Lecture 3 - Developing a Client Rx Flashcards
What are 5 things to know when making a client Rx?
- About the Client
- Risk Factors
- Diagnosis
- Treatment
- Patient Monitoring
How can you base your Rx on being client centred?
- create rapport
- gather information
- determine strategies for behaviour change
How can you create rapport?
- Creating rapport that allows openness to new information through effective conversation
- identify current disease(s), client’s preferences, goals, & barriers
- Opening package information/requests
- Interview processes
- results received from a clinical test
How can you gather information about the client?
- through effective questioning to identify needs & determine the individuals commitment to change:
- Client Activity History Past, present, future activities
- Needs, wants, & lifestyle
- Daily behaviour patterns
- Barriers to physical activity
How can you develop strategies for change?
- Use strategies for behaviour change that are designed to increase your clients perceptions of personal control through effective strategic planning:
- Motivation (GOALS)
- Knowledge & Beliefs
- Access & Abilities
- Environment & Equipment
- Support
- Desire to undertake assessment
What are 5 preliminary evaluation components?
- Greet the client and explain the purpose of this process
- Informed consent
- Administer an Activity Readiness evaluation
- Get Active Questionnaire
- Blood profile results if available
- Administer an Activity Readiness evaluation
- Lifestyle evaluation questionnaire
- Baseline measurements
- Heart Rate (HR) & Blood Pressure (BP)
- Baseline measurements
What is informed consent?
- Ensure to educate your client on the purpose of this process, reasons you are asking these questions & why it is important for you to have accurate information
- Ensure that your collection methods and information storage is anonymous & confidential
- Keep your records for 7 years
- You will do this again for your fitness assessment
What are 3 exercise design & outcomes?
- Health Enhancement: Meeting or exceeding health standards
- Increase in General Fitness: Want to increase their physical fitness
- Increases in Performance (Occupational/Recreational): Higher level performance based on what they are already doing
What are 3 basic considerations of a client?
- What is the client’s level of PA?
- Does the client’s “needs” match-up or affect their goals?
- Components of the exercise program?
What are 8 risk factors for coronary heart disease (CHD)?
- Age (>45 years old for males & >55 years old for females) (non-modifiable)
- Family History (non-modifiable)
- Cigarette Smoking (modifiable)
- Hypertension (.140/90 mmHg) (modifiable)
- Dyslipidemia (modifiable)
- Impaired Fasting Glucose (semi-modifiable)
- Obesity (modifiable)
- Physical Inactivity (modifiable)
What is a screening flow chart?
- To systematically evaluate a client’s health risks by asking specific questions about their medical history, lifestyle habits, & current health status
If an individual does not participate in regular exercise what should they do if they have no disease or signs of CV/Meta/Renal?
- No Disease & No Signs (CV/Meta/Renal):
- No medical clearance required - Light-moderate PA - Gradual progression to VPA; following guidelines
If an individual does not participate in regular exercise what should they do if they have a known disease & asymptomatic?
- Known Disease & Asymptomatic:
- Medical clearances may be needed; recommended - Post-clearance allows light-moderate PA - Gradual progression as tolerated following guidelines
If an individual does not participate in regular exercise what should they do if they have signs or symptoms of disease CV/Meta/Renal?
- Any Signs or Symptoms of Disease (CV/Meta/Renal):
- Medical clearance is recommended - Post-clearance allows light-moderate PA - Gradual progression as tolerated following guidelines
If an individual does participate in regular exercise what should they do if they have no disease & no signs of CV/Meta/Renal?
- No Disease & No Signs (CV/Meta/Renal):
- No medical clearance required - Moderate-Vigorous PA - Gradual progression following guidelines
If an individual does participate in regular exercise what should they do if they have known disease & are asymptomatic?
- Known Disease & Asymptomatic:
- Medical clearance required - Recommended before vigorous PA (or ~ 12 event) - Post-clearance continue moderate PA - Gradual progression as tolerated following guidelines
If an individual does participate in regular exercise what should they do if they have signs or symptoms of disease CV/Meta/Renal?
- Any Signs or Symptoms of Disease (CV/Meta/Renal):
- Discontinue exercise (seek medical clearance) - After clearance, gradually progress as tolerated following guidelines
What are 3 practical skills within a resting baseline measurements for screening a client?
- BMI & Body composition
- resting heart rate
- resting blood pressure
What is Body Mass Index (BMI)?
- Determines if weight is appropriate for height
- Correlated with health risk as a predictor for mortality
- Does not distinguish between fat-mass and fat-free mass
- Should be done in combination with waist circumference (WC)
How can you calculate BMI?
- BMI = weight (kg) / height (m2)
What is basic anthropometrics (anthropometry)?
- the science that defines physical measures of a person’s size, form & functional capacities
What is basic anthropometrics used for?
- Applied to occupational injury prevention, & used to study the interaction of workers with tasks, tools, machines, vehicles, & personal protective equipment
- Especially to determine the degree of protection against dangerous exposures, whether chronic or acute
What is resting heart rate?
- your heart rate when at rest
- generally between 60-100 bpm
What are 4 ways you can measure heart rate?
- palpation
- auscultation
- HR monitor
- ECG/EKG
How does palpation measure heart rate?
- Place your index & middle fingers on the inside of your wrist or on the side of your neck & gently press until you feel a pulse
- then, count the number of beats for 30 seconds & double that number, or count the beats for 15 seconds & x by 4 to get your beats per minute (BPM)
How does auscultation measure heart rate?
- A procedure that involves listening to the heart’s sounds with a stethoscope to determine the heart rate
How do heart rate monitors measure heart rate?
- Devices that detect & measure your heart or pulse rate (i.e., smart watch)
- while these devices are excellent for personal use, they’re no substitute for medical devices that are much more accurate
How does an ECG/EKG measure heart rate?
- it is an Electrical conduction of the heart
- Causes the heart to pump (is a double pump system)
- It moves blood through the body (can feel or listen to it as a pulse)
- Identifies the rate at which the heart beats & whether the rhythm is steady or not
What is bradycardia & tachycardia?
- bradycardia refers to a slow/low heart rate (i.e., under 60 bpm)
- tachycardia refers to a heart rate over 100 bpm (can be caused by stress/anxiety)
What is Tanaka’s equation for measuring Max HR?
- Max HR = 208 - (0.7 x age)
How can we measure direct HR max?
- Client must be able to perform a maximal effort safely
- Important to acquire a directly measured HR maximum
- When using submaximal testing to determine VO2 from age predicted HR maximum
- When HR maximum is used to determine target ranges for exercise prescription
What is Karvonen’s method for target HR?
- Gold Standard for HR zone determination if done without & prediction equations
- (HRmax - HRrest) x training intensity % + HRrest
- i.e., individual with a HRmax of 180 bpm and a HRrest of 70 bpm: THR (50% intensity) = ([180 – 70] x 0.5) + 70 = 125 bpm
What is resting blood pressure?
- The pressure in your arteries when your heart is at rest, or between beats
- Essentially indicating how much pressure remains in your blood vessels when the heart is not actively pumping blood out
How is resting blood pressure measured? What is a normal/abnormal value?
- Can be measured via cuff or stethoscope
- A reading below 120/80 mmHg is considered normal
- Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80
