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APPENDIX 9: VITAL SIGNS
Your vital signs include pulse, blood pressure measurement, weight and respiratory rate. Keeping accurate records of these signs during illness and health can provide valuable information to your doctor. This information may be useful in preventing illness, maintaining good health and monitoring or following the course of an illness.

Normal values for vital signs depend on your age, sex, state of physical conditioning and other factors. Work with your physician to establish YOUR normal values.

How to Take Your Pulse
Your PULSE is the number of time your heart beats per minute. To evaluate heart rate, learn to check your pulse at rest and during exercise.

At Rest
Don't check your resting pulse immediately after eating a big meal, after exercise or during an emotional upset. Have a stopwatch or a watch or clock with a second hand available. Sit quietly. Relax for 2 to 3 minutes. Breathe normally. Gently place your index and middle fingers on your wrist just above the thumb until you can feel the rhythmical movement of your pulse at this point. It takes some practice to find it quickly. Never count your pulse with your thumb because your thumb has a pulse of its own that may cause an inaccurate record. If you find it difficult to find your pulse at your wrist, place your index and middle fingers on the carotid artery in your neck. Find the back of your jawbone with your fingers. Lightly place your fingers just in front and down a little from the jawbone. Count the pulse beats for 30 seconds and multiply by 2. This gives you the rate for 1 minute. For your records, record your pulse rate and the date.

During Exercise
Stop exercising. Locate your pulse by following the instructions above. Count your pulse for 6 seconds. Add a zero to this figure to obtain your pulse rate for 1 minute. During exercise, don't count your pulse rate for 1 minute because your heart slows quickly at rest. A count for 1 minute may not accurately reflect your true exercise pulse rate. If your exercise pulse is 10 or more beats a minute HIGHER than your target heart rate, don't exercise as hard. If your exercise pulse is 10 or more beats a minute LOWER than your target heart rate, exercise harder.

How to Take Your Blood Pressure
Blood pressure reflects pressure of blood on the walls of your arteries when your heart contracts (systolic blood pressure) and pressure when the heart relaxes (diastolic pressure).

High blood pressure can be an important risk factor for developing heart disease, hard-ening of the arteries, strokes, eye problems or kidney problems. Keeping track of your blood pressure and keeping it within normal limits may be one of the most important tests you can learn to do for yourself.
Purchase a blood-pressure measuring device. Read the manufacturer's instructions carefully. Put the ear piece of the stethoscope in your ears. Slip the bottom part (the diaphragm) of the stethoscope under the cuff in the middle or inner part of the arm. Wrap the cuff securely around your upper arm just below the elbow. Wrap it tightly enough to make it possible for you to slide only two fingers between the cuff and your arm. Close the screw close to the pressure scale by turning it counter clockwise. Rapidly inflate the cuff until the scale on the blood-pressure recording device reaches 160. Stop inflating. Slightly open the screw by turning it clockwise. Watch the scale as it slowly descends. When you first hear your heartbeat through the stethoscope, make a mental record of the level of the scale at that point. This is the SYSTOLIC PRESSURE, the top number of the recorded blood pressure. Continue deflating the cuff until you no longer hear the heartbeat. Make a record of the level of the scale at that point. This is the DIASTOLIC PRESSURE, the bottom number of the recorded blood pressure. Deflate the cuff completely, and remove it. For your records, record the systolic and diastolic pressure, such as 120/70, the date and the time.

How to Measure Your Weight
Accurate weight records may be needed to follow progress if your diet is restricted, if you have kidney disease, liver disease or heart disease, or if you take diuretic medication.
The following suggestions are helpful if you need to keep an accurate record of your weight.
Be sure your scale is accurate. Empty your bladder, but weigh BEFORE a bowel movement. Remove all clothing. Weigh yourself early in the morning at about the same time. Keep an accurate record of your weight. For your records, record the date, time and how much you weigh. Slight fluctuations from day to day must be expected. These fluctuations represent the presence or absence of excess fluid in the tissues rather than actual weight gain or loss. A continuing trend of weight that moves up or down may have clinical significance, especially for people with controlled congestive heart failure, diabetes, obesity disorders that require taking diuretics or any chronic illness. For weight loss (dieting), weigh only once a week. More often may discourage you. For weight maintenance, weigh every day. It is important to recognize weight gain before it gets out of hand.

How to Take Your Respiratory Rate
Your respiratory rate represents the times you breathe per minute. It is an important observation in making an accurate diagnosis and in following the progress of many illnesses.
A normal respiratory rate varies according to age, sex and your activity level.
Rest quitely. Have someone count the number of times you breathe for 1 minute. For your records, record the date and your respiratory rate.

 
From Complete Guide to Medical Tests by H. Winter Griffith, M.D. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.

 

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