Emotions

Activity level

Condition of air/environment

Medications/drugs

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.

Demonstration8

Additional TipsRemove bulky clothingHave your helper place their hand on your

back and feel for each breath

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

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)

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

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.

Types of MonitorsThere 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

DemonstrationMake sure:

your monitor is placed in the appropriate positionyou are sitting down with feet flat on the flooryour arm is supported on a table or other flat

surface at the level of the heart

Additional tipsAvoid 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

When To Contact Your DoctorIf, while monitoring your blood pressure, you get13:

A systolic reading of 180 mmHg or higher ORA 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.

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)

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?

?