individuals with cardiovascular and pulmonary disease

Question 1

cardiac rehabilitation is commonly used to

Answer 1

deliver exercise and other lifestyle interventions to individuals with CV disease

Question 2

pulmonary rehabilitation is often provided for those with

Answer 2

various chronic obstructive pulmonary disease, emphysema, bronchitis

Question 3

cardiovascular disease

Answer 3

diseases that involve the heart and/or blood vessels

Question 4

peripheral artery disease

Answer 4

diseases of the arterial blood vessels outside the heart and brain

Question 5

cerebrovascular disease

Answer 5

diseases of the blood vessels that supply the brain, resulting and stroke

Question 6

coronary heart disease

Answer 6

disease of the arteries of the heart

Question 7

acute coronary syndrome

Answer 7

the acute manifestation of coronary heart infarction or sudden death

Question 8

myocardial ischemia

Answer 8

temporary lack of adequate coronary blood flow relative to myocardial oxygen demands

Question 9

myocardial ischemia is often manifested as

Answer 9

angina pectoris (chest pain)

Question 10

myocardial infarction

Answer 10

injury/death of the muscular tissue of the heart

Question 11

pulmonary disease

Answer 11

diseases that involve the lungs

Question 12

acute manifestations of pulmonary disease

Answer 12

shortness of breath, difficult or rapid labored breathing, chest tightness, bouts of coughing, wheezing, more frequent colds/flu/pheumonia

Question 13

inpatient cardiac rehabilitation guidelines

Answer 13

current clinical status assessment
mobilization
identification and provision of information regarding modifiable risk factors and self care
discharge planning with HEP and ADL
refer to outpatient CR

Question 14

inpatient cardiac rehab. programs

Answer 14

clinical assessments
each sessions should include assessments and documentation of vital signs
supervised daily ambulation
individual education

Question 15

AACVPR parameters for inpatient cardiac rehabilitation daily ambulation

Answer 15

no new or recurrent chest pain
stable or falling creatine kinase and troponin values
no indication of decompensated heart failure
normal cardiac rhythm and stable electrocardiogram

Question 16

at hospital discharge, the individual should have

Answer 16

specific instructions regarding strenuous acuities that are permissible and those that should avoid

Question 17

until evaluated with an exercise test or entry into a clinically supervised outpatient CR program, the upper limit of HR or RPE noted during exercise should not exceed

Answer 17

those levels observed during the inpatient program

Question 18

(inpatient cardiac rehab) individuals should be counseled to identify

Answer 18

abnormal signs and symptoms suggesting exercise intolerance and the need for medical evaluation

Question 19

indicts for inpatient and outpatient cardiac rehab

Answer 19

medically stable postmyocardial infarction
stable angina
coronary artery bypass graft
percutaneous transluminal coronary angioplasty
stable heart failure (cardiomyopathy)
heart transplantation
valvular heart disease/surgery
peripheral arterial disease

Question 20

contraindications for cardiac rehab

Answer 20

unstable angina
uncontrolled hypertension
orthostatic BP drop >20
aortic stenosis
atrial or ventricular arrhythmias
sinus tachycardia
heart failure

Question 21

adverse responses to inpatient exercise leaning to exercise discontinuation:
diastolic BP >

Answer 21

110

Question 22

adverse responses to inpatient exercise leaning to exercise discontinuation:
decrease in systolic ____ during exercise with increasing workload

Answer 22

> 10

Question 23

adverse responses to inpatient exercise leaning to exercise discontinuation:
significant ventricular or partial _____ with or without symptoms

Answer 23

arrhythmias

Question 24

adverse responses to inpatient exercise leaning to exercise discontinuation:
_____ degree heart block

Answer 24

2nd or 3rd

Question 25

adverse responses to inpatient exercise leaning to exercise discontinuation:
signs and symptoms of exercise intolerance including

Answer 25

angina, marked dyspnea, ECG changes

Question 26

FIIT recommendations for cardiac inpatient:
frequency, aerobic and flexibility

Answer 26

2-3 sessions for the first 3 days
minimally once per day, as often as tolerated

Question 27

FIIT recommendations for cardiac inpatient:
intensity, aerobic and flexibility

Answer 27

seated or standing RHR +20 bpm for individuals with an MI and +30 bpm for individuals recovering from heart surgery
upper limit <120bpm, RPE <13 (6-20 scale)
mild stretch discomfort

