Special Pops Exam 3 Flashcards
(36 cards)
1
Q
Miocardial Infarction Pathophysiology
A
- Endothelial dysfunction
- Inflammation (C reactive protein CRP)
2
Q
Miocardial Infarction Signs and Symptoms
A
- Chest px/pressure
- sweating nausea vomiting
- INC cardiac enzymes; creatine kinase, troponin
- means cells died/exploded into blood stream
- EKG changes
3
Q
Exercise Stress Test Goals Cardiac
A
- reproduce angina
- EKG changes
4
Q
Angina pathophysiology
A
- Ischemia/hypoxia
- obstruction
- heavy constriction behind sternum
- radiating px
- short of breath, nausea
- 2-10 min
5
Q
Angina Silent, unstable, triggers, treatment
A
Silent -asymptomatic/ diabetes Triggers -rest/nitroglicerine Unstable -less predictable/at rest -INC severity, freq, duration, threshold -precurser to MI (anticoagulants/ angioplasty)
6
Q
Cardiac Interventions
A
REVASCULARIZATION -CABG -PTCA IMPLANTABLE DEVICES -pacemaker/defibrilator VALVE REPLACEMENT TRANSPLANT LIFESTYLE -exercise/diet/stop smoking MEDICATION SURGERY
7
Q
Goal of Cardiac interventions
A
- increased heart function
- angiogenesis
- fibrolysis
- vagal tone
8
Q
Exercise Testing Cardiac
A
- inc pt confidence
- evaluate
- HR capacity/recovery
- aerobic and myocardial capacity
- symptoms
- EKG changes
- NO graded Ex test (use pharmacological)
- get to ischemic threshold
9
Q
Cardiac EX RX
A
RESISTANCE progress slowly F-2-3 d/wk I-RPE 11-13 T-12-15 reps CV F-4-7 d/wk I-RPE 11-16, below ischemic/shock threshold T-Long warmup/cooldown progress to 20-60 min T- varied aerobic
10
Q
Special Cardiac Considerations
A
- sternotomy
- ECG monitoring
- transplants
- Return to work (specificity)
11
Q
Cardiac Rehab
A
Phases 1 inpatient 2 12 weeks, egg monitored/discharged 3 intermittent/no ecg/ supervision 4 no ecg, supervision
12
Q
COPD causes
A
narrowing of airways limiting airflow
- most common (80 smokers)
- small airway inflammation
- dificulty breathing out
- athsma
- cystic fibrosis
13
Q
Restrictive PD
A
restrict lung expansion
- neuromuscular/neurological
- trouble breathing IN
14
Q
COPD Signs and symptoms
A
-dyspnea
neuro input form chemo and mechano receptors
-wheezing
-chronic cough
15
Q
COPD consequences
A
- ventilatory impairments (resistance/recoil)
- abnormal gas exchange (inc hemoglobin)
- CV impairments
- muscle impairments
- breathlessness
- psychological
16
Q
COPD EX benefits
A
- CV músculo, reconditioning
- DEC
- ventalitory req at given workload, hyperinflation
- INC
- vent efficiency
- desensitization to dyspnea
17
Q
EX testing COPD
A
- causes of imitations
- coexisting conditions
- Cycle ergometer ( ramp protocol/ measure gas ex/ blood sampling)
- TM or 6 min walk (inc conf in ex)
18
Q
EX RX COPD
A
CV focus -RPE 11-13 -60% of limiting symptoms workload -monitor dyspnea -3-5 d/wk, 30 min intermittent initially -progress duration Breathing/Flex/Balance -tai chi, yoga -arm ROM -Progress to RT
19
Q
pulmonary rehab
A
- ex
- breathing tech
- meds
- psych
- nutrition
- energy conservation
- smoking cessation
- patient education
20
Q
Asthma
A
-intermittent exacerbations and remissions influence ability to ex
21
Q
Ex testing Asthma
A
- normal testing and Rx in controlled indiv
- 75% HR max
- Min 8 min
- measured air flow obstruction 6-8 min post
22
Q
asthma considerations
A
- running asthmogenic; lifting objects can increase dyspnea
- longer WU/CD
- borg CR 10 dyspnea scale
23
Q
HAART pros/cons
A
PROS -extend life expect by 15 yrs -inc immune system stat, dec muscle wasting CONS -lipodystrophy -dysliidemia -CVD,HTN,myopathies -diabetes -osteopenia -GI issues -fatigue, anemia
24
Q
AIDS EX testing
A
- monitor BP and EKG
- universal precautions
- avoid w/acute infections
- low intensities, submax testing
25
AIDS EX RX
```
F- aerobic 3-4 d/wk
rt 2-3 d/wk
I- 40-60% avoid overtraining
T- 30-60 min
T- WB, avoid contact sports
```
26
Cancer treatments
```
-surgery
amputations
-radiation
(scar tiss, dermatitis, fatigue, px)
-chemo
(scar tiss, cardiomypath, anemia, fatigue, nausea)
-immunotherapy
(muscle wasting BC changes)
```
27
Cancer ex benefits
- ROM
- strength
- dec side effets
- sense of control
- mood
- QOL
28
Cancer guidelines/considerations
-conservative
-treatment cycle
-alternate modes
-slow progression
-dose resp to fatigue
AVOID
-high impact/contace
-muscle wasting
-public places
-swimming
29
Pregnancy Ex reap mother and fetal
```
Mother
-inc acute reap VO2, HR, SV, Q, T, VE
FETAL
-BF redisribution
-no thermoregulation
```
30
pregnancy considerations
- sedentary start slow
- avoid contact, loss of balance
- supine 1st trimester only
- RT muscl eendurance
- thermoneutral
- post partum
31
absolute pregnancy contraindications
- incompetent cervix
- risk form preterm
- persistant bleeding
- placenta privia
- ruptured membanes
- preclampsia
- signif heart of lung disease
32
pregnancy ex testing
```
-if test submax <75%
ADVERSE EVENTS
-bleeding
-dramatic uterine px
-dizzy/headache
```
33
pregnancy rx
```
F- 3-7 d/wk
I- 40-60 %
use RPE 12-14
~ 140 bmp max
T- 15-30 min
T- Dynamic
```
34
Children ex testing
- only w/ health concern
- familiarization session
- TM or cycle
- psych immature
- lower risk than adults
35
Children Ex considerations
- thermoneutral
- proper instruction/supervision RT
- over wt/inactive progress slow
- tailor to disease
- dec sedentary activities
36
children ex rx
Attention span, adult involvement, enjoyment
F- 3-7 d/wk
I- mod- vig
T- 30-60 min
T- variety, free play, lifelong activity promotion
