Term
| normal response to exercise should show what type of increase? |
|
Definition
|
|
Term
| measure used for cardiopulm PT which shows how much activity the body can sustain |
|
Definition
|
|
Term
|
Definition
| mild, noticeable to patient, but not to observer |
|
|
Term
|
Definition
| mild, some difficulty, noticeable to observer |
|
|
Term
|
Definition
| moderate difficulty, but can continue with activity |
|
|
Term
|
Definition
| severe difficulty, patient cannot continue with activity |
|
|
Term
| patients on beta blocker will have what heart rate at rest? |
|
Definition
| lower than normal heart rate (40-60 bpm) |
|
|
Term
| patients on beta blocekrs will show what type of heart rate during exercise |
|
Definition
| blunted heart response, HR won't increase as much as it would for a normal person, 120-130 for a normal, 100 for a betablocker |
|
|
Term
| definition of cardiopulmonary physical tehrapy |
|
Definition
| exam, assessment, and intervention of the pt with cardiovascular/pulmonary impairments |
|
|
Term
| Goals of Cardiopulm PT: reverse (3) |
|
Definition
| risk factors, treatable pathologies, CAD |
|
|
Term
| Goals of Cardiopulm PT: prevent |
|
Definition
|
|
Term
| Goals of Cardiopulm PT: minimize (2) |
|
Definition
| chronic conditions, loss of function after acute condition |
|
|
Term
| defintion of cardiac rehabilitation |
|
Definition
| multidisciplinary team approach to the care and mgmt of cardiac problems |
|
|
Term
| Key players in cardiac rehabilitatoin (5) |
|
Definition
| primary care giver, cardiac nurse, dietician, exercise therapist (PT), behavior psychologist |
|
|
Term
| Major goals of cardiac rehab |
|
Definition
| improve life expectancy, and QOL through mgmt of cardiac condition and decrease risk factors |
|
|
Term
| Cardiac Evaluation: Observation would include what? (7) |
|
Definition
| skin color, posture, general overall appearance, BMI, VItals, Heart ausculation, heart rhythm |
|
|
Term
| Cardiac Evaluation: Observation: issues with skin color |
|
Definition
normal?
pale? cyanotic? (lack of O2)
pink? reddish? flush? (too much vasodilation, acute distress) |
|
|
Term
| Cardiac Evaluation: Observation: why is posture important |
|
Definition
| could effect the size of the thoracic cavity |
|
|
Term
| Cardiac Evaluation: Observation: importance of general overall appearance? |
|
Definition
| overweight? hair loss (extremities?) frail? |
|
|
Term
| Cardiac Evaluation: Observation: importance of BMI |
|
Definition
| combine with waist size = a good predictor of CAD |
|
|
Term
| Cardiac Evaluation: Observation: importance of vitals |
|
Definition
|
|
Term
| Cardiac Evaluation: Observation: importance of auscultation and rhythm |
|
Definition
| heart sounds, EKG for rate and rhythm |
|
|
Term
| Phases of Cardiac Rehab: Phase I would be what setting |
|
Definition
|
|
Term
| Phases of Cardiac Rehab: Phase II would be what setting |
|
Definition
| sub-acute, early outpatient, or home based rehab |
|
|
Term
| Phases of Cardiac Rehab: Phase III would include what? |
|
Definition
|
|
Term
| Phases of Cardiac Rehab: general note |
|
Definition
| the stage of cardiac rehab does not matter, contraindications in any stage |
|
|
Term
| Phases of Cardiac Rehab: contraindications to exercise: patient symptom |
|
Definition
|
|
Term
| Phases of Cardiac Rehab: contraindications to exercise: resting vitals (HR, SBP, DBP) |
|
Definition
| HR >120, SPB>200, DBP>100 or <60 |
|
|
Term
| Phases of Cardiac Rehab: contraindications to exercise: EKG readings |
|
Definition
| atrial or ventricular tachycardia, frequent PVC's, multi-focal PVCs, PVC's which increase with exercise or resting S-T segment depression of >2mm, 3rd degree heart block |
|
|
Term
| Phases of Cardiac Rehab: contraindications to exercise: metabolism related |
|
Definition
|
|
Term
| Guidelines to Stop Early Mobilization of COmplicated MI or High RIsk Patients: development of |
|
Definition
|
|
Term
| Guidelines to Stop Early Mobilization of COmplicated MI or High RIsk Patients: drop in BP of |
|
Definition
|
|
Term
