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Special Populations > Special Pops Exam 3 > Flashcards

Special Pops Exam 3 Flashcards

1
Q

Miocardial Infarction Pathophysiology

A
  • Endothelial dysfunction

- Inflammation (C reactive protein CRP)

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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
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3
Q

Exercise Stress Test Goals Cardiac

A
  • reproduce angina

- EKG changes

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4
Q

Angina pathophysiology

A
  • Ischemia/hypoxia
  • obstruction
  • heavy constriction behind sternum
  • radiating px
  • short of breath, nausea
  • 2-10 min
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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)
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6
Q

Cardiac Interventions

A 
REVASCULARIZATION
-CABG
-PTCA
IMPLANTABLE DEVICES
-pacemaker/defibrilator
VALVE REPLACEMENT
TRANSPLANT
LIFESTYLE
-exercise/diet/stop smoking
MEDICATION
SURGERY
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7
Q

Goal of Cardiac interventions

A
  • increased heart function
  • angiogenesis
  • fibrolysis
  • vagal tone
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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
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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
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10
Q

Special Cardiac Considerations

A
  • sternotomy
  • ECG monitoring
  • transplants
  • Return to work (specificity)
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11
Q

Cardiac Rehab

A 
Phases
1 inpatient
2 12 weeks, egg monitored/discharged
3 intermittent/no ecg/ supervision
4 no ecg, supervision
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12
Q

COPD causes

A

narrowing of airways limiting airflow

  • most common (80 smokers)
  • small airway inflammation
  • dificulty breathing out
  • athsma
  • cystic fibrosis
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13
Q

Restrictive PD

A

restrict lung expansion

  • neuromuscular/neurological
  • trouble breathing IN
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14
Q

COPD Signs and symptoms

A

-dyspnea
neuro input form chemo and mechano receptors
-wheezing
-chronic cough

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15
Q

COPD consequences

A
  • ventilatory impairments (resistance/recoil)
  • abnormal gas exchange (inc hemoglobin)
  • CV impairments
  • muscle impairments
  • breathlessness
  • psychological
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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
Q

AIDS EX RX

A 
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
Q

Cancer treatments

A 
-surgery
amputations
-radiation
(scar tiss, dermatitis, fatigue, px)
-chemo
(scar tiss, cardiomypath, anemia, fatigue, nausea)
-immunotherapy
(muscle wasting BC changes)
27
Q

Cancer ex benefits

A
  • ROM
  • strength
  • dec side effets
  • sense of control
  • mood
  • QOL
28
Q

Cancer guidelines/considerations

A

-conservative
-treatment cycle
-alternate modes
-slow progression
-dose resp to fatigue
AVOID
-high impact/contace
-muscle wasting
-public places
-swimming

29
Q

Pregnancy Ex reap mother and fetal

A 
Mother
-inc acute reap VO2, HR, SV, Q, T, VE
FETAL
-BF redisribution
-no thermoregulation
30
Q

pregnancy considerations

A
  • sedentary start slow
  • avoid contact, loss of balance
  • supine 1st trimester only
  • RT muscl eendurance
  • thermoneutral
  • post partum
31
Q

absolute pregnancy contraindications

A
  • incompetent cervix
  • risk form preterm
  • persistant bleeding
  • placenta privia
  • ruptured membanes
  • preclampsia
  • signif heart of lung disease
32
Q

pregnancy ex testing

A 
-if test submax <75%
ADVERSE EVENTS
-bleeding
-dramatic uterine px
-dizzy/headache
33
Q

pregnancy rx

A 
F- 3-7 d/wk
I- 40-60 %
  use RPE 12-14
   ~ 140 bmp max
T- 15-30 min
T- Dynamic
34
Q

Children ex testing

A
  • only w/ health concern
  • familiarization session
  • TM or cycle
  • psych immature
  • lower risk than adults
35
Q

Children Ex considerations

A
  • thermoneutral
  • proper instruction/supervision RT
  • over wt/inactive progress slow
  • tailor to disease
  • dec sedentary activities
36
Q

children ex rx

A

Attention span, adult involvement, enjoyment
F- 3-7 d/wk
I- mod- vig
T- 30-60 min
T- variety, free play, lifelong activity promotion

Special Populations (3 decks)

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