Pt Cp Tests And Measures

Front 1

contraindications for cardiac rehab

Back 1

• unstable angina
• critical aortic stenosis
• acute systemic illness/fever
• resting systollic >200, diastollic>110
• orthostatic bp drop of >20 with s/s
• uncontrolled arrhythmimas
• resting ST segment depression >2mm
• uncompensated CHF
• 3rd degree atrial ventricula block no PM
• recent embolism, thrombophlebitis, sctive peri/myo carditis

Front 2

angina scale

Back 2

1 mild, barely notice

2. moderate, bothersome

3 moderately severe, uncomfortable

4 worst ever

Front 3

s1 heart sound

Back 3

• lub, occurs at onset of artioventricular systole
  
• higher freq/lower pitch and longer duration than S2

Front 4

s2 heart sound

Back 4

closure of semilunar valves t onset of ventricular diastole

Front 5

s3 heart sound

Back 5

• vibrations of distended ventricular walls due to passive flow of blood for atria rapidly filling
  
• normal in healthy kiddos
  
• abnormal in adults, may be associated with heart failure, called ventricular gallop
  

Front 6

S4 heart sound

Back 6

• pathological sound of vibratio of ventricular wall with fillng and atrial contraction
  
• often referred to as atrial gallop
  
• assocaited with HTN, MI
  

Front 7

BMI values

Back 7

• <18.5 underweight
• 18.5-24.9
• 25-29.9 overweight
• 30-34.9 obesity class 1
• 35-39.9 obesity class2
• >=40 extreme obesity

Front 8

normal tracheal and broncheal sounds

Back 8

normal vesicular sounds

Front 9

adventitous breath sounds

Back 9

breaths sounds indicating pathology, may be continous or not

Front 10

crackles

Back 10

• high pitch popping heard more often during inspiration
  
• pulmonary edema produces fine crackles
• crackles in later 1/2 of respiration represent atelectasis, fibrosis, pulmonary edema or pleural effusion

Front 11

pleural rub

Back 11

dry crackling sound heard during both inspiration and expiration

• occurs when inflammed viseceral and pareital pleura rub together
  

Front 12

rhonchi

Back 12

• continuous low pitched sounds described as a gurgling
  
• caused by air passing through an obstructed airway or bronchospasm

Front 13

stridor

Back 13

continuous high pitched wheeze heard with inspiration or expiration; indicates upper airway obstruction

Front 14

reasons to discontinue exercise during cardiac rehab, phase 1

Back 14

• HR.130 bpm or >30 above resting
  
• DBP >=110
• significant dysrhythmia
• decrease SBP >10
• s/s angina, marked dyspnea, ECG change suggestive of ischemia

Front 15

intensity and duration phase 1 cardiac rehab

Back 15

• RPE <13
• post surg H <30bpm above resting
• post infarction HR, <120 bpm or <20 from resting
• bouts of 3-5 min increaseing to 10-15 min

Front 16

reasons to discontinue exercise cardiac rehab phase 2

Back 16

• plateau of decrease of HR with inc work
• SBP plateaus or falls w/ inc work OR >250
• DBP >115
• ST segment depression >1mm
• ventricular dysrhythmias
• angina

Front 17

RPE 12-16

Back 17

• somewhat hard to hard
  
• 40-80% max capacity

Front 18

RPE 11-13

Back 18

• fairly light to somewhat hard
  
• appropraite upper limit for intial phase of outpaitent cardiac rehab
• 
  

Front 19

< 3 METs

Back 19

• walking slow
  
• toliting
• driving
• desk work
• making a bed, washing dishes
• bathing
• cooking
• playing cards, arts and crafts
• playing a musical instrument
• sitting and fishing

Front 20

moderate (3-6 METS)

Back 20

• walking 3mph (3-4)
• walking 4 mph (4.5-7)
• washing windows /car
• sweeping/vacuuming
• light gardening
• carry/stacking wood
• power lawn mow
• slow dance
• ping pong
• sex
• golf/walking
• swimming (4-8)
• tennis bicycle flat 10-12mph (6)

Front 21

vigorous (>6METS)

Back 21

• walking 4.5
• jogging 5mph = 8
• running 7mph = 11.5
• shoveling
• carrying heavy things
• heavy farm work and digging ditches
• backpacking
• basketball games
• biycling (12-16mph) 8-10 METs

Front 22

karvonen formula

Back 22

• 220- age = max HR
  
• ((max HR - rest HR) x %)+ rest HR

Front 23

contraindications pulmonary rehab

Back 23

• ischemic heart disease
• congestive HF
  
• acute cor pulmonale
• severe pulmonary HTN
• significant hrpatic dysfx
• metastatic Ca
• renal failure

Front 24

intensity guidelines exercise for pulmonary rehab

Back 24

• 50% of peak pulmonary consumption
• RPE 4-6 (0-10 scale); RPE 12- 16 (6-20) scale
• max sa02 >90%