| Guidelines to Stop Early Mobilization of COmplicated MI or High RIsk Patients: rapid rise in BP above what |
|
Definition
|
|
Term
| Guidelines to Stop Early Mobilization of COmplicated MI or High RIsk Patients: signs of intolerance to activity (3) |
|
Definition
| diaphoresis, severe SOB, CP |
|
|
Term
| Guidelines to Stop Early Mobilization of COmplicated MI or High RIsk Patients: heart rate rise of what in PHase I? |
|
Definition
|
|
Term
| Phase I patient types (5) |
|
Definition
| Mi and post surgial cardiac pts' most common,new onset arrythmias, CHF exacerbations, syncope |
|
|
Term
| Goals of Phase I: develop |
|
Definition
| a plan of mgmt of the pt's disease or symptoms |
|
|
Term
| Goals of Phase I: Prevent |
|
Definition
|
|
Term
| Goals of Phase I: protect... |
|
Definition
| heart while in the injury recovery stage |
|
|
Term
| Goals of Phase I: PT must protect heart while in the injury recovery stage which can last how long? |
|
Definition
|
|
Term
| Goals of Phase I: Educate the patient regarding what (3) |
|
Definition
| monitor responses to activity, the rehab process, initiate lifestyle education |
|
|
Term
| Goals of Phase I: the patient whould be exercise at what level by exit? |
|
Definition
| 2-3 METS up to 15-20 minutes/day |
|
|
Term
| Goals of Phase I: how do you monitor exercise tolerance or resposne to activity? |
|
Definition
Vitals: HR, BP, EKG
Subjective measures: Borg, dyspnea, angina, talk test |
|
|
Term
| Uncomplicated MI: Low Risk Subgroup: infarct size |
|
Definition
|
|
Term
| Uncomplicated MI: Low Risk Subgroup: EKG reading |
|
Definition
| stable EKG by the end of the 4th day post MI |
|
|
Term
| Uncomplicated MI: Low Risk Subgroup: hospital course? |
|
Definition
| normal, 5 days with gradual increase in low level aerobic exercise functional activities and transition to phase II rehab |
|
|
Term
| Uncomplicated MI: Low Risk Subgroup: what is done to determien the level of blockage and further treatment? |
|
Definition
|
|
Term
| Uncomplicated MI: Low Risk Subgroup: if the pt is cleared for increasing activity, what is the role of the PT |
|
Definition
| PT instructs pt on home program |
|
|
Term
| Uncomplicated MI: Moderate/High Risk Subgroup: developing or showing signs of increasing problems during phase I such as (3) |
|
Definition
| low ventricular function (EF 30-45%), ischemia with low level activity, occasional EKG changes |
|
|
Term
| Uncomplicated MI: Moderate/High Risk Subgroup: how do patients in this category progress? |
|
Definition
| followed up closely and transitioned to an outpatient Phase II program or a home program as appropriate |
|
|
Term
| Complicated MI: High Risk Subgroup: infarcts/EKGS |
|
Definition
| really large infarcts and/or unstable EKGs |
|
|
Term
| Complicated MI: High Risk Subgroup: patients in the subgroup have what done? |
|
Definition
| some surgical intervention |
|
|
Term
| Complicated MI: High Risk Subgroup: what happens to the pt's EKG/symptoms with exercise? |
|
Definition
| persist or exacerbate with exercise |
|
|
Term
| Complicated MI: High Risk Subgroup: ejection fraction |
|
Definition
|
|
Term
| Complicated MI: High Risk Subgroup: BP |
|
Definition
|
|
Term
| Complicated MI: High Risk Subgroup: patient sign |
|
Definition
|
|
Term
| Complicated MI: High Risk Subgroup: patients in this subroup usually have to do this exercise as appropriate |
|
Definition
| low level functional movements |
|
|
Term
| Phase I Progression: Uncomplicated MI: when would you begin to progress |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 2 after MI: assess physiologic response to change in position (3) |
|
Definition
| out of bed/edge of bed, change of position, restrictions d/t lines |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 2 after MI: assess physiologic response to activity |
|
Definition
| low level activity ~2 Mets |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 2 after MI: assess physiologic response to duration |
|
Definition
| about 5-7 minutes, rest, and can do more after |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 2 after MI: educate patient on (2) |
|
Definition
