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Cardiopulm > 2nd test > Flashcards

2nd test Flashcards

1
Q

Pa vs exercise

A

both cna be used to improve or maintain physical fitness

PA: any movement that is carried out by muscles and that movement requires energy expenditure
ADLs, Gardening, Dancing
Ex: any planned, structured, rep and intentional movement
Aerobic v Resistance

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2
Q

strength reflects what

A

number of cross bridges that are effectively engaged, max amt of force in a single mm contraction

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3
Q

Cachexia vs sarcopenia

A

Cachexia: muscle wasting that occurs with an illness
Sarcopenia: natural occurance of decreased muscle mass due to aging

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4
Q

power

A

amount of work produced per unit time
force * Velocity

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5
Q

power OMs

A

TUG
5xSTS
6MWT - distance covered in certain amount of time (distance/ body wt)
peak cycling test
stair climb test

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6
Q

acute CV response to exercise

A

inc HR, SBP, CO, SV, RR
No change in O2 and DBP

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7
Q

Red flags for acute CV response

A

SBP fails to increase or drops below resting levels
DBP increases more than 10
BP downt return to norm in 8-10 min

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8
Q

frequency what is it
recommendations

A

number of session
3-5xwk aerobic
2x wk resistance

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9
Q

intensity what is it
recommendations

A

higher intensity requires longer recovery
HR linearly related to intensity

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10
Q

Time what is it
recommendations

A

duration total amount of time spent

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11
Q

type /mode

A

exercise specificity
aerobic and strength

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12
Q

progression

A

typically change in duration/frequency than intensity

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13
Q

how to know when to progress

A

no assessment of fatigue - can talk
BP and HR response to exercise
too much exercise may be as effective as too little

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14
Q

volume

A

summation of intensity and duration of an individual bout

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15
Q

physical activity guidelines

A

Moderate intensity: 150 - 300 mins a week
Vigorous intensity: 75- 150 min a week
Strength: >2xweekly

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16
Q

new exercise bouts do what

A

of any length contribute to the health benefits - 10 min minimum removed

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17
Q

Light METs 1.6 - 2.9

A

Ex: carrying 15lb child, Walking <2mph, bird watching, boating, canoeing 2-3.9mph

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18
Q

Mod METs 3-5.9

A

Ex: cycling <10mph, walking (descending stairs, pushing stroller), pushing w/c

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19
Q

vig >6 METs

A

Ex: running 6mph, climbing hill w/ 42lb, walking uphill at 5mph

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20
Q

L lung vs R lung lobes

A

L has 2
R has 3

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21
Q

absolute CI to stop ex

A

Suspicion if an MI
Drop SBP >10 or falls below value obtained in same position prior to test
Systolic pressure >250 and/or DPB >115
Serious Arrhythmias
Signs of poor perfusion: pallor, cyanosis, cold and clammy skin
Recent EKG change
Unstable angina
Uncontrolled arrhythmias
uncontrolled symptomatic HF
Symptomatic severe Aortic stenosis
Acute PE
Physical disability that deems ex unsaf

22
Q

relative for stopping ex

A

Failure of HR to increase w/ increasing intensity
Change in heart rhythm
At rest: systolic >200, Diastolic >120

23
Q

PAR-Q

A

if they answer yes the questions than should consider MD refferal

24
Q

Submax (bruce) testing

A

Ramped and progressive protocol - pt achieves a predetermined submax exertional level then test is stopped
VO2max extrapolated from the results
HR measured & RPE at each stage and BP if possible

25
Q

when is bruce testing stopped

A

Achieved pre determined HR
85% of HRMax - safety and cut point for chronotropic incompetence
Volitional fatigue
Pt choice

26
Q

age specific HR max

A

HRmax= 207 -(0.7*age)

27
Q

THR karovonen

A

((HRmax-resting HR)*percentage of desired activity)) + resting HR = THR

28
Q

first think you need to know about your pt PMH

A

Meds - can tellyou if they HTN HR issues
cardiac surgery
underlying conditions

29
Q

Prevent hypo/hyperglycemia - idk if we need to know this

A

Before exercise
Eat 1-3 hrs before exercise
Insulin: 1 hr before exercise
glucose <100 - pre exercise snack
>250 - delay exercise
During:
Supp calories w/ carbs every 30 mins during extended strenuous ex
After:
Increase caloric intake 12-24 hrs after activity

