Exam 1 (cont) Flashcards Preview

732 > Exam 1 (cont) > Flashcards

Flashcards in Exam 1 (cont) Deck (129)
Loading flashcards...
1

10 year EX training in CHF:
-123 pts
-Trained group: supervised EX training @ 60% VO2 peak , 2x/week, x10 years
-Nontrained group: "did not Ex formally
-Changes in peak VO2 (T vs NT)
-Conclusion, "Moderate supervised ET performed _____ weekly for 10 years maintains _______________________ of more than 60% of maximum VO2..."
-NT pts, peak VO2 _________progressively

twice
functional capacity
decreased

2

"Aerobic interval training versus moderate continuous training" - HF,
Results:
VO2 peak increased (__)
Decreased LVEDV and LVESV (___)
Increase LV EF (___)
BNP decreased (___)

(IT & C)
(IT only)
(IT only)
(IT only)

3

Benefits of EX in HF:

Exercise training may reverse peripheral abnormalities
(autonomic function, skeletal muscle blood flow, localized oxidative capacity)

4

Heart failure education:

- frequent bouts w/ rests in-between
-teach daily weighting to check for changes in fluid
-Teach daily checks on activity by instructing in RPE or dyspnea monitoring
-Teach about watching for dyspnea when laying down
-Energy conservation

5

Perception scales:

- "How hard are you working?"
-"Pain scale" (1+light, barely noticeable ,2+ moderate/bothersome, 3+ server/very uncomfortable, 4+ most severe pain)
- "Breathing Scale" (1+mild noticeable to pt, 2+ mild noticeable to observer, 3+ moderate difficulty , 4+ severe difficulty)

6

Aerobic EX improves:

-VO2 max
-Dyspnea
-LV function

7

Resistance Ex improves:

-LV function
-Peak lactate levels
-Muscle strength & muscle endurance

8

Do you need to include both (aerobic Ex & resistance Ex) types of Ex in patients with HF?

yes, include both

9

Name 1 Contraindication to EX training:

progressive worsening of exercise tolerance or dyspnea at rest over previous 3-5 days

10

Name a 2nd Contraindication to EX training:

significant ischemia during low-intensity EX (2 METS)

11

Name a 3rd Contraindication to EX training:

uncontrolled diabetes

12

Name a 4th Contraindication to EX training:

Recent embolism

13

Name a 5th Contraindication to EX training:

thrombophlebitis

14

Name a 6th Contraindication to EX training:

New-onset atrial fibrillation / atrial flutter

15

Name some potential outcome tools:

-knowledge of disease /self management of disease
- chair raise
- Gait speed
- 6 MWT
- Balance
- Symptom history
-Anxiety/ depression
- Quality of life - HRQOL

16

Inspiratory muscle training leads to:
-Pi max -->
-Peak oxygen uptake -->
-6 MWT -->
-VO2 slope during recovery, ventilatory response to exercise and QOL ________

115%
17%
19%
improved

17

** List 5 clinical implications for PT regarding HF:

1. screen for CV & orthopedic conditions
2. identify medication action & side effects
3. re-evaluate CV status every session & throughout EX
4. Know abnormal responses to EX and observe patient carefully (HR, BP, dyspnea, fatigue, angina)
5. Prescribe effectively (aerobic & strength

18

Cardiac rehab is defined asa supervised program to help pts recover from:

- Myocardial infarction (MI)
- Heart surgery such as bypass, ventricular assist device (VAD), valve repair
-Minimally invasive procedures such as angioplasty, stenting, valve replacement, pacemaker or implantable cardioverter defibrillator (ICD)
- risk factors such as CAD or angina
- HF

19

"All cardiac rehab programs should contain specific core components that aim to _____________________________________, foster healthy behaviors and compliance with these behaviors, ______________ and promote an active lifestyle for pts w/ cardiovascular disease."

"All cardiac rehab programs should contain specific core components that aim to OPTIMIZE CARDIOVASCULAR RISK REDUCTION, foster healthy behaviors and compliance with these behaviors, REDUCE DISABILITY and promote an active lifestyle for pts w/ cardiovascular disease."

20

What is one goal of cardiac rehab:

Mitigate the adverse physiologic effects of cardiac illness

21

What is a 2nd goal of cardiac rehab:

mitigate the adverse psychological effects of cardiac illness

22

What is a 3rd goal of cardiac rehab:

reduce the risk of sudden death or reinfarction

23

What is a 4th goal of cardiac rehab:

control cardiac symptoms

24

What is a 5th goal of cardiac rehab:

stabilize or reduce atherosclerosis

25

What is a 6th goal of cardiac rehab:

improve functional capacity

26

What is a 7th goal of cardiac rehab:

enhance psycho-social and vocational status

27

What is a 8th goal of cardiac rehab:

gives the pt a safe, monitored EN for EX

28

Name 5 general principles/ Goals of Cardiac rehab:

1. decrease length of hospital stay to 3-5 days
2. early mobilization
3. assessment
4. prepare for readiness for discharge
home
5. recommendations for home care
6. referral to outpatient cardiac rehab program.

29

During the initial assessment, PTs need to review chart and note the following:

- past medical history
- signs & symptoms
- employment
- risk factor assessment and plan for intervention or teaching... stress management psychological concerns, weight, diabetes, smoker, drinker, inactivity, etc
- medications

30

What CAN'T cardiac rehab do?

- reverse atherosclerotic process (education re: meds may influence)
- decrease myocardial ischemia
- HAVE MUCH EFFECT ON EJECTION FRACTION
-reverse effects of lung disease such as chronic obstructive pulmonary disease (COPD).