CP Exam 3: Ischemia/ MI Rehab

Question 1

What is a cardinal sign of ischemia?

Answer 1

flat or dropping hemodynamic response with increasing activity

Question 2

What happens if there ischemia in the right atrium?

Answer 2

this will affect the SA and AV node which will then have an effect on HR

Question 3

What is RPP?

Answer 3

Rate product pressure = HR x SBP

correlates strongly to MVO2 demand

Question 4

Can RPP be used in exercise prescription?

Answer 4

yes only if pt has KNOWN ischemia

get RPP from max test then reduce 10-20% for max training number

Question 5

What are important things to hear from patient during an interview?

Answer 5

have them describe the sx, intensity of sx (0-10)

Question 6

What are good questions to ask pt with ischemia?

Answer 6

1. when does it occur?
2. How long does symptom last?
3. when does symptoms begin?
4. have sx been worsening over time?

Question 7

What are some inappropriate hemodynamic responses to activity?

Answer 7

rising DBP over 10 mmHg and over 90 mmHg is indicative of CAD or ischemia

dropping or flat SBP or HR during exercise

exaggerated HR with other sx

Question 8

What meds are used for ischemia that decrease BP?

Answer 8

ACE I

Question 9

What meds are used for ischemia that decreases after load and decreases myocardial oxygen demand?

Answer 9

CCB, BB, ARB, ACE I

Question 10

During 6-8 weeks recovery after MI what is important to remember in regards to exercise?

Answer 10

cant go above 70% max HR or above 5 METS, can do stairs but not above that

Question 11

What meds are used post MI that reduce myocardial oxygen demand?

Answer 11

BB, ACE I, ARB and CCB

Question 12

What meds are used post MI to increase myocardial oxygen supply?

Answer 12

nitrates and vasodialators

Question 13

What drugs are used to increase contractility?

Answer 13

digitalis/cardiac glycosides

Question 14

What are the goals of PT in acute care post MI

Answer 14

1. maintain current function or attain indpt function
2. asses HD response with fnxl activity
3. EDUCATE

Question 15

What is important to remember about HD to fnxl activity?

Answer 15

if there is an inappropriate response then they are NOT FUNCTIONAL

Question 16

What is target time walking before they enter cardiac rehab?

Answer 16

15-20 mins to prevent deconditioning