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30 Cards in this Set

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What are some possible complications of an MI?

Heart failure, arrhythmias, thrombus formation, structural damage to the heart


Note: Arrhythmias are most likely to affect therapy as they are most common (90% of pts. s/p MI)

How far above baseline value should a BP cuff be inflated?

15-25 mm Hg

During a session, the patient suddenly begins to demonstrate signs of intolerance to being upright. What might these be?

Tachycardia, dizziness, nausea, syncope

Which conditions would MOST likely result post-operatively if a patient’s hemoglobin level was low?

Hypoxia or anemia

With what conditions might diuretics be prescribed?

CHF, hypertension, possibly liver or kidney disease

What is a normal left ventricular ejection fraction? What LVEF is indicative of heart failure?

Normal: 60-70%


CHF: < 40%

A PTA documents the following clinical signs: pallor, cyanosis, and cool skin. These clinical signs are MOST consistent with:

Anemia


Other s/s are vertigo, weakness, HA, malaise

During Phase I cardiac rehab, what drop in systolic BP is acceptable?

10 mm Hg

Why should a PTA not increase the amount of oxygen even if the patient’s oxygen saturation level falls below their acceptable range?
The increased levels of oxygen may depress the hypoxic drive in patients with chronically high PaCO2.

For cardiac patients, exercise is sometimes measured by METs. Give examples of activities that require moderate energy expenditure (3.0-5.9).


MET = metabolic equivalent of task

Heavy housework (wash windows, vacuum)


Walking at 2.5-3.4 mph


Mowing lawn


Playing golf


Bicycling at 10-12 mph


Badminton or doubles tennis

What vital signs should be monitored when using a tilt table?

BP and pulse


Note: Also monitor for change in consciousness, perspiration, LE edema, loss of pedal pulses, nausea, numbness, pale skin, and vertigo.

Intermittent claudication during exercise is usually the result of what condition?

Ischemia caused by arterial PVD


(arteriosclerosis or atherosclerosis)

What is the primary reason for using a tilt table?

The primary use of a tilt table is to provide low grade stress to a patient’s circulatory system to force it to adapt to upright positioning.

After recovering from a cardiac event, most patients can return to work as long as the average demand of their job is no greater than ___ of the peak METs achieved on a graded exercise test.

50%

Why is it important to include a cool-down period in any exercise program?

1. Prevents pooling of blood in extremities


2. Prevents myocardial ischemia, arrhythmias, and other CV complications

If a patient has functional limitations or disabilities, why should a maximal exercise test not be performed?

Patient performance may be limited by fatigue or pain rather than exertion. (Leading to an inaccurate measure of max O2 consumption.)

What four parameters should be included when assessing respiration rate?

Rate, rhythm, depth, and character

What are some words a patient might use to describe a vascular pattern of pain?

Throbbing, pounding, pulsing, beating, etc.

What is the most appropriate method to utilize when measuring exercise intensity with a patient on hemodialysis?

Rating of perceived exertion (HR and BP are too variable when a pt. is on dialysis.)

What are the clinical manifestations of left-sided heart failure?

Dyspnea (exertional progressing to paroxysmal nocturnal)


Fatigue


Muscular weakness


Pulmonary edema

What are the clinical manifestations of right-sided heart failure or cor pulmonale?

Exertional dyspnea


Fatigue


Palpitations


Swelling of LEs


Dizziness & syncope

Abnormal levels of ______ can cause palpitations and cardiac arrhythmia.

Potassium; normal is from 3.5-5.0 mEq/L.

What are some common side effects of diuretics such as Lasix that are given to decrease blood volume?

Lightheadedness, fatigue, weakness, hypotension, electrolyte imbalance, polyuria, increased LDL, and arrhythmias

Deep and fast breathing that is often associated with metabolic acidosis. Pt. may exhibit dyspnea, panting, and labored respiration.

Kussmaul's respiration

Cycles of increasing and decreasing rate and depth of breathing with periods of apnea

Cheyne-Stokes respiration. This may occur with CNS damage or congestive heart failure.

Dyspnea that occurs during recumbency that is relieved with sitting upright

Orthopnea


(Typically 2nd to cardiopulmonary disease)

What might produce a sharp, sudden pain that begins at the sternum, radiates, and increases with inspiration?

Pericarditis


(Inflammation of the pericardium of the heart)

What are some interventions to use for a patient who is experiencing orthostatic hypotension due to prolonged bed rest?

Elastic stockings


Abdominal binder


Tilt table

Dramatic blanching of the plantar aspect of the foot occurs when the leg is elevated for 1 minute.


What is this test and what does it signify?

Rubor dependency test for peripheral arterial disease

What should the frequency and intensity of exercise be for patients with chronic obstructive pulmonary disorder if trying to improve cardiovascular endurance?

Frequency: 3-5x per week


Intensity: 11-13 on the RPE scale