| RPE, reinforcing previous education |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 2 after MI: educate patient on RPE, as in what? |
|
Definition
| how should you feel when you are exercising, what should you do if you start feelign something you shouldn't |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 3 after MI: reassess... |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 3 after MI: review... |
|
Definition
| patient education including RPE |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 3 after MI: in regards to activity |
|
Definition
| increase activity duration and initate unsupervised activity - ambulation and general condtioning exercises |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 4 after MI: reassess |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 4 after MI: progress activity to |
|
Definition
| 3 METS BID for 5-7 minutes each time |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 4 after MI: educate for |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 4 after MI: establish |
|
Definition
| transition to home program - ambulation, stairs, education, exercises |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 5 after MI: assess what level activity |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 5 after MI: assess moderate level activity for what duration |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 5 after MI: what should be done for discharge from phase I |
|
Definition
| low levels stress test up to 5-6 METS |
|
|
Term
| Phase I Progression: Uncomplicated MI: Day 5 after MI: pt should be discharged with transition for what? |
|
Definition
| after care including education of family members or significant other |
|
|
Term
| Phase I Progression: Uncomplicated MI: Major note about this progression |
|
Definition
|
|
Term
| Phase I Progression: Uncomplicated MI: The timeline is ideal but can not always be followed secondary to what |
|
Definition
| not being able to see the patient 2x/day, double up the amount of exercise with double rest breaks so pt gets the same amt of exercise |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day #1 should include what (4) |
|
Definition
| PT eval, UE/LE exercises, incentive spirometer, education |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post op day #1: how should you order the exercises? |
|
Definition
| do toughest exercises first, than do the easiest. least fatigue |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day #1: what should the seated LE exercises include? |
|
Definition
| hip flexion, knee extension/flexion, and ankle pumps in sitting |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day 1: what should the UE exercises include? |
|
Definition
| shoulder flexion less than 90, elbow flexion |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day #1, LE exercises in supine |
|
Definition
| straight leg raise, heel slides, hip abd, ankle pumps |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post op Day #2: UE exercises in what position |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post op day 2: LE exercises in what position |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day 2: what types of UE exercises |
|
Definition
| same as day 1, shoulder flexion less than 90, elbow flexion |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day 2: LE exercises should include what |
|
Definition
| hip flexion, hip abduction, marching in place |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day 2: 3 other interventions on this day |
|
Definition
| ambulation (if apprpriate as determined by PT), incentive spirometer, Education |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: post op day 2: how should the exercises be progressed? |
|
Definition
| easiest to toughest. purpose is to get the pt to fatigue slightly and get the pt ready for return to PLOF |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: UE and LE exercises shoudl be done in what position |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: types of exercises |
|
Definition
UE same as day 1, LE same as day 2.
