Midterm Flashcards
(123 cards)
1
Q
Do you need to gain medical clearance to exercise a patient that does not regularly exercise and does not have any signs and symptoms of CVD?
A
-No
2
Q
What type of exercise can you perform with someone who does not regularly exercise and does not have any signs or symptoms of CVD?
A
-light to moderate
3
Q
Do you need to gain medical clearance to exercise a patient who does not regularly exercise, has a CVD?
A
-It is recommended (even if they are asymptomatic)
4
Q
Excercise testing can be used to test for what type of diseases?
A
-Ischemia, CAD
5
Q
What is exercise testing not a good predictor of?
A
-acute events
6
Q
How much does HR increase with exercise?
A
-10 beats per met
7
Q
How much does systolic BP increase with exercise?
A
-10 mmHg per met
8
Q
How much does diastolic BP increase with exercise?
A
-it doesnt
9
Q
How should O2 sats change with exercise?
A
-it shouldnt
10
Q
How does breathing change with exercise?
A
-tidal volume increases until it reaches 40-50% of vital capacity then RR increases
11
Q
How much can cardiac output increase until maximum exericse?
A
-about 4 times
12
Q
How much can HR increase from rest with maximum exercise?
A
-about 3 times
13
Q
How much can SV increase with maximum exercise?
A
-about 1.5 times
14
Q
CO stops increasing at about percent of maximum exercise?
A
-40%
15
Q
VO2 can increase about how much at max exercise?
A
-3 times
16
Q
What is the MET?
A
-The ratio of the rate of energy expended during an activity to the rate of energy expended at rest
17
Q
what is 1 MET equal to?
A
-3.5; or 1 kcal
18
Q
Where does the normal aerobic threshold occur?
A
-at 55% of VO2 max
19
Q
How does anaerobic training improve the lactate thresh hold?
A
-improving muscle alkaline reserves
20
Q
What type of PVCs are contraindications to exercise testing?
A
-multifocal or more than 10 in a minute
21
Q
What type of angina is a contraindication for exercise testing?
A
-unstable
22
Q
What type of heart failure is a contraindication for exercise testing?
A
-decompensated
23
Q
New onset Afib with what is a contraindication for exercise testing?
A
-RVR >100
24
Q
What degree heart block is a contraindication for exercise testing?
A
-2nd degree with PVCs, or 3rd degree
25
BP over what is a contraindication for exercise testing?
-180/105
26
What coronary artery supplies the right atrium, right ventricle and the inferior left ventricle?
-The RCA
27
An RCA infarct will be in what location?
-Inferior
28
What are the common complications of an RCA?
-AV block, Arrhythmia, RV infarct
29
What coronary artery supplies the anterior LV?
-The left coronary artery
30
What coronary artery supplies the left atrium, and lateral/posterior LV?
-Circumflex
31
ECG changes will be seen on what leads with an RCA infarct?
-II, III and avF
32
A left main coronary infarct will cause changes where?
-anterior and lateral
33
ECG changes with a left main artery infarct will be seen on what leads?
-V1-V6 and aVL
34
What are the common complications of a left main infarct?
-pump dysfunction/failure
35
What is the most commonly coronary artery infarct?
-LAD
36
ECG changes from an LAD infarct will be seen on what leads?
-V5, V6, aVL and I
37
What causes cardiac tamponade?
-more than 20mL of fluid in the pericardial space
38
Cardiac Tamponade can eventually cause what?
-CHF
39
What is the most common cause of CHF?
-MI
40
What is elevated BP?
-120-129/<80
41
What is stage I hypertension?
-130-139/80-90
42
What is stage II hypertension?
-140 or higher/90 or higher
43
What is a hypertensive crisis?
->180/>120
44
Angina is cause by what?
-A partial CA block
45
MI is cause by what?
-A total CA block
46
What does smoking cause that increases risk for CAD? (3)
-increased BP, Decreases HDLs, enhances platelet aggregation
47
Exercise can improve what to lessen risk of CAD?(4)
-improves lipid profile, improves insulin sensitivity, improves glucose control, and reduced BP
48
How does hypertension increase the risk of artherosclerosis?
-causes mechanical damage to endothelial cells, and increases the permeability of lipids and promotes plaque formation
49
SBPs of 140-150 increase risk of CAD by what?
-6- to 70%
50
SPB greater than 160% increase the risk of CAD by what?
-100-130%
51
What cholesterol is responible for atherosclerotic deposites?
-LDL
52
What are the 3 major risks for artherosclerosis?
-LDLs >190, diabetes and age 40-75
53
What fasting glucose levels are contraindicated for exercise?
-above 250 or less than 60
54
What is the Avg age for MI in males?
-65
55
What is the Avg age of MI in females?
-72
56
What gender is more likely to have a fatal MI?
-women
57
How does stress increase risk of arthersclerosis?
-causes sympathetic stimulation that increases BP and HR and increases clotting activation
58
What is sudden cardiac death?
-caused by vfib, initial presenting syndrome in 40-50% of CHD patients
59
What is unstable angina?
-inadequate blood flow to the heart without conditions to provoke it
60
Acute MI causes an increase in what levels?
-toponin
61
What type of MI is commonly causes by a partial block to a major artery or a total block or a minor artery?
-Non-STEMI
62
What type of damage will be caused by a Non-STEMI?
