This document provides guidance on monitoring vital signs while taking medications and exercising. It defines the key vital signs - temperature, pulse, breathing rate, and blood pressure. It explains normal ranges and how medications and activities can affect readings. Guidelines are given for safely taking each vital sign at home and when to contact a doctor. An example patient case is presented to demonstrate applying the guidelines when deciding if exercise is safe. The document aims to help patients and physical therapists understand vital sign monitoring in the context of medication use and exercise.

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. ?