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Physical Education 5091 Praxis -Exam Questions and Answers, Exams of Nursing

Physical Education 5091 Praxis -Exam Questions and Answers Physical Education 5091 Praxis -Exam Questions and Answers Physical Education 5091 Praxis -Exam Questions and Answers

Typology: Exams

2023/2024

Available from 07/08/2024

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Download Physical Education 5091 Praxis -Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! pretest considerations for healh appraisal - ANSWER-systematic approach in screening clients for: signs and symptoms, family history, risk factors for disease informed consent - ANSWER-an agreement to do or allow something to occur, made with an awareness of relevant facts, including: procedures, risks, benefits, limitations, and discomforts -legal and ethical document -often paired with release of liability form Par-Q - ANSWER-used for screening Physical Activity Readiness Questionnaire minimal standard for moderate intensity exercise 7 questions; if answered "yes" to any question, then require to get medical release form from healthcare provider physician referral - ANSWER-safeguard for high risk clients who may compromise health with exercise without medically trained staff -physician's name, stating diagnosis, and exercise perscription risk stratification - ANSWER-assigns individuals to low, medium, or high risk based on presence of conditions ACSM risk stratification matrix - ANSWER-makes recommendations based upon low, moderate, or high risk clients positive risk factors - ANSWER-family history of disease cigarette smoking hypertension hyercholesterolemia/dyslipidemia impaired fasting glucose obesity sedentary lifestyle family history of disease - ANSWER-myocardial infarction, coronary revascularization, or sudden death before age 55 in males and 65 females (1st degree relatives) cigarette smoking - ANSWER-currently smoking or quit withing 6 months, or exposed to 2nd hand smoke over 6 months 1 ACSM Personal Trainer Certification Exam Review hypertension - ANSWER-clients currently taking antihypertensive medication confirmed (2 separate occasions) 140/90 BP or higher hypercholesterolemia/dyslipdemia - ANSWER-clients currently taking lipid lowering medication and/or those with total serum cholesterol >200 mg/dL, or high density lipoprotein cholesterols of 0.35 mg/dL impaired fasting glucose - ANSWER-fasting blood glucose > or equal to 110 mg/dL (2 separate measurements) obesity - ANSWER-BMI > or equal mg/m^2 or waist girth exceeding approximately 39.4 inches sedentary lifestyle - ANSWER-those not meeting recommended amount of physical activity (at least 30 minutes of physical activity at a moderate intensity 40-60%, at least 3 days a week for at least 3 months) negative risk factors - ANSWER-high serum HDL cholesterol: >60 mg/dL emerging risk factors - ANSWER-inflammatory markers: reactive C protein (CRP) and fibrinogen low risk - ANSWER-men <45, women <55, asymptomatic, with 1 or less risk factors A) current medical examination and exercise testing prior participation- not necessary for moderate or vigorous exercise B) physician supervision of exercise tests- not necessary for submax or maximal tests moderate risk - ANSWER-men >45, women >55, or those who meet the threshold for 2 or more risk factors A) current medical examination and exercise testing prior participation- not necessaryfor moderate but recommended for vigorous exercise B) physician supervision of exercise tests- not necessary for submax but recommendedfor maximal tests high risk - ANSWER-1 or more signs and symptoms listed or a known cardiovascular, pulmonary, or metabolic disease A) current medical examination and exercise testing prior participation- recommendedfor moderate or vigorous exercise B) physician supervision of exercise tests- recommended for submax or maximal tests exercise testing steps - ANSWER-M.R.I.P.L. medical history risk factor assessment interpreting the data (cardio endurance, muscle strength/endurance, flexibility, body comp) prescribing exercise program 2 and/or 5 hyperventilation - ANSWER-increase minute ventilation relative to metabolic need hyperpnea - ANSWER-disproportionate rise in minute ventilation relative to an increase in metabolic level unilateral edema - ANSWER-a limb completely swollen, often cause by venous thrombosis or lymphatic blockage in limb ankle edema - ANSWER-most common, sign of heart failure or bilateral chronic venous insufficiency heart murmur - ANSWER-usually harmless cause by blood flowing through a damage or overworked heart valve can indicate valvular abnormalities intermittent claudication - ANSWER-muscle with inadequate blood supply being stressed by exercise, causing pain -doesn't occur when standing/sitting, more severe when walking upstairs/hill *symptoms:* often described as a cramp, disappears couples minutes after stopping exercise paroxysmal nocturnal dyspnea (PND) - ANSWER-dyspnea that occurs after 1-2 hours of sleep *symptoms:* wheezing/coughing that wakes client up; usually relieve once awake to sit up or productively cough syncope - ANSWER-fainting or sudden loss of consciousness caused by lack of blood supply to the cerebrum -fall in BP -when accompanied with dizziness may result from cardiac disorders preventing normal cardiac output: severe coronary artery disease, hypertrophic cardiomyopathy, aortic stenosis, and malignant ventricular dysrhythmias palpitations - ANSWER-fluttering, rapid, or punding sensations in the chest related to cardiac arrhythmias, such as premature ventricular contractions (PVCs) -usually harmless -triggered by stress, exercise, or medication *if accompanied with chest pain/discomfort, fainting, shortness of breath, and/or severe dizziness seek emergency medical attention* indication - ANSWER-valid reason to use certain