Front 25

ABI value normal

Back 25

1.0-1.3

Front 26

ABI value rigid arteries and need for ultrasound to check PAD

Back 26

>=1.3

Front 27

ABI value mild blockage

Back 27

0.8-0.99

Front 28

ABI value moderate blockage

Back 28

intermittent claudication 0.4-0.79

Front 29

ABI value severe blockage

Back 29

<0.4 may have resting claudication

Front 30

heart mummur

Back 30

vibrations of longer duration that heart sounds; often due to blood going thru a stenotic or regurgint valve

Front 31

PR interval

Back 31

time for conduction of SA to AV node. 0.12 to .20sec

Front 32

QRS complex

Back 32

0.06 to 0.10

Front 33

QT interval

Back 33

0.20-0.40

Front 34

significance PAC

Back 34

common and generally benign

Front 35

significance A FIb

Back 35

• atria depolarize btwn 350 and 600x a min, no distinct p wave
  
• occurs in healthy and diseased hearts
• stagnation of blood in atria can predispose to thrombi

Front 36

1st AV block

Back 36

no sx/ significant change in function

Front 37

2nd AV block

Back 37

2 types, type II bad can progress to III, normal PR intervals and then a weird one

Front 38

3rd AV block

Back 38

• all impulses are blocked at AV node and none get to ventricles, atria and ventricles paced independently artial rate > vent rate
• medical emergency requiring a pace maker
  

Front 39

Premature ventricular complex

Back 39

common, may be assymp or palpations, can be caused by coffee

Front 40

v tach

Back 40

• >30 sec life threatening; not able to maintain adequate BP and can lead to v fib and cardiac arrest
• MI< cardiomyopathy and valvular disease

Front 41

vfib

Back 41

ventricles don't work and the heart stops, requires immediate defribrillation

Front 42

absolute indications for terminating an exercise stress test

Back 42

• drop in SBP>10mmHg despite increase in exercise with other evidence of ischemia
• moderately severe angina (3/4)
• inc nervous systems sx
• signs of poor profusion
• sustained v tach
• 1 mm ST elevation

Front 43

relative indications for terminating an exercise test

Back 43

• drop in SBP>10mmHg despite increase in exercise without other evidence of ischemia
  
• 2mm ST segment depression
• arrythmias other than sustained v tach
• fatigue, SOB, wheeze, claudication
• development of bundle branch blocks or intraventricular delay
• inc shest pain
• SBP>250, DBP >115

Front 44

RPE rating very light

Back 44

9 (2 other scale)

Front 45

RPE rating somewhat hard

Back 45

13 (corres to 4 on other scale)

Front 46

RPE rating very, very light

Back 46

7 (0.5 other scale)

Front 47

RPE rating hard

Back 47

15 (5 strong other scale)

Front 48

RPE very hard

Back 48

17 (7 other sclae)

Front 49

RPE very very hard

Back 49

19 (10 other scale)

Front 50

RPE 13-14 what significance?

Back 50

-70% max HR

Front 51

RPE 11-13 what significance

Back 51

-upper limit of prescribed HR for early cardiac rehab

Front 52

normal Respiratory rate newborn

Back 52

33-45 bpm

Front 53

Respiratory rate 1 year

Back 53

25-35 bp

Front 54

10 years respiratory rate

Back 54

15-20

Front 55

Respiratory rate adult

Back 55

12-20

Front 56

aerobic exercise prescription adults

Back 56

• 55%-90% HR max
  
• karvonin
• 3-5 days per week 20- 60 min depending on intensity of exercise
• lower intensity >= 30 min
• higher intensity >=20min

Front 57

precautions airway clearance

Back 57

• ICP >20mmHg
• recent spinal surgery
• active hemoptysis
• active hemorrhage/hemodynamic instability
• unstable head an neck injury, rib fracture, surgical wound, PE, large pleural effucsion, pulmonary edema with CHF, empyema

Front 58

postural drainage apical lobe

Back 58

sit, lean back 30-40

Front 59

ppostural drainage posterior segement R upper lobe

Back 59

1/4 from prone on L head and shoulders on pillow

Front 60

postural drainage posterior segment L upper lobe

Back 60

1/4 from prone on R HPB elevated 45; head and neck on pillow

Front 61

postural drainage lingula

Back 61

1/4 from supine FOB elevated 12

Front 62

postural drainage ant upper

Back 62

supine

Front 63

postural drainage right middle

Back 63

1/4 from supine on L FOB elevatied 12

Front 64

postural drainage l and R lower

Back 64

prone

Front 65

postural drainage ant basal L and R

Back 65

supine, FOB 18

Front 66

postural drainage L and R lower lobe

Back 66

prone FOB 18

Front 67

lateral basal

Back 67

sidelying FOB 18

Front 68

positions for segmental breathing

Back 68

• sitting, basal attelectasis
• sdlyye with affected lung uppermost
• postural drainage with afffected lung uppermost
• apply pressure to area to be expanded at end of exhale, gradually dec pressure as pt inhales

Front 69

cor pulmonale

Back 69

R ventricle cannot effectively pump blood due to prolonged presence of pulmonary HTN and inc R ventricular after load - sx progress to pitting edema and jugular vein dystension, echo, lab test, chest x ray and ECG