UE: shoulder flexion less than 90, elbow flexion
LE: marching in place, hip flexion, hip abduction |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: other interventions for this day |
|
Definition
| ambulation, stair climbing, incentive spirometer, review HEP and education materails in preparation for D/C |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: ambulation goals |
|
Definition
| progress as able to at least 200' if possible |
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: when should stair climbing be initiated? |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: how should stair climbing be progressed |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: even if the patient only has 2 stairs into their home, why should you as teh PT get them todo a flight? |
|
Definition
|
|
Term
| Guidelines for CABG and Other Post-Surgical Pts: Post Op day #3 and forward: minimum amount of stairs a pt should try and complete |
|
Definition
|
|
Term
| Notes on Surgical Progression: what was listed in the ppt were guidelines, but as a PT how should you progress the pt? |
|
Definition
| progress based on tolerance, medical conditions, according to facility's policies |
|
|
Term
| Notes on Surgical Progression: when should vitals, cardiac complaints, and other signs of activity intolerance be monitored |
|
Definition
| when you get in, during activity, after activity |
|
|
Term
| Notes on Surgical Progression: try to push them to what duration within the first few days |
|
Definition
|
|
Term
| Notes on Surgical Progression: prior to discharge the patient should be exercising for how long |
|
Definition
|
|
Term
| Notes on Surgical Progression: how often should exercises be performed |
|
Definition
|
|
Term
| Notes on Surgical Progression: at what Borg scale rating should pt's be able to exercise at by the time they are d/c home? |
|
Definition
|
|
Term
| how early can phase II begin |
|
Definition
| as early as 24 hrs post d/c |
|
|
Term
| how long can phase II last? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| how are phase II patients in a home setting monitored? |
|
Definition
| telecommunication, internet |
|
|
Term
| how are phase II patients monitored |
|
Definition
| EKG, vital signs, by nurse, PT, exercise physiologist |
|
|
Term
| Phase II emphasis is on the patient doing what? |
|
Definition
| self-monitoring by RPE, HR (if appropriate), talk test, S/S of interolance to activty |
|
|
Term
| Phase II ex rx is based on what? |
|
Definition
|
|
Term
| Basic monitoring Equipment needed for Phase II recovery (4) |
|
Definition
| BP cuff, stethoscope, telemetry of EKG, HR monitor |
|
|
Term
| Exercise equipment needed for phase II of recovery |
|
Definition
| stationary/recumbent boke, arm ergometer, treadmill, ellipitical trainer, stair master/steps, light weight/theraband, rowing machine, mats for stretching |
|
|
Term
| Emergency equipment/personnel for phase II |
|
Definition
| defibrillator, O2, suction, general first aid supply, oximtery, phone, cardiac meds, 1 percon ACLS certified |
|
|
Term
| A person who is ACLS certified (advanced cardiac life support) is able to do what? |
|
Definition
| give meds at proper time, able to run a CODE, how to defibrillate |
|
|
Term
| Equipment for patients to self monitor in phase II recovery |
|
Definition
| clock with large hands and a second hand, instructional posters HR conversion, Dyspnea and RPE sacles |
|
|
Term
| Most important piece of emergency equipment for Phase II recovery |
|
Definition
|
|
Term
| Phase II exercise program: warm up duration |
|
Definition
|
|
Term
| Phase II exercise program: aerobic activity should be what type? |
|
Definition
| mode negotiated by therapist and patient |
|
|
Term
| Phase II exercise program: how long should aerobic activity go for in the first 1-2 weeks |
|
Definition
|
|
Term