tests, medications, procedures, etc. contradictions - ANSWER-conditions or facts requiring the withholding of certain medical treatments or tests absolute contradictions - ANSWER-do not perform exercise test! 6 -acute myocardial infarction, unstable angina, uncontrolled cardiac arrhythmias, symptomatic severe aortic stenosis, symptomatic heart failure, acute pulmonary embolus, pulmonary infarction, acute myocarditis or pericarditis, acute dissection, dissection aneruysm, or acute system infection with fever body aches or swollen lymph glands relative contradictions - ANSWER-test may still be performed, sometimes with modifications -left main coronary stenosis, moderate stenotic valvular heart disease, electrolyte abnormalities, severe arterial hypertension, tachyarrhythmias or bradyarrhythmias, hypertropic cardiomyopathy, outflow tract obstruction, neuromuscular, musculoskeletal or rheumatoid disordors, ventricular aneurysm, uncontrolled metabolic disease, chronic infectious disease, mental or physical impairment, high degree atrioventricular block absolute indications - ANSWER-immediately stop if any seen: sings of heart attack onset of chest pain drop in systolic BP below resting pressure or with increasing workload signs of poor circulation extreme shortness of breath ataxia, vertigo, visual or gait problems, or confusion abnormal heart rhythms technical inability to monitor the ECG client's request to stop relative indications - ANSWER-do not call for immediate stop: increasing chest pain shortness of breath severe fatigue wheezing leg cramps/ intermittent claudication hypertensive response (260/115 mm Hg or higher) pronounced ECG changes from baseline bundle branch block supraventricular tachycardia or other less serious arrhythmias 5 components of fitness assessment - ANSWER-cardio endurance muscular strength muscular endurance flexibility body comp isotonic contraction - ANSWER-contraction wherein the muscle remains unchanged, and the distance between the origin and insertion shortens 7 isometric - ANSWER-muscle contraction without shortening or changing distance between the origin and insertion isokinetic - ANSWER-concentric muscle or eccentric muscle in which the speed and tension are constant throughout the range of lengthening or contractin 1 RM testing - ANSWER-1. cover movement, then do light warm up 5-10 reps of light- moderate exertion 2. rest for 1 min, light stretching, then 3-5 reps of moderate-heavy exertion 3. add 5-10 pounds if successful lifting previous weight, rest 5-10 minutes before addingweight again 4. divide 1 RM by their body weight to get relative results BMI equation - ANSWER-703 * lbs/in^2 BMI categories - ANSWER-underweight: < 18 normal weight: 18.5-24.9 overweight: 25-29.9 obese > 30 normal BP - ANSWER-< 120/80 pre-hypertensive BP - ANSWER-120-139 / 80-89 stage 1 hypertension BP (HTN) - ANSWER-140-159 / 90-99 stage 2 hypertnsention BP - ANSWER-> 160/10 periodization - ANSWER-the process of varying a training program at regular time intervals to bring about optimal gains in physical performance -improves muscular endurance, strength, power, motor performance, and/or muscle hypertrophy variable resistant - ANSWER-a resistance that changes over ROM when an isotonic contraction is used to move a load plyometric exercise - ANSWER-"jump training" dynamic resistance exercises that rapidly stretch a muscle and then rapidly shorten it EX) jumping/hopping exercise recommendations for adults - ANSWER-150 min/week of moderate activity or 75 min/week of vigorous activity (use if want to improve fitness level) 5-7 days/week stretching 3-5 days/week cardio 2-3 days/week of resistance training for 45-60 min/day 10 horizontal loading - ANSWER-completing all sets of an exercise before moving on to the next exercise vertical loading - ANSWER-completing one set of all exercises before beginning the second set proper breathing - ANSWER-breath diaphragmatically during aerobic activity (through stomach) -if clients cannot switch to proper breathing pattern, refer them to a health care professional inhale concentric exhale eccentrically valsalva maneuver physiological response - ANSWER-initial pressure rise first 5-10 sec reduced venous return and 15-20 sec compensation 20-23 sec pressure relief 24 sec + return of cardiac output eccentric contraction - ANSWER-strongest of 3 muscle actions target heart rate zones - ANSWER-*zone 1:* recovery zone 40-60% *zone 2:* aerobic zone 65-85% *zone 3:* peak zone 85%+ exercise perscription components - ANSWER-mode intensity duration frequency progression target heart range for moderate activity - ANSWER-50-70% of max HR specificity principle - ANSWER-exercising a certain body part that develops primarily that part must perform exercise/skill to improve on exercise/skill overload principle - ANSWER-body easily adapts to increase or decreased physical demand, enabling people to develop muscle coordination and sports-specific skills adaption principle - ANSWER-greater stress than normal is required for adaption to occur to improve fitness/strength/endurance, then workload must increase accordingly progression principle - ANSWER-optimal overload level and optimal time frame for overload to occur if overload is too slow, then less improvements if overload too fast could cause injury or muscle damange adequate rest and recover cardiovascular disease (CVD) - ANSWER-any disease that affects the heart or blood vessel increase risk of heart attack, heart failure, sudden death, high blood pressure, stroke, and cardiac rhythm problems *preventable/treatable:* high blood pressure, high cholesterol, excess weight, diabetes, physical inactivity, metabolic syndrome, smoking, excessive alcohol consumption, illegal drug use, and stress *nonpreventable/treatable:* previous heart attack, family history of heart disease, increasing age, gender, and race athersclerosis - ANSWER-plaque