Primary prevention, Risk reduction, Deconditioning Flashcards

1
Q

Exercise dose that will maintain the patient’s conditioning level and prevent deterioration; Intensity is primary to frequency (i.e. better to complete high intensity exercise less frequently than low intensity exercise with increased frequency)

A

Rehabilitation

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2
Q

Prevention of ischemic heart disease can be prevented & “optimal” cardiovascular health can be achieved through moderate volume of regular physical activity at an intensity of ___METs.

A

6

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3
Q

What can be done to prevent detrimental effects on the CV system due to bedrest?

A
  1. Mobilization and exercise ENHANCE mucociliary transport and airway clearance. RESULT: Improved pulmonary function
  2. Changes in body position assist in airway clearance to minimize pooling and stagnation of bronchial secretions. RESULT: Decreased risk of atelectasis
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4
Q

What are the effects of bedrest on the CV system?

A
  1. Loss of fluid-volume and pressure regulating mechanism
  2. Decrease in plasma volume
  3. Diuresis
  4. Increased hematocrit
  5. Increased risk for deep vein thrombosis (DVT)– this is PREVENTABLE
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5
Q

What are the effects of bedrest on the pulmonary system?

A
  1. Increased work of breathing
  2. Secondary effect of decrease lung volumes - Functional Residual Capacity = Worse in supine; improved in sitting; Residual Volume; Forced Expiratory Volume
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6
Q

What are the effects of bedrest on the msk system?

A
  1. Bedrest Muscle Atrophy - Weakness, Discoordination, Impaired balance
  2. Excessive strain on ligaments and joints = Joint contracture
  3. Disuse osteoporosis - Needs to be prevented because once bone loss occurs it is largely irreversible; Increased risk for fracture!
  4. Limited alternatives to lying in bed result in poor postural alignment, stiffness, soreness - neck pain after ventilator
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7
Q

What are effects of bedrest on other systems?

A
  1. Orthostatic hypotension
  2. Increased risk for skin lesions and decubitus ulcers
  3. Increased renal load, may lead to dysrhythmia, muscle wasting, weakness, neuropathy, glucose intolerance, and reduced bone density
  4. Decreased activity of the sympathetic nervous system
  5. Decreased electrical activity in the brain
  6. Emotional & behavioral changes, decreased reaction times, sleep disturbance, impaired psychomotor performance
  7. Decreased insulin sensitivity
  8. Decreased lymphatic flow and impaired immune system response
  9. Depression
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8
Q

What are alternatives to bedrest?

A
  1. Use of creatively-designed furniture that supports normal physiological functioning. (i.e. stretcher chair) - Kinetic & rotating beds
  2. Avoid passive positioning whenever possible!
  3. Active standing > passive standing
  4. Upright sitting > passive standing
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9
Q

Effects of acute exercise on the CVP system results in increased airway diameter in addition to the following increases:

A
  1. Minute alveolar ventilation
  2. Alveolar ventilation
  3. Tidal Volume
  4. Respiratory Rate
  5. Air flow rates
  6. Cardiac Output
  7. Stroke volume
  8. Heart rate
  9. Blood pressure
  10. Rate pressure product (HR + Systolic BP)
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10
Q

Hemodynamic benefits are greater in ____ positions. For those with impaired venous return and myocardial contractility, begin with ________. In those with stroke and other clotting disorders, _______ are associated with minimal increases in platelet activity.
There is no evidence to support this as a risk factor in this population.

A

upright; moderate-intensity recumbent cycling; moderate levels of activity

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11
Q

What are the effects of exercise on the endocrine system?

A
  1. Mobilization and exercise are stimulating
  2. Increased sympathetic nerve stimulation, which improves processing of sympathetic neurotransmitters
  3. Many benefits of increase catecholamines, including anti-inflammatory effects
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12
Q

What are the effects of exercise on the central nervous system?

A
  1. Arousal due to activation of the reticular activating system
  2. Parasympathetic inhibition coupled with sympathetic activation to assist with systemic responses to exercise
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13
Q

What are the effects of exercise on the metabolic system?

A
  1. Improved sensitivity to insulin

2. Increased growth hormone synthesis

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14
Q

What are the effects of exercise on the immunological system?

A
  1. Improves white blood cell production
  2. Dose-dependence is unknown
  3. Prolonged exhaustive exercise is associated with compromised immunity
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15
Q

What are the effects of exercise on the psychological system?

A
  1. Improved well-being and mood

2. Not well utilized amongst those with mental illness

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16
Q

What are the steps you should take to prepare for mobilization of a patient?

A
  1. The patient should be physically prepared.
  2. The patient’s medication schedule should be reviewed.
  3. Equipment should be noted and positioned appropriately.
  4. Move procedures and techniques should be discussed with the team before implementation.
17
Q

how should you be monitoring the mobilization session?

A
  1. Adapt communication needs to the learner
  2. Assess baseline
  3. Metabolic response to mobilization and exercise should be monitored
  4. How? HR, EKG, BP, Rate Pressure Product, Respiratory Rate, RPE, Breathlessness, Pain/discomfort, Fatigue
18
Q

What are the specific long-term effect of mobilization and exercise on the pulmonary system?

A

increased respiratory m strength and endurance

19
Q

What are the specific long-term effect of mobilization and exercise on the CV system?

A
  1. Increase myocardial efficiency
  2. exercise-induced bradycardia
  3. decr HR and BP
  4. improved orthostatic tolerance
20
Q

What are the specific long-term effect of mobilization and exercise on the hematological system?

A
  1. increase RBC

2. optimize hematocrit and cholesterol

21
Q

What are the specific long-term effect of mobilization and exercise on the central nervous system?

A
  1. increased sense of well-being

2. increased concentration

22
Q

What are the specific long-term effect of mobilization and exercise on the NM system?

A
  1. improved NM control
  2. improved postural control
  3. improved efficiency of movement
23
Q

What are the specific long-term effect of mobilization and exercise on the msk system?

A
  1. improved m vascularization
  2. increased glycogen storage capacity
  3. increased biomechanics efficiency
  4. m hypertrophy
  5. incr strength, endurance, and leg tensile strength
  6. maintain bone density
24
Q

What are the specific long-term effect of mobilization and exercise on the endocrine system?

A

Increased efficiency of hormone production and degradation to support exercise

25
Q

What are the specific long-term effect of mobilization and exercise on the immunological system?

A

increased resistance to infection

26
Q

What are the specific long-term effect of mobilization and exercise on the integumentary system?

A
  1. increased efficiency of skin as heat exchanger and sweating efficiency
  2. decr skin breakdown
  3. improved healing