| Phase II exercise program: how long should aerobic activity go for after the 2nd week |
|
Definition
| being increasing duration to 30 minutes + |
|
|
Term
| Phase II exercise program: what should the cooldown consist of? |
|
Definition
| 5-10 minutes of lighter exercising/stretching |
|
|
Term
| Phase II exercise program: in an outpatient program the cooldown is often followed by what? |
|
Definition
|
|
Term
| Phase II exercise program: HR range (2 answers) |
|
Definition
115-130 (if not on beta blockers)
20-30 beats above resting |
|
|
Term
| Phase II exercise program: RPE |
|
Definition
|
|
Term
| Phase II exercise program: by the end of phase 2, RPE should be between what? |
|
Definition
|
|
Term
| Phase II exercise program: dyspnea scale |
|
Definition
|
|
Term
| Intolerance to activity - HEP: patient presents with symptoms but resolve with rest and nitro rescue, what do you as the PT do? |
|
Definition
| report incident for follow-up for clinical advice |
|
|
Term
| Intolerance to activity - HEP: patient presents with symptoms and symptoms persist for more than 10-15 minutes with rest and meds. what do you as the PT do? |
|
Definition
| call PCP for same day urgent care consultation |
|
|
Term
| Intolerance to activity - HEP: patient presents with symptoms. if after 15 minutes, symptoms of ischemia are not relieved/situation escalates, what do you as the PT do? |
|
Definition
| call 911, patient does not drive themselves to hospital |
|
|
Term
| Phase III is considered the ______ program |
|
Definition
|
|
Term
| Phase III rehab is essentially what |
|
Definition
|
|
Term
| Phase III goals: patient is enrolled into what |
|
Definition
| conditioning program of exercise |
|
|
Term
| Phase III goals: important note about patients performing group activities |
|
Definition
| they're great, but ex rx is individual |
|
|
Term
| Phase III goals: exercise that is intergrated into a a patient's lifestyle is important why? |
|
Definition
| to move patient out of a "sick" role |
|
|
Term
| Phase III goals: intensity range |
|
Definition
|
|
Term
| Phase III goals: how is the intensity range determined (2) |
|
Definition
| determined by maximum stress test or 20-30 bpm above resting HR to start |
|
|
Term
| Phase III exercise program: HR range |
|
Definition
| 125-135 (unless on beta blockers) |
|
|
Term
| Phase III exercise program: RPE of |
|
Definition
|
|
Term
| Phase III exercise program: dyspnea scale |
|
Definition
|
|
Term
| Phase III exercise program: warm up time |
|
Definition
|
|
Term
| Phase III exercise program: aerobic/resistiance ex time |
|
Definition
|
|
Term
| Phase III exercise program: cool down time |
|
Definition
|
|
Term
| Phase III exercise program: education in... |
|
Definition
|
|
Term
| Considerations with Exrx: what are the 2 considerations? |
|
Definition
| pscyhological recovery, compliance |
|
|
Term
| Considerations with Exrx: pscyhological recovery, the patient may fell what |
|
Definition
|
|
Term
| Considerations with Exrx: other than the patient, who else should be included in the education and progression of activity whenever possible? |
|
Definition
|
|
Term
| Considerations with Exrx: other than the patient, who else should be included in the education and progression of activity whenever possible? |
|
Definition
|
|
Term
| Considerations with Exrx: important note about educating your patient |
|
Definition
| tailor your education to each patient (don't overly do it too early or stress the pt) |
|
|
Term
| Considerations with Exrx: compliance: how many patients continue exercise after 1 year |
|
Definition
|
|
Term
| Considerations with Exrx: how to improve compliance |
|
Definition
| easy/convenient programs, energetic staff, group/spousal involvement |
|
|
Term
| a pt with these 2 lines can not be gotten up, not even into sitting |
|
Definition
| ICP (intracranial pressure), IABP (intra aortic baloon pump) |
