Flashcards in OS T#3: S1 Deck (44):
When is Symptom limited exercise testing normally performed?
Before stating Phase II outpatient cardiac care
how do you find out your target HR?
Age predicted method: (220-age=HR max)
(less error: 208 - 0.7 x age= HR max)
((HRmax - HRresting) x intensity ) + resting = target zone
What are the conditions for a submax Exercise tolerance Test (ETT)?
The test is symptom limited and terminated at 85% of of age predicted HR
When is submax used?
to evaluate patients for early exercise after MI, coronary bypass, or coronary angioplasty
When can maximal ETT take place?
Only when there is advanced cardiac life support o hand to handle any abnormal reactions
What should happen do diastolic BP during exercise?
It should remain about the same
What are the absolute indications for terminating an ETT? (7)
-Drop in SBP by more than 10 mmHg from baseline despite increase in workload (with evidence of ischemia)
-Moderately severe angina (3 out of 4 pain)
-Signs of poor perfusion
-1.0 mm ST elevation in leads without diagnostic Q waves
-Increasing nervous system symptoms
What are relative indications for terminating an ETT? (7)
-Drop in SBP by more than 10 mmHg from baseline despite increase in workload (without evidence of ischemia)
-More than 2 mm ST segment depression
-Arrhythmia's other than sustained V-Tach
-Fatigue SOB wheezing, leg cramps, mild claudication
-Increasing chest pain
-SBP at or above 250 mmHg, DBP at or above 115 mm Hg
-Development of bundle branch block or intra-ventricular delay
Describe a 3rd degreed heart block
All impulses are blocked at the AV node, atria and ventricles beat at different rates (atria faster than ventricle)
Considered a medical emergency and needs pace maker
Pt may faint if ventricular output is too low
What causes a 3rd Degree heart block?
Degenerative changes in the conduction system
What does a depressed ST segment indicate?
What is phase I of Cardiac Rehab?
Inpatient Cardiac Rehab (acute)
What is the exercise limitations for Phase I of Cardiac Rehab?
Starting from 2-3 METS (walking 2mph) progress to 5 METS(walking 3.5-4 mph)
Post MI: limited to 70% of HR max and/or 5METs until 6 weeks post MI
Post surgery normally progresses quicker
Lifting actives are restricted for 6 weeks
What is Phase II of Cardiac Rehab?
Outpatient Cardiac Rehab (subacute)
What is the exercise limitations for Phase II of Cardiac Rehab?
Duration: 30-60 mins with 5-10min warm up/cool-down
Single/Multiple mode(s) of training
Suggested Exit point 9 METs (running 5.5 mph, biking 13 mph)
What is Phase III of Cardiac Rehab?
Community Exercise Programs
What is an Extremely low APGAR scale?
0-3 at 1 and 5 minutes (exhibit need for resuscitation) if scores remain this low neurological complications can be expected.
What are PT's/ PTA's liable for?
PTA's/PT's are liable for their own negligence, but supervisors may assume liability of the workers if they provide faulty supervision or in appropriate delegation of responsibilities. PT's are liable for the use of defective equipment if they contributed to the malfunction or continued to have it used in treatment with out having it checked.
What are the exercise:rest ratios used for a person post MI or with CAD
Acute care (Phase I) 1:1
Subacute outpatient (Phase II) 2:1
Goal for progression 5:1
What is Spondylolysis?
Fracture of the par interarticularis without movement
What is Spondylolisthesis?
Fracture of the par interarticularis with anterior displacement of the vertebral body movement.
What should be avoided with Spondylolysis and Spondylolisthesis in its early stages.
Lumbar extension beyond neutral and rotation
What is semi-fowler position?
The Semi-Fowler's position is the position of a patient who is lying in bed in a supine position with the head of the bed at approximately 30 to 45 degrees. Upright at 90 degrees is full or high Fowler's position.
Signs and symptoms for Addisons disease (hypocorticolism).
Nausea and vomiting
When instructing parents on the exercise program for an infant why i it important to assess the anxiety and attention of the clients?
If the clients are overwhelmed with the information given or the diagnosis of their child they will be unable to adequately follow the HEP
What is a typical early manifestation of Cystic Fibrosis?
Increased appetite with weight loss
What kind of estim is used before a painful procedure to modulate pain?
What is the first part of the body that a pt should align when a pt is in sitting?
What motions go into D1 flexion?
Shoulder: Flex, Add, ER
What motions go into D1 Ext?
Shoulder: Ext, Abd, IR
Wrist: Ulnar dev
What motions go into D2 flexion?
Shoulder: Flex, Abd, ER
What motions go into D2 ext?
Shoulder: Ext, Add, IR
Wrist: Ulnar dev
How do you bias the tibial nerve for Neural tension testing?
Straight leg raise with dorsiflexion and eversion
How do you bias the sural nerve for Neural tension testing?
Straight leg raise with dorsiflexion and inversion
How do you bias the fibular nerve for Neural tension testing?
Straight leg raise with plantarflexion and inversion
What is one clinical finding of a patient with COPD Gold stage III
What are the dimensions for a benign mole (vevus)?
Boarders: Clearly defined
Color: Uniform (black usually)
Diameter:less than 6 mm
What are signs of Myasthenia Crisis?
Labored Talking/ Chewing
What does a valsalva maneuver produce?
Increased Venus pressure /Increased BP
Increased preload on the heart after relaxation
3 causes for pitting edema:
What a score indicating a high risk for falling on the Tinetti Performance Oriented Mobility Assessment (POMA)?
Less than 19
McBurney's point is associated with which disease?
Murphy's Sign is associated with which disease?