Exercise Testing and Prescription in Peds Flashcards Preview

PTRS 825 Final Exam > Exercise Testing and Prescription in Peds > Flashcards

Flashcards in Exercise Testing and Prescription in Peds Deck (58)
Loading flashcards...
1

CV Responses for Children

CO increases 3-4 times above resting level (due to HR)
Low SV compared to adults; therefore, higher HR
Boys: HR is lower and SV slightly higher

2

Submax HR

Declines with age

3

Max HR

Ranges from 195-210
Declines in late teens or early 20s

4

Boys

Faster post-exercise decline in HR than girls

5

Obese Children

Higher submax HR than lean -> reduces HR reserve

6

Environment

High temp and humidity increase HR 10-20 bpm

7

Fear or Apprehension

HR may increase due to being scared
See if they can relax more after test, than take a resting HR

8

Mode of Testing

Affect HR

9

Pharmacologic agents

May increase or decrease HR
Rely on 1-20 scale instead

10

BP

Rhythmic exercise will cause rise in systolic proportion to exercise intensity
African americans have higher BP due to stiffer arterial surfaces

11

Normal Responses to Exercise

SBP increases
>220 = concern
DBP varies +/- 6-10

12

Unique Responses to Exercise

VO2 - higher at submax, higher/equal at max
HR - higer at both max/submax
All other variables are lower

13

Voluntary Hypohydration

Even forced to drink, most children are underhydrated

14

Perpetual Response Difference to Exercise

Children tend to be slower/weaker BUT perceive intensities to be lower, recover faster

15

Considering Exercise Testing a Child

Begin around 6-8 yo

16

Testing Protocols

Bruce/Modified Bruce
Balke
CMH Max
Manual

17

Bruce/Modified Bruce

Most traditional
3 min stages at 10% grade and increase grade 2% each stage
Steep grades/large MET increases/long stages difficult for young pts

18

Balke

3.0-3.5 mph with 2% increase every min or 2.5% increase every 2 min

19

CMH Max

Used with athletes
No longer than 12 minutes

20

Tilt Table Indications

Presyncope
Dizziness
Tachycardia
Extreme fatigue

21

Tilt Table Monitoring

HR
BP
O2 Sat

22

Passive Tilt

20 min supine
20 min with HOB @ 80 deg
Assess patients whose symptoms occur with change of position/non-exercise related
Most common in slender, rapidly growing adolescents w/limited fluid intake

23

Active Tilt

Exercise test followed by 20 min with HOB @ 80 deg
Assess patients whose symptoms are related to exercise
Most common in competitive athletes

24

Tilt Table Positive Findings

LOC
Symptomatic hypotension/bradycardia/asystole
Persistent tachycardia w/o dec BP (POTS)
Inappropriate hypotension (HR gives out before BP)

25

Ped Chest Pain and SOB

More likely in chronic/recurring issues

26

Ped Chest Pain and SOB Acute Causes

Pericarditis
Trauma
Arrhythmias

27

Ped Chest Pain and SOB Non-cardiac Causes

Pneumothorax
Pleurodynia
Acute esophagitis
Foreign body

28

Ped Chest Pain and SOB Chronic Causes

MI
Coronary artery anomalies
Pericarditis
Esophagitis
Costochondritis
Asthma
Sickle cell
Vocal cord dysfunction

29

Asthma

Spirometry changes on expiration
Most common serious chronic childhood disease
Don't have to have a wheeze

30

Exercise Induced Asthma Symptoms

Coughing
Wheezing
Tightness
Typically begin 5-20 min after exercise on dry/cold days