|
|
Term
|
Definition
| cardiac line, heart is too weak on its own, the baloon helps the heart pump |
|
|
Term
| a pt with the IABP can be stood up if the IABP is inserted how? |
|
Definition
|
|
Term
| what can you do with a pt who has a Swan-Ganz catheter |
|
Definition
| may sit up in bed with them with approval from MD |
|
|
Term
| a pt with a Swan-Ganz catheter cannot do what activity |
|
Definition
|
|
Term
| purpose of the swan-ganz catheter |
|
Definition
| monitor the heart's function and blood flow. used with very ill pt's in the ICU |
|
|
Term
| how is the Swan-ganz catheter inserted |
|
Definition
| put into the right side of the heart and then threaded into the pulmonary aa |
|
|
Term
| when exercising patients with multiple lines, this would be a good idea |
|
Definition
| have 2 ppl. 1 to exercise, 1 to mind the lines. |
|
|
Term
| with the swan-ganz catheter was is crtically important? |
|
Definition
| that is not moved/shifted |
|
|
Term
| IV post op cardiothoracic pt's will have |
|
Definition
|
|
Term
| what can you do with a pt with a triple lumen catheter |
|
Definition
| can move and ambulate with patient as long as you bring the IV pole with them |
|
|
Term
| what does an arterial line do? |
|
Definition
| measures present time BP in the aa, reads out on the monitor |
|
|
Term
| if a pt has an arterial line, what can you do. |
|
Definition
| with MD permission, can dc line and ambulate, Nrsg will need to re-connect and zero it out |
|
|
Term
| if the MD does not approve d/c of arterial line, what can you do? |
|
Definition
| Need to stay in or near bed, but can get OOB |
|
|
Term
| what should be avoided movement wise for a pt with an arterial line |
|
Definition
| avoid elbow flexion or pressure (cane, walker) so the line does not kink |
|
|
Term
|
Definition
|
|
Term
| where will the chest tube be located on the chest? |
|
Definition
| depends on the surgery, usually on side that its needed on, cardiothoracic surgeries right in the center |
|
|
Term
| important note of educating the patient on their chest tube |
|
Definition
| red fluid is not active blood flow, but saline, blood, and other fluids from surgery that need to be drained |
|
|
Term
| with MD approval what you can do with a pt with a chest tube |
|
Definition
| can dc from wall if need be, take the container with you and reconnect at end of session. must be in a gravity dependent position relative to the chest |
|
|
Term
| if a MD does not approve, what can you do with a pt with a chest tube? |
|
Definition
| move the patient around the room as far as the tube will reach |
|
|
Term
| how is O2 usually administered? |
|
Definition
|
|
Term
| what can you do with a pt that needs supplementary O2? |
|
Definition
| can move and amb pt as long as they have portable O2 |
|
|
Term
| role of PT when treating a pt using supplemental O2 |
|
Definition
| remove O2 to see how far pt desaturates. purpose of cardiac rehab is to wean them off as they didn't use it before surgery |
|
|
Term
| what can you do with a pt with a foley catheter? |
|
Definition
| move and amb with pt, just keep bag gravity dependent |
|
|
Term
| how many electrodes and leads are on cardiac pts for EKG? |
|
Definition
|
|
Term
| What can you do with a pt in an ICU that has EKG attached |
|
Definition
| can usually disconnect for the few minutes to ambulate and then reconnect |
|
|
Term
| on step down units, pt's attached to EKG will have what? |
|
Definition
|
|
Term
| exrx from stress test, at waht percentage do do you want to exercise the patient of maxHR |
|
Definition
|
|
Term
|
Definition
|
|
Term
| can you use the karvonen method with pateitns on beta blockers? |
|
Definition
| yes since it uses resting heart rate |
|
|
Term
| Exrx without HR max: what should their heart rate look like? with and without betablockers? |
|
Definition
