Exercise Testing B Flashcards
Normal response to stress testing: blood pressure
Systolic: 120 to 250
Diastolic from 80 to 95
Normal response to stress testing: Max heart rate is ___.
A high heart rate with no ECG changes are commonly seen in patients who are ___.
Up to 200
Deconditioned
Normal response to stress testing: Maximum number of PVC’s during stress testing.
10 per minute.
PVC’s are commonly seen during exercise testing.
During stress testing, if systolic BP doesn’t rise or the diastolic pressure falls rapidly, what should you do? What does this indicate?
Terminate the test and call the doctor.
It indicates that the patient’s cardiac output is not increasing appropriately.
Normal response to stress testing: What is a normal RER? (Respiratory exchange ratio)
0.8 is normal RER.
Normal response to stress testing: pH will (rise or fall) because of hyperventilation. pH will (rise or fall) when anaerobic threshold is reached.
Rise with hyperventilation.
Fall when anaerobic threshold is reached.
Normal response to stress testing: Dead space (VD/VT) will normally (increase or decrease) during stress testing.
Deadspace will decrease as a result of increased pulmonary perfusion.
Normal response to stress testing: Pulmonary artery pressure will (Rise or fall) during stress testing.
It will stay the same. This is the result of recruitment and distension of vessels in the pulmonary vascular system.
Normal response to stress testing: What does an increase in PAP indicate?
Ventilatory limitations due to lung disease or vascular impairment.
You should end the test if minute volume (FEV1) is ___.
35
Poor conditioning can be indicated by an increased heart rate with ___ watts. ECG will be ___.
Increased heart rate at low to moderate watts with normal ECG. (This question was in bold print in textbook. Know it!)
To identify poor effort on a stress test, look at ___, ___, and ___. They will be normal. You can also look at the ___, which is less than ___ of the MVV. Also, ___ will not have been achieved.
ECG, SaO2, and heart rate are normal
MV is less than 70% of the MVV.
Anaerobic threshold has not been achieved. (Know this!)
ECG changes that mean you should end the stress test: ST segment ___ or ___, Inverted ___ waves, Pathological ___ waves, multifocal ___.
elevation or depression
T waves
Q waves (very large Q waves)
Multifocal PVC’s
If patient has angina during the test, what should you do?
End the test.
If patient looks really pale and sweaty during the test, what should you do?
End the test.
On the flow volume loop, a normal response to exercise will demonstrate a decrease in ___ and ___.
IRV and ERV
The objective of a 6 min walk test (6MWT) is for the patient to ___.
What unit of measurement is used?
Walk as far as possible (meters) in 6 min.
If SpO2 decreased lower that ___ during a 6 min walk test (6MWT), stop the test.
(True or false) The patient may slow down or stop to rest during the test.
85%
True
Perodic re-testing of the 6 min walk test (6MWT) can measure changes in patient progress. A __% improvement is considered significant for patients with COPD.
10%
What is the normal measurement of the central venous pressure? (mmHg and cm H2O)
2-6 mm Hg
4-12 cm H2O
Central venous pressure may also be referred to as ___.
There’s 4 answers
Right side pre-load
Right atrial pressure
Right ventricular filling pressure
Right ventricular end-diastolic pressure
The pulmonary artery pressure (PAP) is the same thing as ___.
Wedge pressure
What is the normal pressure for the pulmonary artery pressure?
25/8
Mean: 14
(Remember PAP is the same thing as wedge pressure)
When drawing a blood sample from the Swan-Ganz, what must you do first?
If you draw if with the balloon inflated, what will happen?
Deflate the balloon.
The blood will be arterial blood.
PAP or wedge pressure may also be referred to as: (x5)
Left side preload Left atrial pressure Left atrial filling pressure Left ventricular filling pressure Left ventricular end-diastolic pressure
You should terminate the stress test if the PaO2 decreases lower than ___.
55 torr
In healthy people, the A-a gradient will be ___ during exercise.
20-30 torr
Normal dead space is ___. During exercise, it will (increase or decrease?)
0.2 to 0.4.
Decrease
Anaerobic threshold may not be reached in patients with ____.
Severe pulmonary disease
According to the NBRC, what is the normal rate of breathing while at rest? (It’s not 12-20!)
8-12. (For testing purposes only!)
When detecting poor effort, you can look at these three values. If they are less than ___ of the MVV, that’s poor conditioning.
Respiratory rate, tidal volume, and minute volume less than 70% of MVV.
