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CP skillscheck > CVP exercise prescription > Flashcards

CVP exercise prescription Flashcards

1
Q

abnormal response to exercise - HR

A

increases >30 bpm above resting HR with mild exercise

decreases below resting HR

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2
Q

abnormal responses to exercise - systolic BP

A

increases > 20-30 mmHg above resting level

decreases > 10 mmHg below resting level

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3
Q

abnormal responses to exercise - diastolic BP

A

> /= 10 mmHg

norm - 0-10 mmHg > rest

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4
Q

abnormal responses to exercise

A

O2 drops below prescribed level

pt becomes severely SOB

RR increases to a level not tolerated by pt

ECG changes

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5
Q

60% Max HR

A

4.8 METS

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6
Q

80% max HR

A

6.4 METS

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7
Q

1 MET

A

3.5 ml O2/kg/min

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8
Q

max MET level on a GXT

A

8 METS

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9
Q

target HR 60% HR

A

Max HR x 0.60

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10
Q

for cardiac pts with a low functional capacity, initiate exercise programs at what level?

A

40-40% max HR

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11
Q

for pulmonary pts with a low functional capacity, initiate exercise programs at what level?

A

20-40% max HR

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12
Q

monitoring of intensity - duration

A

usually assessed as pts tolerance 5-15 mins

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13
Q

monitoring of intensity - frequency

A

1-2x/day due to likely decreased level of conditioning

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14
Q

dyspnea scale

A

1-5 assess SOB
1 = little breathlessness related to exercise
5 = severe breathlessness related to exercise

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15
Q

angina scale

A

scale 1 -5
1 = slight pain perception
5 = infarction pain

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16
Q

phase 1 of cardiac rehab

A

the inpatient program that begins soon after a cardiac event and finished when the patient is ready to go home from the hospital. the emphasis is on low-level exercise and education for the patient and family

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17
Q

phase 2 of cardiac rehab

A

an outpatient hospital based program that begins approx. 2 weeks after discharge from hospital. dieticians, social workers, pharmacists, physicians and other may be involved in care. this phase emphasizes monitored exercise and continued education on exercise and lifestyle management

18
Q

phase 3 cardiac rehab

A

an ongoing community based exercise and education program supervised by cardia nurses and exercise specialists. spouses and SO may also participate in this maintenance program with a referral from a physician

19
Q

phase 4 cardiac rehab

A

a continuation of phase 3 but without supervision. the patients continue to apply what they have learned during the preceding phases

20
Q

Peripheral Artery Disease

A

pts w PAD are at greater risk of having coronary and cerebral vascular disease than those without PAD

21
Q

PAD risk factors

A

smoking, atherosclerosis, diabetes, 60+

22
Q

PAD pts with intermittent claudification

A

start with short bouts of low intensity exercise
progressed to continuous low level exercise as tolerated

23
Q

PAD pts exercise rec

A

twice a day at low intensity
progress to 3x a day increase the intensity

24
Q

PAD pts with elevated resting systolic BP exercise rec

A

begin exercise at a low target HR

40-60% for cardiac pts
20-40% for pulmonary pts

25
Q

if a pts BP won’t normalize during exercise what should happen

A

termination of the exercise

26
Q

alterations in exercise prescription for older adults

A

rest HR may be elevated
warm up - longer and stretching often required
support for balance

27
Q

physiological differences in older adults

A

decrease in maximal oxygen consumption (VO2)
(greater differences seen in sedentary vs active)

changes in ventricular compliance

decrease in Max HR (more significant in sedentary vs active)

elevated respiration rate disproportional to exercise

increase in systolic pressure due to increased arterial stiffness (increased afterload)

decreased ability to sweat

increased infiltration of body fat

with PAD: decreased oxygen supply to muscle

28
Q

what do beta blockers do

A

affect HR and incrase fatigue

29
Q

what do diuretics do

A

affect blood volume and blood flow to muscle

30
Q

exercise duration for older adults

A

use intermittent exercise to tolerance

31
Q

exercise frequency for older adults

A

incorporate a day of rest between exercise sessions inless exercise is of very low intensity and short duration

performing multiple times a day

32
Q

what % is okay to increase exercise

A

never increase more than 10% during one sessoin

increase duration first up to 30-40 mins before adding increases in intensity

33
Q

what happens to adolescents and young adults for exercise

A

physical activity levels decline dramatically

34
Q

ExRx for young children intensity

A

weight loads - 8 or more reps
heavy weights can damage developing skeletal and joint structures
avoid repetitive use of maximal amounts of wt in strength training during adolescence

35
Q

ExRx young children duration

A

perfrom 2-3 sets of 8-10 different exercises ensuring major muscle groups are included

36
Q

ExRx young children frequency

A

limit strength training to 2-3x/wk and encourage other forms of PA

37
Q

exRx children risks

A

avoid thermal injury
chilren have increased risk of hypothermia

38
Q

warning signs to progress slowly - CHF

A

Low angina threshold
Low anaerobic threshold
Resting Tachycardia (HR >100)
Excessive SOB or other S & S
Fall of SBP > 20mmHG
Slow recovery from activity
Excessive fatigue lasting > 1-2 hrs post exercise
Increase in arrhythmias during activity
Lack of HR or BP response to activity
Excessive HR or BP responses to activity
LE claudication

39
Q

indications to terminate exercise session

A

SBP > 200-220
DBP >110
HR >80-85% of predicted maximum

40
Q

prognosis and goal setting in cardiopulm PT

A

Prognosis for Pulmonary patients is guarded because of their up and down status - easily triggered

41
Q

prognosis and goals of pulm pts

A

Key to achieving success with pulmonary patients is to address symptoms and activities - reduce the work of breathing

Goals for pulmonary rehabilitation are:
- Control and alleviate symptoms
- Minimize pathophysiological complications of respiratory impairment
- Train the patient to achieve optimal capacity to carry out ADLs

Patient Education

Decrease psychological symptoms -> anxiety or depression

Improve quality of life

Return the patient to gainful life and employment

Promote independence and self-reliance

Reduce exacerbations and hospitalizations = decreased morbidity and mortality

Encourage participation in recreational pursuits

Assist with Nutritional Support

42
Q

prognosis and goals - cardiac pts

A

Cardiac Patients prognosis often more favorable as compared to pulmonary pts

Primary goal is secondary prevention with emphasis on:
Improving functional capacity
Reducing or managing symptoms  angina
Improving overall skeletal muscle fitness
Improve the Quality of life

Patients with acute MI and CABG have been shown to demonstrate significant improvement in aerobic capacity following exercise conditioning
The greatest improvements found in patients with the lowest initial max VO2

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