| 20-30 above RHR, 10-20 above RHR with betablockers |
|
|
Term
| when should exrx be increased? |
|
Definition
| based on s/s, monitored EKG responses, RPE, or talk test |
|
|
Term
| how should a patient be progressed for exrx? |
|
Definition
| increase duration prior to intensity. never do both at the same time |
|
|
Term
| Exrx without maxhr: what should the dyspnea scale look like? rpe scale? |
|
Definition
|
|
Term
| normal blood glucose levels |
|
Definition
|
|
Term
| hypoglycemic blood sugar levels |
|
Definition
|
|
Term
|
Definition
|
|
Term
| general PT mgmt of a pt with DM |
|
Definition
| check for neuropathy, skin integrity, functional mobility, AROM, MMT. if there are deficits want to treat and adjust program accordingly |
|
|
Term
| Physical Activity benefits for a pt with DM: Improve |
|
Definition
| glucose uptake from cells |
|
|
Term
| Physical Activity benefits for a pt with DM: stabilize |
|
Definition
| glucose levels in blood over time (long term benefit) |
|
|
Term
| Physical Activity benefits for a pt with DM: increase |
|
Definition
| peripheral circulation for general well being, as well as wound healing |
|
|
Term
| Physical Activity benefits for a pt with DM: maintain |
|
Definition
| joint, muscle, and skin integrity |
|
|
Term
| Physical Activity benefits for a pt with DM: loss of what |
|
Definition
|
|
Term
| What should you examine on a pt with DM: |
|
Definition
| LE's, skin integrity, sensation, feet, balance |
|
|
Term
| prior to ex what should a pt with DM do? |
|
Definition
| check their blood glucose |
|
|
Term
| for a pt with DM what do blood glucose checks do? |
|
Definition
| set guidelines for ex based on that reading |
|
|
Term
| Outpt setting with blood glucose levels below 65: what should you do? |
|
Definition
| introudce a quick sugar 4-6 oz of juice and two graham crackers or equivalent. wait 15 mins and recheck |
|
|
Term
| <65 pt with DM eats and rechecks blood sugar. if it is normal what can you do in terms of exercise? |
|
Definition
| can do a normal routine, but would want pt to eat immediately after exercise. when in doubt check blood sugar |
|
|
Term
| What can you do with an outpt with DM with blood glucose levels between 145-300 |
|
Definition
| may exercise at a lighter workout intensity, however the therapist needs to reinforce a control regime and follow up with PCP |
|
|
Term
| outpt presents with 300 mg/dl blood glucose: what should teh therapist do |
|
Definition
| cancel PT for that day. ask pt if they took their meds that day. what they ate that mornign/last night. |
|
|
Term
| outpt shows up with 300+mg/dl blood glucose. who should you inform? why? |
|
Definition
| inform PCP to make sure this isnt something happening on a daily basis |
|
|
Term
| inpatient with DM has 300-440 mg/dl blood glucose what should you do? |
|
Definition
| relative contraindication. can do light, more functional activity, not heavy stuff |
|
|
Term
| biggest factor for peripheral vascular disease |
|
Definition
| intermittent claudication |
|
|
Term
| pt's with PVD need to stop this habit |
|
Definition
|
|
Term
| best exercise for pt's with PVD |
|
Definition
|
|
Term
| exercise program for pt's with PVD |
|
Definition
| walk to onset of symptoms, rest til symptoms subside, walk to onset of symptmos, rest repeat |
|
|
Term
| goal of walking for a pt with PVD |
|
Definition
| increase collateral circulation which will allow mm to get better at pulling O2 out of the circulation and improving peripheral circulation |
|
|
Term
| who will help you as the PT to motivate pt's with PVD |
|
Definition
|
|
Term
| pt's with COPD need to stop this habit |
|
Definition
|
|
Term
| what should pt's with COPD do to recover RR as needed? |
|
Definition
|
|
Term
| how will the ex tolerance of COPD pt's be? what should you use to judge their tolerance? |
|
Definition
