Week 5 Flashcards
Ontario helps organizations identify and remove barriers to improve
accessibility for people with disabilities in 5 areas of daily life
- Customer service
- Information and communication
- Transportation
- Employment
- Design of public places
Obesity
Chronic & Progressive
Similar to diabetes or high bp
Characterized by excess body fat that threatens or affects health
Bariatric
Patient who has weight of 250 lb and higher
Body shape is also another consideration
Bariatric hospital bed
Spirt one - 1000lb capacity
Bed can low to ground
Widen and lengthen with padding inserts
Air bed mattress
Remote hand control for bed features
Short bed rails for more space and easier transfers
Bariatric Physical environment
Transfers equipment:
- Different types of lifts + repositioning sling/transfer sling
Trapeze bar
* Bed trapeze (normally 500 lbs capacity)
* Wheeled trapeze bar (450-1000 capacity)
Transfer boards
Bariatric wheelchairs/geriatric chair
- walkers (4pt, 2ww, 4ww)
- canes (side walker, 4 pt)
ADLS:
- bath chair/stool (built into wall/foldable)
- wheeled stationary over toilet commode
- sock aids (wider than standard, both hard and soft versions)
- bath transfer bench (400-500 pounds)
- bariatric gait belt
- pericarp aids (easy wipe tongs)
-ethica pads (toileting in bed)
-bedside chair
- step stool
Important Cardiovascular history to know for exercise
- Coronary Artery Disease
vs. valve surgery / other - Post Myocardial Infarction
- Intervention vs. medical
management - Congestive Heart Failure
- Pacemakers / ICD
- Prevention
Co-morbidities to exercise
- PVD
- Osteoarthritis
- Diabetic Neuropathies
- Osteoporosis
- Diabetes
Timeline for resuming exercise after cardiac event
1) Begin with low intensity, or easy exercise, as
soon as it feels comfortable to do so
2) Progress to moderate intensity once 30
minutes of easy exercise is achievable, but not
before 3 weeks
3) Sternal precautions for 6-8 weeks if necessary
4) Patients with a pacemaker or ICD are advised
not to lift their arm above shoulder height for 2
weeks & not to lift items over 10lbs for 4
weeks.
Goal setting for exercise
SMART goals
Specific
Measurable
Achievable
Results focused
Time sensitive
Guide for how long should aerobic exercise
30-60 mins of aerobic exercise
Benefits of Warm up and cool down
Injury prevention
Cardiovascular optimization
Reduce arrhtyhmias
Retard progression of cad
Steady state and interval training can be effective
Fitt principle
Frequency
Intensity
Type
Time
Prescribing intensity
20-20 beats above hr
Rpe 3-5 or 12-15 (moderate to somewhat difficult intensity)
Talk test
Stress test
Borg scale
Talk test
Step counts
Heart rate
Exercise test
Low exercise
Hr- rest hr +20 bpm
Rpe: 12-13
Talk test - can talk with exercise
Moderate exercise
Hr - rest hr + 30 bpm
13-15
Can talk with exercise
Moderate + (vigorous)
Hr - rest hr + 30-40 bpm
14-15
Not talking comfortably
Signs of over exertion
Cant talk and workout
Tired 30-60 mins post workout
Muscle and joint soreness
Lightheaded
Hr 20 above resting bpm
Resistance training of each major muscle group
2-4 sets
8-12 reps (10-15 older adults
Rest interval 2-23 between sets
FOR OLDER ADULTS:
- Unilateral exercise
- Sitting reduces energy by 25%
Pt can safely resume strength training program…
- When aerobic is comfy for 2-4 weeks
- 6-8 weeks post surgery
- 5 weeks post heart attack
Pain/discomfort is not likely angina if…
Localized
No palpation
Worse with deep breathing
Myocardial Ischemia
Lack of oxygen to the heart muscle
STABLE ANGINA
- Occurs with progressive exercise at approximately the
same exercise heart rate - Exercise training is indicated
as long as the training
intensity remains below the
level at which angina occurs
STABLE ANGINA SYMPTOMS
- Pain
- Discomfort
- Heaviness
- Squeezing
–> Women often have vague
symptoms which may also occur in
different locations
STABLE ANGINA SYMPTOMS are triggered by what?
- Physical activity
- Emotional stress
- Exposure to cold
- Consuming a heavy
meal - Smoking
UNSTABLE ANGINA
Chest discomfort occurs with
increasing frequency and severity
with progressively less activity
or at rest
- Contraindication to exercise
training - Requires medical attention
