CV rehab management Flashcards by Demond Fleming

What is the recommended duration of moderate-intensity aerobic exercise per week according to ASCM/AHA/CDC guidelines?
A) 75-150 minutes
B) 150-300 minutes
C) 300-450 minutes
D) 45-60 minutes

B) 150-300 minutes

How well did you know this?

Not at all

Perfectly

According to ASCM/AHA/CDC guidelines, patients should engage in moderate-intensity strength training at least ______ days per week.

How well did you know this?

Not at all

Perfectly

True/False: The guidelines recommend at least 75-150 minutes of vigorous-intensity exercise per week.

True

How well did you know this?

Not at all

Perfectly

What is a major limitation in current research on exercise for patients with cardiovascular dysfunction?

A) Lack of funding for research
B) Lack of research on exercise outside of a treadmill or cycle ergometer
C) Too many guidelines available
D) Excessive focus on strength training

Lack of research on exercise outside of a treadmill or cycle ergometer

How well did you know this?

Not at all

Perfectly

The ASCM guidelines suggest that when older adults cannot perform more than ______ minutes of moderate-intensity aerobic activity per week due to chronic conditions, they should be as physically active as their abilities allow.

150

How well did you know this?

Not at all

Perfectly

Which of the following is NOT a common clinical presentation associated with cardiovascular dysfunction?
A) Sarcopenia
B) Osteoporosis
C) Increased muscle power
D) Frailty

C) Increased muscle power

How well did you know this?

Not at all

Perfectly

True or False: There is a consensus in the literature regarding the optimal timing and amount of activity for patients following a cardiovascular event.

False

How well did you know this?

Not at all

Perfectly

Limited literature exists regarding resistance training for patients classified as ________ to ________ risk.

moderate to high

How well did you know this?

Not at all

Perfectly

True or False: Normal oxygen delivery is essential for maintaining muscle function, including power, speed, and endurance.

True

How well did you know this?

Not at all

Perfectly

___________is the loss of muscle mass and strength associated with aging, which can contribute to increased frailty and reduced physical function in older adults, especially those with cardiovascular dysfunction.

Sarcopenia

How well did you know this?

Not at all

Perfectly

What impact does impaired oxygen delivery over long periods have on muscle function?
A) It enhances muscle endurance.
B) It alters muscle power, speed, and endurance.
C) It increases muscle hypertrophy.
D) It has no impact on muscle function.

B) It alters muscle power, speed, and endurance

How well did you know this?

Not at all

Perfectly

According to ACSM/AHA recommendations, how many repetitions should patients with cardiovascular dysfunction aim for during strength training?
A) 5-10 reps
B) 10-15 reps
C) 15-20 reps
D) 20-25 reps

10-15 reps

How well did you know this?

Not at all

Perfectly

The recommended rate of perceived exertion (RPE) for strength training in patients with cardiovascular dysfunction is between ______ and ______.

11 and 13

How well did you know this?

Not at all

Perfectly

What are known benefits of resistance training in patients with cardiovascular dysfunction?
A) Increased muscle mass only
B) Decreased insulin resistance, systemic vascular resistance (SVR), and blood pressure (BP)
C) Improved cardiovascular endurance only
D) Enhanced flexibility only

B) Decreased insulin resistance, systemic vascular resistance (SVR), and blood pressure (BP)

How well did you know this?

Not at all

Perfectly

Research on resistance training in post-operative cardiovascular patients is limited due to concerns regarding ______ precautions.

sternal

How well did you know this?

Not at all

Perfectly

How long should a patient wait after a CABG before starting resistance training?
A) 1-2 weeks
B) 3-4 weeks
C) 4-8 weeks
D) 12-16 weeks

C) 4-8 weeks

How well did you know this?

Not at all

Perfectly

After a myocardial infarction (MI) ad HF, resistance training should not start until at least ______ weeks post-event, and initial training should be at less than ______% of 1RM.

3-4 weeks; 30-40%

How well did you know this?

Not at all

Perfectly

True or False: Patients who have undergone valve repair or replacement can start resistance training immediately after the procedure.

False; wait 4-8 weeks start with low weight and high reps

How well did you know this?

Not at all

Perfectly

For patients with heart failure (HF), what is the initial recommendation for resistance training in terms of repetitions and weight?

A) 3-5 reps of high weight
B) 8-10 reps of low weight
C) 12-15 reps of moderate weight
D) 15-20 reps of very high weight

B) 8-10 reps of low weight

How well did you know this?

Not at all

Perfectly

Patients who have had a PCI or stent should wait ______ to ______ weeks before starting resistance training and should gradually increase weight.

2 to 5 weeks

How well did you know this?

Not at all

Perfectly

What can decreased ROM due to prolonged surgical precautions affect in patients with cardiovascular dysfunction?