| poor tolerance. use dyspnea scale |
|
|
Term
| purpose of rehab for COPD pts |
|
Definition
| maintain/progress functional endurance as much as possible |
|
|
Term
| how should a COPD pt position themselves on a treadmill? |
|
Definition
| use UE's to stabilizeto fix accessory muscles for increased ventilation |
|
|
Term
| for pt's with a CVA the PT should especially monitor what vital |
|
Definition
|
|
Term
| why should the PT monitor a CVA pt's BP? |
|
Definition
| CVA most likely d/t having high BP |
|
|
Term
| exercise equipment for a CVA pt |
|
Definition
| airdyne bike which uses all 4 extremities for movement |
|
|
Term
| why do pt's with renal disease have a decreased exercise tolerance? |
|
Definition
| d/t decreased hemoglobin and hematocrit levels which would decrease O2 carrying capacity |
|
|
Term
| exercise has been show ton increase what? |
|
Definition
| hematocrit level which in turn helps impact hemoglobin levels |
|
|
Term
| exercise has been shown to improve what? (3) |
|
Definition
| glucose tolerance, Bp control, overall endurance |
|
|
Term
| for a pt on dialysis what should the rest:exercise ratio be? |
|
Definition
|
|
Term
| transection of the cervical spinal cord prevents what part of the nervous system from the cardiovascular system |
|
Definition
| sympathetic nervous system, prevents sympathetic driven changes |
|
|
Term
| transection of the cervical spinal cord prevents sympathetic nervous system from reaching teh cardiovascular system preventing what sympathetic driven changes |
|
Definition
| can't increase heart rate and force of myocardial contraction, decreased vasomotor control |
|
|
Term
| pt's with an SCI injury have what insuffiency |
|
Definition
| insuffiency of venous return |
|
|
Term
| why do SCI pt's have an issue with insuffiency return |
|
Definition
| flaccid muscles are not working on pumping blood back up |
|
|
Term
| SCI pti's are more at risk for this positional syndrome |
|
Definition
| orthostatic hypovolumic shock |
|
|
Term
| what factor influences the venous insuffiency of an SCI pt |
|
Definition
| level of lesion, the lower the lesion the more control |
|
|
Term
| pulmonary dysfunction in SCI pt's is indicated at what levels |
|
Definition
| thoracic or highe rlesions |
|
|
Term
| pulmonary hygiene impairment is in indviduals with lower thoracic loss d/t loss of what? |
|
Definition
|
|
Term
| Lesions: Mgmt consideration for C1-C2 |
|
Definition
|
|
Term
| Lesions: Mgmt consideration for C3-C4 (3) |
|
Definition
ventilator assist (may eventually wean off to night time only)
diaphgragm partially inntervated.
use of higher accessories |
|
|
Term
| Lesions: Mgmt consideration for C5-C7 |
|
Definition
| ventilator assist initially |
|
|
Term
| Lesions: Mgmt consideration for T1-T5 |
|
Definition
| loss of intercostals and abdominals |
|
|
Term
| Lesions: Mgmt consideration for t6-t10 |
|
Definition
|
|
Term
| Lesions: Mgmt consideration for below t10 |
|
Definition
|
|
Term
| Lesions: Impairments: Bronchial hygiene is affected from what levels? |
|
Definition
| C1-C2, C3-C4, C5-C7,T1-T5 |
|
|
Term
| Lesions: Impairments for ineffective cough affect what levels |
|
Definition
|
|
Term
| Lesions: Impairments for impaired ventilation volumes affect what levels |
|
Definition
| C1-C2, C3-C4, C5-C7, T1-T5 |
|
|
Term
| Lesions: Impairments for complete sympathetic control impairment for what levels? |
|
Definition
|
|
Term
| Lesions: Impairments for some sympathetic control impairment |
|
Definition
|
|
Term
| Lesions: Impairments for impaired venous return for what levels |
|
Definition
| C1-C2, C3-C4, C5-C7, T1-T5, below T10 |
|
|
Term
| Lesions: Impairments for severe endurance impairments |
|
Definition
|
|
Term
| Lesions: Impairments for moderate endurance impairments |
|
Definition
|
|
Term
| Lesions: Impairments for mild endurance impairments |
|
Definition
|
|
