contraindications Flashcards
Kidney contraindications (9)
electrolytes
arrhythmias
fluid overload
inter-dialytic weight gain
acute changes in meds?
unstable BGL
unstable BP
cant take BP with the arm with the fistula
Cant exercise them after the 1/2 point in dialysis
angina
10-15 beats below the angina threshold
Must have nitrates with them to ex (and they need to be in date)
-massive vasodilation, increases HR, increase o2 delivery/decrease demand
- take 1 every 5minutes up to 3 times
long warm up and cool down
unstable angina (at rest)
Avoid Valsalva
Stent
stay below 120 bpm
Low BP (whatever that means)
- to limit the vasodilation
therefore only light ex
- so that the body can heal and the stent can be fully embeded in the wall
MI
4 weeks AT before resistance training starts
- want to start working the heart early (AT ex) so that other arteries can form on the heart and O2 supply can develop
CAGS
no UL ex until 6-8 weeks
have to place the hand on their sternum and check that it doesnt move
Pacemaker
Stay 20 beats below the shock threshold (only for ICD)
avoid raising the arm for 2-3 weeks on the affected side
HF
weigh them each time they come in to see if their heart has gotten worse, oedema, 3-5kgs gain, go see a Dr
Retinopathy (6)
strenuous ex
heavy lifting
Valsalva
isometric
head down activities
stop ex if there’s visual changes
Diabetes (7)
<4mmol/L
>15mmol/L (T1D)
>18 (T2D)
if they have used ultra fast and fast acting insulin
Don’t ex at peak ex dose
hypo in previous 24hrs
unstable BGL
uncontrolled HTN
proliferative retinopahty
peripheral neuropathy
avoid high loading activities, running, jumping, step exercises
parkinsons (4)
no treadmill, esp if they have freezing episodes
dyskinesia (uncontrolled involuntary movements)
meds taken 30-45min before ex
postural hypotension
SCI
autonomic dysreflexia- major vasoconstriction below the lesion bc there is something wrong, however, brain doesnt know what is wrong, splotting in vision, blushing on face, serve headache –> take nitrates
severe or infected pressure sore
Acute UTI
uncontrolled spascity and pain
unstable fracture
cauda equina
bladder or bowel dysfunction
pain during the night
saddle anaesthesia
severe neurological deficit
bone (3)
fractures in legs/hips, . . . ? falls risk?
any new fracture that occurs or is discovered in your care
pain at fracture site that is severe or unremitting (possibly non-union)
absolute contraindications (9)
a fib
unstable angina
recent MI
uncontrolled arrhythmias
critical aortic stenosis
uncontrolled HF
myocarditis
dissecting aneurysm
acute systemic infection