A) Leg strength and balance
B) Chest wall movement and posture
C) Breathing and digestion
D) Upper body flexibility only

B) Chest wall movement and posture

How well did you know this?

Not at all

Perfectly

Pain-free range of motion (ROM) is especially beneficial post-sternotomy to prevent ______ during healing.

adhesions

How well did you know this?

Not at all

Perfectly

True or False: Bilateral ROM exercises are recommended post-sternotomy to prevent adhesions.

False; Unilateral ROM is recommended

How well did you know this?

Not at all

Perfectly

What percentage of patients with cardiovascular disease present with some type of cognitive impairment?
A) 10%
B) 1/3
C) 50%
D) 75%

B) 1/3

How well did you know this?

Not at all

Perfectly

Which of the following is an important implication of cognitive impairment in cardiovascular patients? A) Improved medication compliance B) Increased ability to perform ADLs independently C) Difficulty following rehab instructions D) Enhanced safety during daily activities

C) Difficulty following rehab instructions

Cognitive impairment in patients with cardiovascular dysfunction can affect their ability to perform activities of daily living (ADLs) and their qualification for _______ rehab.

post-acute

Potential causes of cognitive impairment in cardiovascular disease patients include

hypotension, alterations in cardiac output, cerebral hypoperfusion, microemboli, and oxygen (O2) desaturation.

What percentage of patients hospitalized for heart failure (HF) showed mild cognitive impairment based on MOCA scores? A) 25% B) 50% C) 74% D) 90% Mild cognitive impairment in hospitalized heart failure patients is typically demonstrated with MOCA scores ranging from ______ to ______.

C) 74% 17 to 25

List the following interventions for improving cognitive function in hospitalized cardiovascular patients?

A) Family involvement B) Frequent reorientation C) Healthy sleep/wake cycles D) Structured schedule

What is a common source of pain after sternotomy or thoracotomy?

Intercostal nerve pain

Post-op lines can irritate the _______ pleura, contributing to pain after surgery.

parietal

Which of the following is NOT a common barrier to cardiovascular rehabilitation? A) Poor exercise tolerance B) Baseline functional capacity or frailty C) Excellent health literacy D) Frequent hospitalization

C) Excellent health literacy

True or False: Lower extremity vein graft sites typically show no signs of bruising or swelling after cardiovascular surgery.

False; can be very bruised or swollen

What is a key factor that influences the prescribing of anti-hypertensive medication? A) Patient’s age B) Context of the patient's condition C) Patient's gender D) Patient's socioeconomic status The more anti-hypertensive medications a patient is on, the greater the need for awareness of ________

B) Context of the patient's condition side effects

True or False: Anti-hypertensive medications consistently lower blood pressure equally during rest and exercise.

False; may not have the same effectiveness during exercise or isometric activities

condition characterized by low potassium levels in the blood, which can be a side effect of thiazide and loop diuretics, leading to muscle cramps, fatigue, and other complications.

hypokalemia

Which diuretics carry a higher risk of causing hypokalemia?

Thiazides and loop diuretics

Only intervention for critically elevated potassium levels is ________.

emergent dialysis

True or False: K-sparing diuretics and beta-blockers are associated with a higher risk of hyperkalemia.

True

For an 82-year-old female patient with HF and HTN on Amlodipine, Lasix, Losartan, and Metoprolol, who is hospitalized for AMS and UTI, which medication is most likely causing her confusion? A) Amlodipine (Norvasc) B) Metoprolol (Lopressor) C) Lasix (Furosemide) D) Losartan (Cozaar)

C) Lasix (Furosemide) (Lasix can lead to electrolyte imbalances, potentially contributing to AMS)

In patients with PVD, as in the 75-year-old male with HTN and PVD s/p AAA repair, ________ may exacerbate hypotension when combined with other anti-HTN medications.

Hydralazine (Apresoline)

Describe the risks of holding anti-hypertensive medications post-op in a 75-year-old patient who underwent AAA repair.

Holding anti-hypertensive medications can lead to uncontrolled blood pressure, potentially increasing the risk of bleeding, stroke, or delayed healing, especially in vascular surgeries like AAA repair.

Which anti-hypertensive medication in the 82-year-old female patient with HF and HTN is a beta-blocker? A) Losartan (Cozaar) B) Amlodipine (Norvasc) C) Metoprolol (Lopressor) D) Lasix (Furosemide)

C) Metoprolol (Lopressor)

What percentage reduction in exercise capacity can hypertension (HTN) cause? A) 5-10% B) 10-20% C) 15-30% D) 30-40%

C) 15-30%

The American Physical Therapy Association (APTA) recommends monitoring blood pressure in patients older than ________ with HTN risk factors.