formation lipid deposits i medium-large sized arteries sedentary lifestyle, diet with high intake of saturated fat, high blood pressure, smoking, and any other toxic agent to the body -endothelial cells of artery can be damaged -increased risk of heart attack obese statistics - ANSWER-1/3 adults 1/5 young people ages 6-19 type II diabetes cons - ANSWER-can increase risk of: affected blood vessels and nerves including: vision impairment, kidney disease, peripheral vascular disease, atherosclerosis, and hpertension chronic diseases - ANSWER-NEED PHYSICIAN APPROVAL BEFORE EXERCISE PROGRAM -or ever exercise recommendations aerobic exercise benefits - ANSWER-conditions heart and lungs by increasing amount of oxygen the heart uses more efficiently -decrease risk of heart disease and stroke -positive effect in decreasing blood cholesterol levels and blood pressure resting metabolic rate - ANSWER-accounts for up to 75% of daily calories. increase in muscles requires more calories to maintain, which mean the higher your high blood pressure and resistance training - ANSWER-use lighter weights with more reps consider consulting physician for strength training routine borg scale - ANSWER-walking or cycling = level 13 strength activities = levels 15-17 11 challenging activities become easier over time acute adaptions - ANSWER-stroke volume and cardiac output stroke volume - ANSWER-how much blood is expelled with each heartbeat at rest ~72 bpm cardiac output - ANSWER-stroke volume and heart rate blood per min = HR * SV at rest ~5 L/min chronic adaptions to heart - ANSWER-decrease CVD, stroke, high blood pressure, and obesity with prolonged exercise: -increase red blood cell's oxygen carrying capacity -increase size of heart (more blood produced) -lower blood pressure -reduced blood lipids pulmonary diffusion - ANSWER-ability of blood to extract oxygen from alveoli metabolic rate - ANSWER-accounts for up to 75% of calories burned by body each day to maintain normal body functions -heart, lungs, brain function heat exhaustion symptoms - ANSWER-heavy sweating cool/clammy skin fatigue nausea fainting heat stroke symptoms - ANSWER-MEDICAL EMERGENCY apply cool water to skin and seek medical help high fever, hot/dry skin w/o sweating, pounding pulse, dizziness, nausea/vomiting, confusion, unconsciousness -higher risk with heart disease or CVD (may cause damage to organs) patients with diuretics or beta blockers - ANSWER-ask doctor about safe levels of water in hot temps vs mild temps cold temps and heart disease - ANSWER-exercising in cold temps makes heart work harder to maintain core temp -ask doctor safe levels of exposure to cold and which activities to avoid -always bundle up 12 hemoconcentration - ANSWER-movement of plasma out of blood decrease of fluids within blood upper respiratory track - ANSWER-nose pharynx (throat) larynx (voice box) lower respiratory track - ANSWER-trachea (wind pipe) lungs bronchi bronchioles (passageway into alveoli) alveoli (air sacs) tricuspid valve - ANSWER-located between right atrium and right ventricle bicuspid valve (mitral valve) - ANSWER-located between the left atrium and left ventricle pulmonic valve (pulmonary semi-lunar valve) - ANSWER-located between the right ventricle and pulmonary artery aortic valve - ANSWER-located between the left ventricle and aorta pulmonary circulation - ANSWER-right atrium to heart w/o oxygen blood. Heart pumps blood into lungs to gain oxygen then to left atrium w/ oxygenate blood -works with lungs systemic ciculation - ANSWER-transports oxygenated blood away from heart and oxygen depleted blood back towards heart -circulated blood to all parts of body, except lungs blood flow of heart - ANSWER-right atrium tricuspid valve right ventricle pulmonic valve pulmonary artery lungs pulmonary veins left atrium mitral/bicuspid valve left ventricle aortic valve aorta (rest of body) anatomy of heart - ANSWER- 15 16 ejection fraction - ANSWER-% of blood in ventricle when heart is in a relaxation (diastolic) state but this blood actually gets pumped out during the contraction (systolic) phase frank-starling law - ANSWER-amount of blood left in each ventricle after end diastolic volume will significantly affect the stroke volume -every contraction creates a greater stretch on heart muscles; contractile force wil eventually increase normal EDV ~125 ml normal ESV ~55ml minute ventilation - ANSWER-volume of air breathed in 1 min at rest ~6 L/min -per breath is *tidal volume* (0.5L - 4 L) shunting - ANSWER-when blood is shunted away from all vital organs of body to exercising muscles axial skeleton - ANSWER-skull vertebral column ribs sternum (supports and protects vital organs) appendicular skeleton - ANSWER-arms legs pelvis pelvic girdle (provides movement and support) spine - ANSWER-33 vertebrae: -7 cervical -12 thoracic -5 lumbar -5 sacral -4 coccygeal scoliosis - ANSWER-abnormal curve of spine in frontal plane kyphosis - ANSWER-outward curve on spine causing hunch thoracic and sacral region -develops as fetus lordosis - ANSWER-inward curve on spine cervical and lumbar regions -develops after birth te*nd*ons - ANSWER-*m*uscle to *b*one ligaments - ANSWER-bone to bone sliding filament theory - ANSWER-theory of muscle contraction; sarcomeres shorten when thick filaments pull on thin filaments length tension relationship - ANSWER-The resting length of a muscle and the tension the muscle can produce at this resting length. -produce greatest tension at resting length (how much contracted/lengthened dependent on force) type I muscle fibers - ANSWER-slow twitch most resistant to fatigue produce large amounts of ATP w/oxygen developed through training and genetics -marathon runners type IIA muscle fibers - ANSWER-fast twitch produce bursts of power fatigue quickly ATP produced w/o oxygen ATP broken down rapidly -sprinters type IIB muscle fibers - ANSWER-combo of Type