Acute Care

Question 1

BUN

Answer 1

10 to 20
If high - kidney problem
If low - liver problem

Question 2

WBC

Answer 2

5000 - 10,000

Less than 5000 with fever - don’t exercise

Question 3

Hgb

Answer 3

F = 12-16 
M = 14-17

Less than 8 = no exercise
8-10 = Be cautious

Question 4

Hct

Answer 4

F = 36-46%
M = 41-51%

Less than 25% = no exercise

Question 5

Platelets

Answer 5

150,00 to 400,000

Less than 200,000 = no exercise

Question 6

Prothrombin

Answer 6

11-12.5 seconds

More than 36 sec = no exercise

Question 7

PTT

Answer 7

25-36 sec

More than 70-100 = no exercise

Question 8

INR

Answer 8

0.9 to 1.1

No exercise if over 4
(over 5 if on anticoagulant)

If low = thick blood, quick to clot
If high = thin blood, slow to clot

Question 9

pH

Answer 9

7.35 to 7.45

Question 10

PaO2

Answer 10

80-100 mmHg

Acute resp failure will be below 60

Question 11

PaCO2

Answer 11

35-45 mmHg

Acute resp failure will be above 50

Question 12

HCO3

Answer 12

22-26 mmHg

Question 13

SpO2

Answer 13

Over 90%

Question 14

Metabolic acidosis

Answer 14

pH less than 7.35
HCO3 less than 23

Trauma, low CO, renal failure

Question 15

Metabolic alkalosis

Answer 15

pH greater than 7.45
HCO3 greater than 27

Resp failure, resp insufficiency

Question 16

Resp acidosis

Answer 16

pH less than 7.35
CO2 greater than 45

Severe lung disease

Question 17

Resp alkalosis

Answer 17

pH greater than 7.45
CO2 less than 35

Tremor, fever

Question 18

Total cholesterol

Answer 18

Less than 200

Question 19

HDL

Answer 19

M over 33

F over 43

Question 20

LDL

Answer 20

Less than 100

Question 21

Triglycerides

Answer 21

Less than 140

Question 22

Na

Answer 22

135-145

Question 23

K

Answer 23

3.5 - 5

Question 24

BUN

Answer 24

10-20

Question 25

Creatinine

Answer 25

0.6 to 1.2

Question 26

Glucose

Answer 26

70-110 If less than 70 or over 250 = no exercise

Question 27

Albumin

Answer 27

greater than 2.5 (3.5 - 5)

Question 28

Arrhythias - contraindicated to exercise or need to stop

Answer 28

``` A fib V tach V fib PVCs (6+ / min) 2nd degree type 2 AV block 3rd degree AV block ST elevation ```

Question 29

Tubes and lines that are contraindications for PT/exercise

Answer 29

Swan Ganz - YELLOW ICP over 20 (norm is 0-15) IABP Pulmonary hypertension greater than 25 (norm is 12-18) Relative - hemodialysis (don't do exercise right before or right after - HTN, toxic and hypotensive if before, fatigued and low nutrition if after)

Question 30

Lab values that are contraindications for PT/exercise ``` Hct Hg WBC Platelets Glucose INR Prothrombin PTT ```

Answer 30

``` Hct below 25% Hg below 8 WBC below 5,000 with fever or if over 20,000 Platelets less than 20,000 Glucose less than 70 or over 250 INR greater than 4 Prothrombin greater than 36 sec PTT greater than 100 sec ```

Question 31

EF - contraindication

Answer 31

Less than 20%

Question 32

HR contraindication

Answer 32

Resting HR over 100 - 120 OR less than 50

Question 33

SBP contraindication

Answer 33

Resting SBP over 180-200

Question 34

DBP contraindication

Answer 34

Resting DBP over 110

Question 35

Changes in BP contraindication

Answer 35

SBP drop of more than 10

Question 36

PO2 contraindication

Answer 36

Less than 60 mmHg

Question 37

SpO2 contraindication

Answer 37

Less than 90% (Dr R said 92%) | COPD if less than 88%

Question 38

Dyspnea - when stop

Answer 38

With exercise can't have them at 3 or higher | With rest can't have them at 2 or greater

Question 39

Angia scale - when stop

Answer 39

With exercise can't have them at 2 or higher | With rest can't have them at 1 or higher

Question 40

After MI - HR increase can

Answer 40

Only increase by 20 bpm from their resting!!! | After cardiac surgery - can go up to 30 bpm above resting

Question 41

BP after cardiac episode is not to exceed

Answer 41

over 220/110

Question 42

Cryotherapy on large body area in someone with hypertension can

Answer 42

Cause diffuse VC and will increase BP even more

Question 43

Don't use superficial heat over

Answer 43

Infected, malignant, recently radiated areas, impaired sensation, impaired communication, reproductive organs...

Question 44

US contraindications

Answer 44

Over heart, pacemaker, electronic devices, preg, recently radiated tissue, cement or plastic implants, growth plates, DVT, tumors, infections, carotid sinus, insensitive tissue

Question 45

Estim contraindications

Answer 45

Pacemaker, pregn belly or back, sup metal implants, tumors, disoreiented pt, insenstivie area...

Question 46

Contraindicatiosn to postural drainange

Answer 46

If pt can't handle head down position (head injury, high ICP, hx of cardiac issues, recent head sx) Right after eating Head and neck surgeries NG tube

Question 47

Contraindications to percussion

Answer 47

``` TB Recent hemorrhage PE Lung cancer Chest sx Rib fx OP Nervous pt ```

Question 48

Pre albumn

Answer 48

18-32

Question 49

HbA1C

Answer 49

4-6% | Levels over 6.5 indicate diabetes and poor blood sugar control

Question 50

Elevated serum creatinine or BUN =

Answer 50

Kidney problem

Question 51

Low serum creatinine or BUN =

Answer 51

Liver problem/malnutrition

Question 52

CPK CPK - MB

Answer 52

CPK = 30-170 CPK - MB = 0-3%

Question 53

Troponin 1

Answer 53

0.0 - 0.1

Question 54

Troponin 2

Answer 54

Less than 0.18

Question 55

Hypocalcemia will cause

Answer 55

neuromuscular hyperexcitability Tetany, seizures, paresthesias, CHF Dec heart actions though because less Ca for contractions

Question 56

Hypercalcemia will cause

Answer 56

Neuromuscular hypoexcitability Lethargy, paresthesias, arthralgias, inc risk of fx, kidney stones, ployuria In heart will cause increaed heart actions

Question 57

Hypo/Hyper magnesemia and Hypokalemia will cause

Answer 57

Alternated electrolye balance - leading to cardiac arrhythmias