Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
20 Cards in this Set
- Front
- Back
|
Describe a MET |
Metabolic equivalent Measurement of O2 consumptions 1 Met = 3.5ml/kg/min = sitting at rest Based on 70kg Male |
|
|
Who may the standard Met classification not apply to? |
Overweight Older Low fitness Women |
|
|
Normal HR response to activity? |
Rise is nearly linear at submax effort Increases about 8-12 bpm/met Rise is greater druing U/E vs L/E work Rise is greater during dynamic vs static work |
|
|
What effects HR |
Disease Inactivity Medications -Betablockers Beta adrenergics (asthma) Fever LBV |
|
|
What are abnormal HR responses |
Rapid rate of rise (deconditioned individuals) Very slow rate of rise in untrained individuals --Inability to acheive near predicted max HR on max test (chronotrophic incompetence) Dec with increased work Irregular |
|
|
Normal Systolic BP response to activity |
Systolic inc with inc workload (8-12bpm/met) Response is greater during UE Response is greater during static vs dynamic |
|
|
Normal Diastolic BP response to activity |
Diastolic BP reamins unchanged or dec during aerobic activity DBP increases during heavy resistance activity |
|
|
Abnormal BP response |
•SystolicBP –Rapidrate of rise –Blunted –Exertionalhypotension (> 10 mm Hg decrease) while exercise increasing •DiastolicBP –Progressiverise (> 10 mm Hg) –Decrease(> 10 mm Hg) |
|
|
Assessing O2 |
Normal: no change or minimal dec Abnormal: dec with inc activity (decrease of 4% (esp if below 90) is clinically significant) Severely abnormal: Drop below 88 |
|
|
Assessing resp rate |
Normal 12-20 Should correspond with HR changes Will severely change with SpO2 drop Resting rate >24 may indicated clinical instabiltiy |
|
|
Absolute contraindication to exercise testing |
-Significant change in ECG indicating ischemia -unstable angina -Dysrhythmias -Severe Aortic stenosis -Uncontrolled HF -Pulmonary embolus/infarction -Acute myocarditis -Dissection aneurysm -Systemic infection |
|
|
Classifying Aortic Stenosis |
Compare pressures in left ventricle to Aorta Mild - if 20mmHg difference Mod - if 40mmHg difference Sever - if 80mmHg difference |
|
|
Relative contraindications to exercise |
•PaO2,60mm/hg or O2 < 90 % •RestingST displacement of >3 mm/hg •Respiratoryrate >45 BPM •Orthostatichypotension –SBPdrop 20 mm/hg DBP –HR10-20 BPM with symptoms |
|
|
Contraindications for exercise lab values (NO exercise) |
Hct < 25% Platelets < 20k mL Hgb < 8 g/dL WBC < 5k mm cubed |
|
|
Lab values for light exercise |
Hct 25 - 30% Platelets 20 - 50k mL Hgb 8 - 10 g/dL WBC > 5k mm cubed |
|
|
Lab values for resisted exercise |
Hct >30% Platelets > 50k mL Hgb >10 g/dL WBC > 5k mm cubed (as tolerated) |
|
|
Tests for coagulation |
PT - 12-15 is normal Increased with liver damage and pts on anticoagulats INR normal 0.8-1.2 INR on warfin 2-3 |
|
|
Contraindications to exercise testing |
Left main coronary stenosis Mod stenotic valvular heart dz Electrolyte abnomalities Severe arterial Hypertension Tachy/bradycardia AV block Chronic infections Uncontrolled metabolic dz |
|
|
Absolute Termination of exercise testing |
•Dropin SBP 10 ≥ with increase work rate or decrease below the resting SBP in thesame position •Moderatelysevere Angina like symptoms ( 3 on angina scale) •Increasingnervous system symptoms ( eg ataxia, dizziness, near syncope) •Signsof poor perfusion ( cyanosis, pallor) •Technicaldifficulties monitoring ECG or SBP •Subjectsdesire to stop •Sustainedventricular tachycardia •STelevation ( +1.0 mm) in leads without diagnostic Q waves (other than V1 or aVR) |
|
|
Relative indications for terminating exercise testing |
•Arrhythmiasother than sustained ventricular tachycardia , including multifocal PVCs ,triplets of PVCs, supraventricular tachycardia , heart block , or bradycardia •Shortnessof breath , wheezing , claudication, leg cramps •Excessiverise in SBP > 250 mm/hg and or diastolic 115 mm/hg •Failureof HR to Increase with increased activity •Developmentof bundle block branch , or intraventricular conduction delay that cannot bedistinguished from ventricular tachycardia •Noticeablechange in Heart rhythm with auscultation |