I and Type II fibers ATP produced w/ and w/o oxygen produce fast.strong muscle contractions more prone to fatigue that type I -resistance training sagittal plane - ANSWER-divides body into left and right sides -flexion and extension -rotates around mediolateral axis (perpendicular) EX) walking or squatting transverse plane - ANSWER-divides body into superior and inferior portion -internal/external rotation, horizontal flexion/extension, and supination/pronation -rotates around longitudinal axis (perpendicular) EX) throwing baseball or golf swing frontal (coronal) plan - ANSWER-divides body into anterior and posterior portions -abduction/adduction, side flexion, and inversion/eversion -rotates around anteroposterior axis (perpendicular) EX) side bending, and lateral arm lifts 17 4. amenorrhea (3 consecutive cycles+) potential complications with anorexia - ANSWER-anemia, kidney problems, and/or death heart issues bone density loss amenorrhea, decreased testosterone gastrointestinal issues electrolyte abnormalities mental health issues and disorders bulimia nervosa criteria - ANSWER-binging at least twice weekly for at least 3 months behaviors different than anorexia self evaluation focused on body shape/weight (vomiting, laxatives, diuretics, enemas, fasting, exercising excessively) complications of bulimia - ANSWER-dehydration (kidney failure) heart issues tooth decay, gum disease amenorrhea digestive problems (dependence on laxatives) anxiety/depression drug/alcohol abuse binge eating disorder (BED) criteria - ANSWER-recurrent bingeing episodes twice weekly for at least 6 months with at least 3 of the following: -eating until uncomfortable -eating when not physically hungry -eating rapidly -eating alone for fear of being embarrassed by how much food is being consumed -feeling disgusted, depressed or guilty after the episode of overeating complications with binge eating disorder - ANSWER-depression suicidal thoughts insomnia obesity high BP type II diabetes high cholesterol heart disease gallbladder disease and other digestive issues joint pain muscle pain headache menstrual problems some types of cancer 20 1 pound = - ANSWER-3500 calories of fat bad fats - ANSWER-saturated and trans fat complex fats good fats - ANSWER-mono-unsaturated and poly-unsaturated fats lower cholesterol and reduce risk of certain diseases calories per gram - ANSWER-carbs - 4 fats - 9 proteins - 4 alcohol - 7 water soluble vitamins - ANSWER-B complex and C assist in ezyme activity like enrgy production fat soluble vitamins - ANSWER-A, D, E, K stored in liver usually no supplements- needed excess can be toxic female athlete triad - ANSWER-low bone mass disordered eating amenorrhea *sublcinical eating disorder* in to cm - ANSWER-*2.54 cm to in - ANSWER-*0.39 kg to lbs - ANSWER-*2.2 lbs to kg - ANSWER-*0.45 par-Q - ANSWER-Physical Activity Readiness identifies people who should not be tested in a field setting. Proceed with caution if a client answers yes to one or more questions. May require physician clearance program planning - ANSWER-needs of the target population, the existing or needed expertise of the care deliverers, and market demand for particular services. -keep up with the health and fitness industry changes and modify programs accordingly! legal and ethical considerations - ANSWER-never try to diagnose a client -look for underlying health issues 21 22 provide them with a written statement of the facilities standards of care, and provide confidentiality written statement of standard of care health risk assessment - ANSWER-before exercising with any client! -identify health risk factors -control health care costs -predict employee absenteeism -encourage clients to be proactive Health Insurance Portability and Accountability Act (HIPPA) - ANSWER-set of federal regulations adopted to protect the confidentiality of patient information and the ability to retain health insurance coverage tort laws - ANSWER-State legislation that applies to civil cases dealing with wrongful conduct or injuries, negligence tort action factors - ANSWER-1. the defendant owed the claimant a duty of care 2. the defendant bread that duty of care 3. reasonably foreseeable damage was caused by the breach of duty 4 basic duties - ANSWER-inform instruct monitor supervise waivers - ANSWER-suggested for every client to lower risk of liability in cases of negligence program development - ANSWER-systematic process that involves ongoing and structured planning to successfully achieve goals overuse injuries - ANSWER-muscle pulls sprains strains over-extension - ANSWER-similar to overuse injuries, but overexertion may result in exhaustion, shortness of breath, dizziness, and other dangerous conditions type I diabetes - ANSWER-insulin dependent typically under age 40 and chronic condition type II diabetes - ANSWER-insulin resistant -resistant to effects or fails to produce enough insulin -more common -disease prevention learning theories of human behavior - ANSWER-behaviorism cognitivism constructionsim humanism behaviorism - ANSWER-views learners as observers who develop or learn their behavior based on the type of outside feedback they receive operant conditioning - ANSWER-the learner is viewed as passive, until acted upon by environmental stimuli cognitivism - ANSWER-a person's learning process is affected by their own unique thinking, memory, and problem-solving abilities -mind being a computer (info comes in, processed, then outcomes) constructionism - ANSWER-people have unique sequences of learning experiences, and holds these past experiences affect the way people process new info -learner is active, constructive process -link info to prior knowledge humanism - ANSWER-most complex theory learners must be evaluated entirely in order to understand, interpret, and predict their reactions to new info -each unique and personal to own self learning phases - ANSWER-cognitive associative automatic cognitive phase - ANSWER-learning basics of exercise/skill -mostly thinking before executing -attention on instruction and guidance associative phase - ANSWER-muscle memory begins -more comfortable with exercise/skill -corrections on form or technique -give constructive criticism automatic phase - ANSWER-perform exercise efficiently without much thought to proper form or technique -muscle memory automatically makes corrections -positive feedback and further instruction necessary 25 26 health belief model - ANSWER-psychological reasons for a person's inactivity by evaluating their current attitudes and beliefs as a set of variables, dependent on individual perceptions, modifying factors, and the likelihood of action health belief model diagram - ANSWER- trans-theoretical model of change in behavior (TMC) - ANSWER-6 stages of change that people go through when developing new patterns of behavior: precontemplation, contemplation, preparation, action, maintenance, (relapse/termination) processes of behavioral change - ANSWER-within trans-theoretical model 10 processes of behavioral change -5 cognitive (best when in initial stages of chage) -5 behavioral (during action and maintenance stages) 5 cognitive processes - ANSWER-1. conscious raising2. dramatic relief 3. environmental reevaluation 4. self-reevaluation 5. social liberation 5 behavioral processes - ANSWER-1. counter-conditioning 2. helping relationships 3. reinforcement management 4. self-liberation 5. stimulus control decisional balance - ANSWER-part of trans-theoretical model of change how people view pros and cons of healthy lifestyle as going through stages of change -beginning cons outweigh pros, the in time they reverse self-efficacy - ANSWER-self-confidence social cognitive theory (SCT) - ANSWER-interaction of behavioral, personal, and environmental influences interaction creates unique behavior patterns -people influence and are influenced by their environments social cognitive theory dynamic model - ANSWER-personal: feelings/thoughts behavioral: demeanor/personality environmental: external events/other people *key constructs: observational learning, reinforcement, self-efficacy rewards - ANSWER-extrinsic ok at beginning (rewards for attaining goals) clients must understand intrinsic rewards (benefits of better fitness) a reward that inspires permanent success electrocardiographs (ECG) - ANSWER-provide basic info about physiological condition of the myocardium -record electrical impulses -HR, rhythm, impulse conduction route, pathology, and/or disease of myocardium ECG paper - ANSWER- ECG - ANSWER-elevation or depression in ST segment indicates serious pathology Einthoven's triangle - ANSWER-pair of electrodes that creates a triangle around the heart formed by the bipolar leads -includes lead I, II, and III ECG interpretation - ANSWER-number of P waves determines atrial rate number of R waves determines ventricular rate 60-100 bpm: SA node 60-80 bpm: atria 40-60 bpm: AV node/junction 20-40 bpm: ventricles cardiac cycle - ANSWER-p wave <0.12 sec PR interval 0.12-0.2 sec QRS complex <0.12 sec T wave amplitude <10mm AT interval <0.40 sec determining arrhythmias - ANSWER-1. determine if regular measure R-R intervals for ventriculary regularity measure P-P intervals for atrial regularity if difference is >0.06 sec, signifies irregularity 2. determine exact HR 3. analyze complex formationP- P intervals equal? PR interval equal? between 0.12-2.0 sec? QRS complex look alike? R-R intervals <0.12 sec? types of arrhythmias - ANSWER-atrial fibrillation ventricular fibrillation (v-Fib) 27 30 -clinical responses, ECG responses, exercise capacity, hemodynamic responses, and what the exercise test score says about the client -ECG or hemodynamic abnormalities -ST segment depression is myocardial ischemia -ST segment changes early on or in recovery indicate CVD or multivessel disease -dysrhythmias hypertension: systolic >250 mmHg or increase of 140 mmHg (should drop quickly after exercise but if doesnt then ischemia and poor prognosis) -chronotropic incompetence (<80% predicted HRR) hemodynamic responses - ANSWER-identify high-risk situations in stress test drop in SBP: decreases cardiac output (absolute termination) radionuclide testing - ANSWER--thallium/technetium stress test -injecting dye to see anything abnormal finding dead tissue from heart attack echocardiographic imaging - ANSWER-ultrasound of heart done before and immediately after stress test pathologies - ANSWER-atrioventricular blocks bundle branch blocks (BBB) myocardial ischemia myocardial infarction (MI) chamber enlargement atrioventricular (AV) blocks - ANSWER-delay within AV node which delays impulse from atria (long pause before ventricular contraction) one 1st degree, 2 2nd degree, and one 3rd degree (complete) heart block types -heart disease, aging, and pericarditis can all cause 1st degree AV block - ANSWER-delay with a prolonged PR interval more than 0.2 sec on ECG cardiac cycle consistently normal, but PR interval is prolonged every cycle -partial block 2nd degree AV block (Wencheback block) - ANSWER-PR interval becomes progressively longer each cycle until AV node no longer conducts stimulus QRS complex eventually drops -irregular rhythm; more P waves than QRS complexes 2nd degree AV block (Mobitz) - ANSWER-punctual P wave is not followed by QRS response NO progressive lengthening of PR interval or premature P wave 3rd degree AV block - ANSWER-complete AV block none of the atrial depolarizations conduct to ventricles -automaticity focus below the blocks escapes overdrive suppression to pace the ventricles at its inherent rate -ventricular rate may be so low that insufficient blood flow to brain occurs bundle branch blocks (BBB) - ANSWER-block in conduction within the right or left bundle branch -wide QRS complex (>120 ms) --disease of