Exercise Testing A Flashcards
Contraindications to exercise testing: PaO2 less than ___ torr on room air.
45
Contraindications to exercise testing: PaCO2 greater than ___ torr.
70
Contraindications to exercise testing: FEV1 less than ___% of predicted
30%
Contraindications to exercise testing: Heart conditions such as a recent ____, unstable ____, and unstable ___.
Myocardial infarction
angina
heart rhythms (2nd or 3rd degree heartblocks)
Use a cycle ergometer when exercise testing patients who have difficulty ___.
Walking
To ensure rhythmic pedaling, use a ___ so patient can keep pace.
Metronome
How is a cycle ergometer better than a treadmill?
Provides more dependable workload.
What is the most common equipment for exercising a patient?
A treadmill.
What is the formula to determine or calibrate the speed of the treadmill?
Belt length x cycles per minute (RPM) = speed
Patient weight (is/is not) a factor when utilizing a treadmill. Patient weight (is/is not) a factor when utilizing a cycle ergometer.
Weight is a factor for the treadmill, but not for the cycle ergometer.
There are two things that are used in-line to monitor O2 and CO2 analyzers to monitor ventilation and expired gas concentrations. What are they?
Douglas Bag and Tissot Spirometer
How do you calculate maximum heart rate?
220-age (years)
In a steady state, the patient is exercised at sub-maximal level for a period of ____ minutes.
Patient is worked at ____% of maximum load.
Timing begins once the target is reached.
5-8 minutes
50-75%
Multistage (incremental) testing is used to determine ____. which is increased at pre-determined levels and measurements are made at the end of each stage. Then increase workload by ___.
Maximum tolerable workload
15 watts/min
Low workload: ____ watts or less
Medium workload: ___ watts
High workload: ___ watts
Too high for stress testing: ___ watts
Less than 50 watts
50-100 watts
Greater than 100 watts
200 watts
Power is measured in what units?
How do you define power?
Watts
Amount of work per minute
How do you define workload?
What units are used to measure workload?
Workload is the amount of energy being generated by a patient during exercise
Measured in kilopond-meters (kpm)
(That’s not a typo. Kilopond-meters is correct.)
How is energy measured? (x2)
It’s measured by O2 consumption (VO2) in liters per minute or in terms of METs.
A ___ is a unit that mesures O2 consumption (VO2) per kilogram of body weight.
MET
How do you calculate energy expenditure at any given workload?
VO2 divided by Patient weight (kg) divided by 3.5 = number of METS performed
What is an anaerobic threshold?
level of exercise or O2 consumption (VO2) at which anaerobic metabolism will begin to supplement aerobic metabolism
What can you expect to see if you are beyond the anaerobic threshold?
Increasing lactate
pH decreases
Heart rate remains stable
RER/RQ will increase to 1.0 or higher
What is O2max?
A point where work continues to increase but VO2 does not.
What is the Bruce Protocol?
It’s a common method used in stress testing where the workload in increased every 3 minutes.
What is the Borg Scale?
What is the Modified Borg Scale?
A rating of perceived exertion. It is the patient’s own evaluation of their level of dyspnea.
During exercise testing, O2sat should remain above __ percent.
A decrease of ____% is significant and indicates a ____ disorder.
90%
4-5%, pulmonary disorder
True or false: When measuring blood pressure during exercise testing, you can use an automatic cuff or a manual cuff.
True. Manual or automatic is fine.
The tidal breathing flow-volume loop can be monitored during stress testing to identify ___.
Disorders that occur only during exercise.
If resting SpO2 is low, what should you do before starting stress testing?
Perform oxygen titration.
What should you do with stress-testing patients with hypoxemia at rest or at a low level of work?
Test with O2 via n/c.