Question 28

FIIT recommendations for cardiac inpatient:
time, aerobic and flexibility

Answer 28

intermittent walk-in 3-5 mins as tolerated, progressively increase
rest period may be slower walk
attempt to achieve 2:1 exercise/rest ratio, progress t 10-15 min continuous walking
all major joints at least 30s per joint

Question 29

FIIT recommendations for cardiac inpatient:
type, aerobic and flexibility

Answer 29

walking
ROM and dynamic movement. passive stretching

Question 30

at the time of physical referral or program entry the following assessments should be performed

Answer 30

medical surgical history
physical examination
review of recent CV tests and procedures
current meds
CVD risk factors

Question 31

routine pre exercise assessment of risk for exercise should be performed

Answer 31

before, during, after each rehab session

Question 32

FIIT outpatient recommentations:
frequency

Answer 32

aerobic: minimally 3d/week, up to 5d
resistance: 2-3 nonconsecutive
flexibility: 2-3d/wk, daily ideal

Question 33

FIIT outpatient recommentations:
intensity

Answer 33

aerobic: with test: 40-80% capacity using HRR, VO2
without test: seated to standing HR +20-+30 bpm or RPE 12-16
resistance: 10-15 rep without fatigue, RPE 11-13, 40-60% of 1RM
flexibility: point of feeling tightness and slight discomfort

Question 34

FIIT outpatient recommendations:
time

Answer 34

aerobic: 20-60 min
resistance: 1-3 sets, 8-10 exercises
flexibility: 10-30s hold for static stretching, >4 repetitions

Question 35

FIIT outpatient recommentations:
type

Answer 35

aerobic: arm ergometer, combination UE LE cycle ergometer, upright and recumbent cycle, stepper, elliptical, rower, stairs, treadmill
resistance: select equipment that is safe and comfortable
flexibility: static and dynamic stretching focused on the major joints of the limbs and lower back

Question 36

for individuals with very limited exercise capacities, bouts ____ daily may be considered as a starting point

Answer 36

<10min

Question 37

if an ischemic threshold has been determined, the exercise intensity should be prescribed at

Answer 37

HR of 10bpm below the HR at which the event was identified

Question 38

if peak HR is unknown, the RPE method should be used to guide exercise intensity using the following relationships (3)

Answer 38

<12 is light or <40% of HRR
12-13 is somewhat hard or 40-59% of HRR
14-16 is hard or 60-80% of HRR

Question 39

individuals on a beta blocker may have an ____ response to exercise

Answer 39

attenuated HR

Question 40

for individuals who have a beta blocker dose change, ____ and establish _____

Answer 40

monitor signs and symptoms, establish a new target for exercise intensity

Question 41

it is recommended that an exercise test be performed anytime that ____ or ___ warrant

Answer 41

symptoms, clinical changes

Question 42

individuals on diuretic therapy are at an increased risk for ___, ____, ___ particularly after bouts of exercise

Answer 42

volume depletion, hypokalemia, orthostatic hypotension

Question 43

outpatient rehab: the aerobic exercise portion of the session should include _______ for maintenance of a healthy body weight and its many other associated health benefits

Answer 43

rhythmic, large muscle group activities with an emphasis on increased caloric expenditure

Question 44

individuals with known stable CVD and low risk for complications may begin with continuous ECG monitoring and decrease to ____ ECG after ____ sessions or sooner as deemed appropriate

Answer 44

little to no
6-12 sessions

Question 45

individuals with known CVD and at moderate to high risk for cardiac complications should begin with continuous ECG monitoring and decrease to ____ ECG after ____ sessions and as deemed appropriate

Answer 45

intermittent or no
12 sessions

Question 46

when considering removing or reducing ECG monitoring the individual should understand

Answer 46

his or her individual exercise level that is safe

Question 47

cardiac outpatient: exercise prescription procedures can be based on

Answer 47

recommendations of these guidelines and what was accomplished during the inpatient phase and home exercise activities

Question 48

although a _______ test prior to starting cardiac rehab is ideal in the development of an exercise program, it is not common

Answer 48

symptom-limited graded exercise test (GXT)

Question 49

in place of GXT, a _____ or other forms of ____ exercise tests can be performed as a measurement of exercise tolerance and capacity

Answer 49

6-MWT, submaximal

Question 50

use of ___ also can be a practical method for prescribing both aerobic and resistance exercises

Answer 50

RPE

Question 51

outpatient CR: the individual should be educated on and closely monitored for signs and symptoms of intolerance such as

Answer 51

excessive fatigue, dizziness, light-headedness, chronotropic incompetence, ischemia