≥ 35

Describe why it is important to use the correct blood pressure cuff size.

too small/narrow= falsely elevated too big/wide = falsely lower

For strength training in patients with HTN, focus on ______ weight and ______ reps.

low, high (muscular endurance)

Which class of medications is most commonly prescribed for lowering cholesterol in HLD management? A) ACE inhibitors B) Statins C) Beta blockers D) Diuretics

B) Statins

Patients starting on statins may experience acute _______ symptoms, which should be differentially diagnosed.

musculoskeletal (MSK)

True or False: Statins are commonly prescribed despite their potential side effects due to their effectiveness in lowering cholesterol.

True

Which of the following increases the risk of side effects when taken with statins? A) Antivirals B) Fibrates C) Grapefruit juice D) All of the above

D) All of the above

Whats the most commonly used DVT screening tool?

Wells Criteria Calculator

What intervention might be planned if a patient with LE DVT cannot be anticoagulated? A) Physical therapy B) IVC filter placement C) Catheterization D) Compression therapy

B) IVC filter placement

True or False: Catheter-based thrombolysis may be indicated and planned for patients with recently diagnosed VTE.

True

True or False: Action Statement 9 requires confirmation of medication class and date/time initiated before mobilizing a patient with a recently diagnosed VTE. According to Action Statement 10, mobilization of a patient with a recently diagnosed LE DVT should occur once they reach the ________ threshold of anticoagulant medication.

True therapeutic

Which of the following is a low molecular weight heparin (LMWH)? A) Apixaban B) Lovenox C) Warfarin D) Arixtra

B) Lovenox

True or False: Unfractionated Heparin (UFH) is typically administered via a SubQ injection.

False (It is administered as a drip/gtt)

Which class of anticoagulants does Xarelto belong to? A) Low molecular weight heparin B) Unfractionated heparin C) Direct oral anticoagulation (DOAC) D) Warfarin

C) Direct oral anticoagulation (DOAC)

Coumadin is the brand name for the anticoagulant _________.

Warfarin

What is the mobility guideline for patients with an INR less than 2? A) Proceed with mobility B) Mobilize with caution C) No mobility (risk of clot too high) D) Mobilize without restriction

C) No mobility (risk of clot too high)

At what INR level should mobility be approached with caution or potentially held due to bleeding risk? A) INR <2 B) INR >2 C) INR >5 D) INR between 2-5

Correct Answer: C) INR >5

In which scenario should you avoid mobilizing a patient with an acute PE? A) If INR is <2 B) If there is right heart failure (R HF) present on echo C) If the patient has an IVC filter D) If INR is between 2 and 5

B) If there is right heart failure (R HF) present on echo

Do not mobilize a patient with an acute PE if there is unstable or increasing ________ requirement.

oxygen (O2)

What is recommended for patients presenting with signs and symptoms consistent with Post-Thrombotic Syndrome (PTS)?

mechanical compression, such as intermittent pneumatic compression and/or graduated compression stockings.

What are the common symptoms of Post-Thrombotic Syndrome (PTS)?

Edema or swelling Chronic leg or arm pain Skin changes Heaviness of the limb affected by DVT.

What percentage of lower extremity DVT patients may develop Post-Thrombotic Syndrome (PTS) more than two years after an acute DVT?

20-50% of patients.

Should compression be used for every patient diagnosed with a DVT to prevent Post-Thrombotic Syndrome (PTS) or recurrent DVT?

What are some risks associated with compression therapy in patients with CV pathologies?

exacerbation of underlying conditions, potential for poor circulation, and complications related to increased venous pressure.

VTE Clinical Practice Guidelines: ______ certainty evidence for use of compression in PTS ______ certainty evidence for use of compression in venous and lymphatic disorders for the treatment of symptomatic PTS

low; high

What is a common indication for using lower extremity compression?

Chronic venous insufficiency (CVI)

The strength of compression for lower extremity categorized: Low: Medium: High:

< 20 mmHg 20-30 mmHg > 30 mmHg

Compression therapy is used post-surgically for the treatment of ___ veins.

Varicose

What is the primary purpose of using graduated compression stockings?

improve venous return, reduce swelling, and prevent complications like VTE and PTS in patients with venous disorders.

What are the absolute contraindications for lower extremity compression in VTE or CVI?

Peripheral arterial disease (PAD) Any peripheral vascular bypass revascularization Heart failure Severe peripheral neuropathy Local skin or soft tissue conditions (e.g., skin graft, cellulitis, infections) Extreme deformity of the leg or unusual size/shape preventing correct fit Patient discomfort

How long should compression garments be worn each day? When should compression garments be removed immediately? How often should compression garments be removed for hygiene and skin inspection?

it depends > 12 hours total if the patient experiences SOB, legs/feet go numb, or acute P! 2x/day

What is an important consideration when applying compression garments?

no wrinkles when applying the garments.