30
Q

Cardiac Rehab not a canidate

A

Not a Candidate
Unstable angina
Hemodynamic instability
SBP> 200
DBP >100
Orthostatic fall >20mmHg
Serious arrhythmias
Conduction abnormalities (2nd and 3rd degree blocks)
Active infections
Uncontrolled DM
Resting ST segment depression

31
Q

Acute/inpatient - CV rehab

A

Starts immediately upon pt becoming medically/hemodynamically stable
ECG monitored
Physical Exam: BP, HR, auscultation, neuropathy, edema, JVD, skin color and wound care
Sternal Precautions - move in a tube

32
Q

exercise tolerance acute inpatient CV rehab

A

Monitor BP
in 3-5 min is pt still hemodynamically stable
Nothing bad happened when walked - walk can be done multiple times and increased duration
Progression is based on tolerance and remains hemodynamically stable

33
Q

treatment acute inpatient CV rehab

A

Short duration w/ multiple sessions
Intensity: <120 BPM or <20-30BPM increase during exertion
Symptom limited

34
Q

stop treatment acute inpatient CV rehab

A

Unusual HR increase
Inappropriate BP response
SBP>210 and/or >10mmHg drop
DBP > 110
Symptoms

35
Q

Goals acute inpatient CV rehab

A

initiate return to I in ADLs
Reduce risk of thromboembolic events, pneumonia
Maintain muscle tone
Education about disease, CV monitoring of symptoms, CPR
Understanding exertional intolerance
Teach energy conservation

36
Q

acute inpatient CV rehab activities

A

I transfers
Bedside sitting - > ambulation
Very light wts
UE/LE AROM
3-5 METs of activity by d/c

37
Q

subacute CV rehab

A

Begins 2-12 weeks after d/c from hospital
ECG monitored for a part of this phase
3 sessions weekly for 6 weeks

38
Q

subacute CV goals

A

Improved exercise tolerance & functionality
Provide education
Perform 3-5METS or 2-3mph for 30 mins

39
Q

abnormal responses subacute CV

A

SBP >240
DBP>110
Symptoms
ECG Abnormalities

40
Q

resistance training CV sub acute

A

5 weeks post MI
8 weeks CABG
2 weeks post PCTA and stent
8-10 reps 2-3xweekly w/ rest day in between
RPE 11-13

41
Q

training or intensive rehab

A

Outpatient
YMCA
No ECG monitoring
Goals:
Achieve 50-80% of HRR
3-4 sessions weekly
>45 mins per session

42
Q

maintenance

A

HEP
self-monitor

43
Q

pulm rehab

A

Doesn’t reverse disease process - but can reduce symptom burden
Indicated for pt w/ chronic pulmonary impairment who are dyspneic, reduced ex tolerance and/or experience a restriction in activities
No specific functional criteria - but usually get referred in advance stages (

44
Q

pulm rehab goals

A

Primary: restore chronic lung disease to bring them to the highest possible level of independent function
Improve QOL and dyspnea

45
Q

pt at undue risk for exersice pulm rehab

A

Unstable angina
uncontrolled pulmonary HTN
Recent MI

46
Q

conditions that makes participation impossible pulm rehab

A

Severe arthritis or other jt problems
Continue smoking
Lack of motivation
Accelerated progression of disease

47
Q

PFT - pulmonary function test

A

Results are compared against data from healthy pts of similar age, gender and ht

48
Q

DLCO

A

pt breathes in carbon monoxides and measure the amt they breathe out
If there is a pathology - they will exhale less carbon monoxide

49
Q

cachexic what do you monitor

A

BMI

50
Q

when pt is bent over forward withhand on needs

A

reverses insertion and origon and makes breathing a CKC activity

51
Q

aerobic walking exercise pulm rehab

A

Goal: 20-30 mins of cont
Intensity: Dyspnea scale and 3-4 or 11-13 on Borg
Don’t rely on HR to reflect workload
Know their dyspnea

52
Q

strength training UE activities pulm rehab

A

Cachexic pt are most resistant to this type of exercise
5-15 mins 3xweekly
1 set of 8-12 reps
Pay attention to their breathing and level of dyspnea

Cardiopulm (5 decks)

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