-Partial Thickness, subendocardial
63
What ECG changes will be seen with a Non-STEMI?
-ST depression, or T wave inversion
64
What type of MI is caused by a total occlusion of a major artery?
-STEMI
65
What ECG changes will be seen with a STEMI?
-ST segment elevation
66
What else is seen with a STEMI?
-Troponin levels increase (gold standard)
67
What limitations does a stage I NYHA have?
-No limitations, ordinary activity does not cause undue fatigue, patient is asymptomatic (can perform METs above 7)
68
What limitations does a Class II NYHA have?
-slight limitations of physical activity, ordinary physical activity leads to symptoms (5 METs)
69
What type of limitations will Class III NYHA have?
-marked limitations; less than ordinary activity causes symptoms (2-3 METs)
70
What limitations does Class IV NYHA have?
-Unable to carry any physical activity without symptoms (Sever CHF) (1.6 METs)
71
A patient who recently had a hemorrhage and has acute low Hbg, what might be their response to exercise?
-They wont tolerate it well
72
A person with chronicly low Hgb respond to exercise how?
-they might be able to tolerate it
73
If a person has Hct values of what should you use a system based approach to determine if exercise is okay?
-<25
74
If a person has a central line, what should you wait for before exercise?
-Xray, to confirm proper placement and rule out pneumothorax
75
What should you not use on an extremity with a central line?
-BP cuff
76
What should you encourage for a limb with a central line placed in it?
-AROM with precautions
77
What two things should increase linearly with exercise?
-HR and VO2
78
What is the best way yo calculate HR max?
-208- (0.7 x age)
79
What is a 0 on the borg scale?
-nothing
80
What is a 0.5 on the borg scale?
-very very slightly (Just noticable)
81
What is a 2 on the borg scale?
-slight breathlessness
82
What is a 3 on the borg scale?
-moderate breathlessness
83
What is a 4 on the borg scale?
-somewhat severe breathlessness
84
What is a 5 on the borg scale?
-severe breathless ness
85
What is a 7 on the borg scale?
-very severe breathlessness
86
What is a 9 on the borg scale?
-very, very severe breathlessness
87
What is a 10 on the borg scale?
-maximum effort
88
How many sessions per day are recommended for inpatient cardiac rehab in the first three days?
-2 to 4 session per day
89
For a patient s/p MI, what HR is reccomended for inpatient cardiac rehab?
-20 BPM over resting
90
For a patient s/p surgury, what HR is reccomended for inpatient cardiac rehab?
-30 BPM over resting
91
What frequency is reccomended for outpatient cardiac rehab aerobic training?
->/= 3 days per week, 5 reccomended
92
What intensity is recommended for outpatient cardiac rehab aerobic training?
-40-80% of exercise capacity, 20-30 BPM over resting, or 12-15 RPE
93
What frequency is recommended for strength training in outpatient cardiac rehab?
-2-3 non consecutive days per week
94
What intensity is recommended for strength training in outpatient cardiac rehab?
-20-15 reps of each exercise without significant fatigue, RPE 11-13, or 40-60% RPE
95
What is recommended for strength training in outpatient cardiac rehab?
-1 to 3 sets of 8-10 exercises, focus on major muscle groups
96
What is normal Right Atrial Pressure?
-0-8 mmHg
97
What is normal RV pressure?
-15 to 30/0 to 8
98
What is normal pulmonary artery pressure?
- 15-30/5-15
99
What is normal pulmonary capillary wedge pressure?
-4 to 15 mmHg
100
What is the normal BUN level?
-8 to 23
101
What is normal mean arterial pressure norms?
-70 to 110 mmHg
102
What are cardiac index norms?
- 25 to 4
103
What is the main complication of aortic stenosis?
-atrial fibrillation; has a high mortality rate
104
How long does the P wave last?
-.11 seconds (2 small boxes)
105
How long does the PR interval normally last?
- .12-.2 seconds (5 small boxes)
106
How long does the QRS complex normally take?
- .06-.1 seconds (2 small boxes)
107
What leads give a view of the heart in the horizontal plane?
-pericordial leads
108
What will an ectopic foci look like on an ECG?
-a large QRS complex
109
How can you tell is there a muliple ectopic foci?
-The abnormal QRS complexes will look different
110
How will atrial flutter apear on an ECG?
-Mutiple PVCs, Saw tooth pattern
111
How will atrial fibrilation appear on an ECG?
-Squigly lines before QRS
112
What will ischemia cause on an ECG?
-ST depression for 2 small boxes
113
What will a non-stemi cause on an ECG?
-Persistent ST depression
114
What is the first thing you will see on an ECG with a STEMI?
-ST elevation
115
With a STEMI, what will appear on a ECG after ST elevation?
-Q wave
116
What appears on an ECG with a STEMI after ST elevation and Q wave?
-T wave inversion
117
What remains chronically in a ECG with a STEMI?
-Q wave
118
How will a 1st degree AV block occur on an ECG?
-Stable PR interval prolongation
119
How will a type I second degree heart block appear on an ECG?
-Progressive prolongation of the PR interval
120
Where do 1st degree, and Type I 2nd degree AV blocks occur?
-At the AV node
121
Where does a Type II second degree AV block occur?
-below the bundle of his
122
How will a 2nd degree heart block appear on an ECG?
-Stable PR interval with some conduction getting through
123
What is a 3rd degree AV block?
-No conduction