bundle branches or ventricular abnormalities, drugs, electrolyte, or metabolic disorders may cause 2 classifications: left and right (RBBB & LBBB) RBBB - ANSWER-activation of the left ventricle occurs before the right ventricle -triphasic complex trigger screening for conditions affecting right side of heart or lungs (pulmonary emboli, COPD, and cardiomyopathy) LBBB - ANSWER-initial ARS deflection is altered due to initial impulse traveling across the septum from the right to left -initial negative deflection V1 and initial upright deflection in V6 (wide notched appearance) -followed by imaging study: underlying cardiac pathology (dialated/hypertropic cardiomyopathy, hypertension, aortic valve disease, cardio disease) myocardial ischemia - ANSWER-partial or complete blockage of blood to the heart muscle moderate-high risk for disease need to identify -evidenced in ST segment as depression >1mm below baseline myocardial infarction (MI) - ANSWER-near-total or complete blockage to artery which blocks blood flow to an area of the heart *MI triad:* ichemia, injury, and necrosis (initial lack of oxygen, ischemia 20-40 min, then death of tissue) -time span of 2-12 hours abnormal Q waves, ST segment depression, ST segment elevation, T wave inversion (scan ALL leads) chamber enlargement - ANSWER-Involves the atria, the ventricles or both. It implies either dilation or hypertrophy of the chamber walls. right atrial enlargement - ANSWER-biphasic P wave, initial component is larger leads V1 and V2 tall, peaked P waves 31 32 can accompany pathologies: COPD, congenital heart disease, coronary artery disease, pulmonary hypertension, pulmonary stenosis, tricuspid valve stenosis, tachycardia, or exercise left atrial enlargement - ANSWER-biphasic P wave broad notched P waves in lead I and II can accompany pathologies: mitral valve disease, hyertension, aortic stenosis or regurgitation, or hypertropic cardiomyopathy right ventricular hypertrophy - ANSWER-height increases in R waves in lead V1 and progressively smaller in leads V2-V6 left ventricular hypertrophy - ANSWER-increased amplitude of R wave in leads V3-V6 increased amplitude in S wave in leads V1-V2 QRS complex exaggerated treatments for cardiac pathologies - ANSWER-pacemakers angiography cardiac catherization coronary bypass surgery pharmacologic agents pacemaker - ANSWER-helps heart beat regularly at appropriate rate -assists or replaces normal electrical conduction system -most common is too slow HR -SA node dysfunction and AV block unnaturally sharp spikes single chamber, dual chamber, and implantable cardioverter defibrillator (ICD) single-chamber packemakers - ANSWER-use 1 lead right atrium or right ventricle (only receives and sends signal and pace where placed) on ECG look for spike followed by P wave for ventricular; spike followed by wide, bizarre QRS complex for atrial dual-chamber pacemakers - ANSWER-2 leads one on right atrium and right ventricle each provide AV synchrony -lower mortality rates and higher survival rates -on ECG: look for 2 spikes in each cardiac cycle implantable cardioverter defibrillator (ICD) - ANSWER-fast HR indicated for sudden cardiac death due to: ventricular tachycardia/fibrillation with no reversible cause; spontaneous and sustained ventricular tachycardia; syncope without known cause; and non-sustained ventricular tachycardia with coronary artery disease angiography - ANSWER-injecting radio-opaque contrasting agent into blood vessel allows the inside of blood vessels and heart chambers to be visualized 35 physical considerations for children - ANSWER-1. existing medical conditions (asthma, epilepsy, diabetes) 2. overuse injuries (inadequate warm up, bad shoes, poor technique, faulty equipment,or overtraining) 3. appropriateness of resistance training: -strict supervision required -sports/activity specific -focus on proper technique (start with body weight exercises, then progress to light weights with frequent repetitions) psychological considerations for children - ANSWER-1. healthy body image (emphasis on health opposed to appearance) 2. mental discipline (parents/coaches must look for: state or trait anxiety, and burn-out) 3 social skills 4. lifestyle attitudes state anxiety - ANSWER-stress reaction that occurs during sport/recreation preparation trait anxiety - ANSWER-intrinsic personality characteristic that may be compounded in situation stress -worry, self-criticism, anxiety burn-out - ANSWER-reaction to stress associated with training and competition symptoms: emotional exhaustion, withdrawal, and decreased physical performance daily PA for children - ANSWER-moderate level of activity 30-60 minutes on most days of the week ages 5-12 need minimum of 60 min of activity several days a week (bouts of 15 min or more each day) -moderate to vigorous activity exercise prescription for children - ANSWER-*aerobic activity:* 5-7 days/week moderate-vigorous activity intermittent in nature 60 min + per day (several sessions of 15-20 min) age appropriate exercises the utilize all muscle groups *resistance training:* 5-7 days/week 4-6 muscle groups 1-3 set of 8-15 reps 20-30 min sessions (add weight up to 6 reps, then add 1-2 reps ever session until 12-15 reps) submax and using full range of motion *flexibility:* 5-7 day/week light-moderate (12/13 RPE) hold 15-30 sec 2-4 static stretches for each muscle group exercise for older adults - ANSWER-pre-exercise evaluation in clinical setting recommended (medical history, physical exam, and lab tests) physiological considerations for older adults - ANSWER-1. lower VO2, reduced max HR and CO 2. higher resting/exercise BP 3. decreased immune function 4. decrease sensitivity in thermoregulation (reduced total body water and capacity for sweating) 5. increased risk factors such as: -hypertension, hyperlipedemia, diabetes, coronary artery disease physical considerations for older adults - ANSWER-1. decrease in bone and muscle mass 2. decreased balance and coordination 3. increase in obesity; higher % of fat mass4. osteoarthritis 5. orthopedic injuries psychological considerations for older adults - ANSWER-1. self-efficacy (improve perception to perform task) 2. self-concept 3. cognitive functioning 4. life satisfaction exercise prescription for older adults - ANSWER-*aerobic activity: 5-7 days/week light-moderate (50-80% max HR) 30-60 min a day (can be 10-15 min intervals) walking, stationary bike, low orthopedic stress *resistance training:* 2 days/week 1 set of 8-10 reps for each muscle group (RPE 12-13) 20-30 min sessions (Gradually add weight as tolerated) weight training machines, tubing and bands (with assistance) *flexibility:* 5-7 days/week light-moderate (12-13 RPE) hold 15-30 sec 2-4 static stretches for each muscle group COPD and restrictive lung disease tests for diagnosis - ANSWER-chest x-ray computerized temography (CT) 36 arterial gas analysis sputum examination pulmonary function test (PFT) restrictive lung disease - ANSWER-group of lung diseases characterized by restriction in the lungs causing the inability to fully inhale -stiffness in lungs, chest wall, weak muscles, or nerve damage interstitial lung disease/pulmonary fibrosis, sarcoidosis, obesity, scoliosis, muscular dystophy or amyotophic lateral sclerosis (ALS) immunosuppressant drugs, corticosteroids, anti-inflammatory drugs, anti-fibrotic drugs, oxygen therapy and pulmonary rehabilitation diabetes - ANSWER-set of metabolic diseases with high blood sugar primary risk factor: family history (especially if parent/sibling) risk factors for type II: obesity/overweight, ethnicity, insulin resistance, hypertension, family history, sedentary lifestyle, age signs/symptoms of cardiopulmonary and metabolic diseases: - ANSWER-1. pain or discomfort in chest, neck, jaw, or back 2. resting or mild exertional dyspnea 3. dizziness or syncope 4. paroxysmal nocturnal dyspnea 5. orthopnea (inability to breath laying down)6. ankle edema 7. plapitations (rapid HR or skiped beat) 8. claudication 9. heart murmurs 10. unusual fatigue or dyspnea with ADLs metabolic syndrome - ANSWER-1. central obesity (men >40 in waist, women >35 in) 2. antherogenic dyslipidemia 3. insulin resistance/glucose intolerance 4. proinflammatory state 5. prothrombic state 6. hyertension (130/85) effects of exercise on pulmonary disorders - ANSWER-reversing muscle deconditioning and improving pace clients walk farther with less dypnea reduce risk of CAD improvement in overall weakness in peripheral and respiratory muscles, anxiety, depression, and nutrition abnormalities effects of exercise on asthma - ANSWER-can be triggered by exercise in cooler weather: scarf in front of mount/nose to trap warm moist air 37 40 impedance plethysmography - ANSWER-venous impedance plethysmography a technique using cuff occlusion of the venous flow from a limb in which the change in limb volume is used to diagnose acute venous obstruction or vascular insufficiency of an extremity diagnostic tests for coronary artery disease - ANSWER-monitor: ECG, hemodynamic, and symptomatic responses frequently used for potential CVD clients -treadmill and bike exercise tests -stress tests with myocardial perfusion imaging -stress echocardiography -cardiac catheterization treadmill and bike exercise tests - ANSWER-workload changes every 3 min -^ speed and incline on treadmill or resistance on bike exercise until fatigued, develop symptoms, reach >85% of age predicted HR, or symptoms occur *symptoms to terminate:* -moderately sever chest discomfort -marked shortness of breath -dizziness -drop in systolic BP >10mmHg from baseline w/ increasing workload, accompanied with ischemia -signs of poor perfusion -sustained ventricular tachycardia -ST elevation (1mm) in lead w/o diagnostic Q waves (other than V1 or Vr) -clients request to stop stress tests with myocardial perfusion imaging (MPI) - ANSWER-nucelar medicine procedure where radionuclide used to examine cardiac tissue and evaluate heart's function and blood flow -will absorb and show where damaged tissue is (bad BF) *exercise:* -start at warm up speed on teadmill -speed up and increase incline every 3 min -exceed 85% age target HR -cool down -stop if develop sings/symptoms -inject radionuclide into vein during exercise -once circulated gamma camera takes pics of heart with client laying still on table prior to exercise (15-30 min) *pharmacologic:* -when medical conditions prevents treadmill use -given medication to dilate arteries -resting images prior to medication 41 stress echocardiography - ANSWER-diagnose, manage, or follow up with clients with known heart disease -size/shape heart chambers, pumping capacity, location and extent of damaged tissue, cardiac output, ejection fraction, and diastolic function *exercise:* -resting study (focus on resting ejection fraction and left ventricular wall) -warm up speed -increase speed and incline every 3 min -stop abruptly when client exceeds 85% of age target HR -stop early if develop signs/symptoms -lie on left side on table -repeat exam videos compared side by side to at rest and exercise -EF ^ w/ ^HR -LV walls shouldn't demonstrate abnormal movement --if either occur, indicates disease *dobutamine:* -resting study (measure EJ, how well heart is contracting, and LV wall) -assess heart muscle under stress -may use dobutamine meds when cannot use treadmill (speeds up HR) -once target HR reached take image and compare --closely monitor for adverse effects of meds!!! cardiac catheterization - ANSWER-used to diagnose and treat cardiovascular conditions catheter inserted into artery or vein in groin, neck, or arm the threaded to reach heart *purposes:* -locate narrowing or blocks in coronary arteries -perform hemodynamic assessment -evaluate cardiac pressures -biopsies -diagnose congenital heart defects -diagnose heart valve abnormalities and defects revascularization procedures - ANSWER-percutaneous transluminal coronary angioplasty (PTCA) percutaneous transluminal coronary angioplasty with stent(s) laser angioplasty coronary artery bypass grafting (CABG) percutaneous transluminal coronary angioplasty (PTCA) - ANSWER-cateter with deflated balloon inserted in groin and threaded to narrow portion of coronary artery -inflate balloon, decreases plaque build up -can be used during active ischemia to decrease myocardial wall damage -usually for younger single vessel disease clients with more distal sites -restenosis rate of 30-50% in 6 months vs more advanced procedures percutaneous transluminal coronary angioplasty with stent(s) - ANSWER-mesh or metal stent acts to hold open walls of arter after PTCA performed -stent on tip of balloon catheter and placed on blockage site -restenosis rate much lower, 10-15% in 6 months (drug eluting stents with an immunosuppressant coating to show even lower restenosis rates of <5%) laser angioplasty - ANSWER-similar to PTCA beneficial when blockage cannot be passed through due to size and calcification of blockage -end of catheter has laser beam that breaks appart plaque build up -often used with stent placement due to lower restenosis rates coronary artery bypass grafting (CABG) - ANSWER-clients with extensive multivessel disease and failed PTCA procedures, medication resistant, or at high risk for future disease development -left or right mammary artery or savenous vein removed then attached to base of aorta below blockage -arterial and mammary more resistant than savenous vein grafts antianginals - ANSWER-can cause depression, fatigue, and dizziness HR and BP lowered use RPE scale to monitor intensity instead 1. beta adrenergic blockers 2. nitrates beta adrenergic blockers - ANSWER-treat hypertension, left ventricular dysfunction, and angina reduce ischemia, decreases oxygen demand controls ventricular dysrhythmias and reduce resting and exercise HR and BP nitrates - ANSWER-treat angina as a vasodilator in heart failure reduce ischemia by decreasing oxygen demand and allows small increase in oxygen supply short and long lasting doses decreases resting and exercising BP antihypertensives - ANSWER-postural hypotension: drop in systolic and/or diastolic BP -dizziness, light-headedness, or loss of consciousness; can result in fall (more frequent with diuretics added) proper hydration is key role diuretics cause weakness and fatigue due to low potassium levels -if levels too low then risk of lethal arrhythmias (VT and VF) at rest or with exercise 1. angiotension-converting enzyme (ACE) inhibitors 42 45 leukotriene antagonists and formation inhibitors (American association of family physicians) - ANSWER-potent inflammatory mediators inducing bronchoconstriction and enhancing airway hyperresponsiveness -stimulate smooth muscle hypertrophy, muscle hypersecretion, and influx of eosinophils into airway tissues xanthine derivatives - ANSWER-stimulate central nervous system, produce diuresis, and relax smooth muscles help relax smooth muscles in bronchial tree -may result in premature ventricular contractions at rest and exercise HR and BP mast cell stabilizers - ANSWER-prevent/control some allergic disorders, block calcium channel essential for cell degranulation, stabilizing cell and preventing release of histamine related mediators -used in inhalers to treat asthma, nasal sprays for fever, and eye drops for allergic conjunctives antidiabetic agents - ANSWER-if on insulin must coordinate injections and food intake with exercise program or diagnostic test *concerns:* foot ulcers and hypoglycemia -intensity, frequency, and duration depends on severity and fitness level -check blood glucose before and after exercise (must be at 100 before and after exercise!!!) 1. biguanides 2. glucosidase inhibitors 3. meglitinides 4. sulfonylureas 5. thiazolidinediones 6. insulin bigaunides - ANSWER-decrease hepatic glucose production and intestinal glucose absorption no effect on rest/exercise HR and BP glucosidase inhibitors - ANSWER-inhibit glucose absorption and have no effect on resting/exercise HR and BP meglitinides and sulfonylureas - ANSWER-stimulate pancreatic islet beta cells no effect on resting/exercise HR and BP thiazolidinediones - ANSWER-increase insulin sensitivity no effect on rest/exercise HR and BP insulin - ANSWER-caries how acts base on type -no effect on resting/exercise HR and BP 46 *1. rapid acting (mealtime insulin):* onset occurring 5-15 minutes, peak at 45-90 minutes, overall duration of 3-4 hours *2. intermediate acting:* covers need for half day or overnight, typically combined with rapid. onset at 1-2.5 hours, peak at 3-12 hours, overall duration 18-24 hours *3. long lasting:* covers needs for full day, typically combined when necessary with rapid or intermediate. onset at 30min-3 hours, peak at 6-20 hours, overall duration 24- 36 hours psychotropics - ANSWER-help with depression and anxiety can increase drowsiness and dizziness -don't exercise too soon after injection! -adequate fluids 1. monoamine oxidase inhibitors (MAOIs) 2. tricyclic antidepressants (TCAs) 3. selective serotonin reuptake inhibitors (SSRIs) monoamine oxidase inhibitors (MAOIs) - ANSWER-prevents breakdown of monamine neurotransmitters and increasing availability for depression, last choice treatment option due to require diet restrictions -cause dangerously high BP when w/certain foods tricyclic antidepressants (TCAs) - ANSWER-act as serotonin-norepinephrine reuptake inhibitors (ANRIs) that block the transporters (SERT and NET) -major depression disorders, generalized anxiety, obsessive compulsive disorder, and post-traumatic stress disorder -significantly high rate of serious cardio diseases *side effects:* tachycardia, increased BP, slight prolongation of intraventricular conduction time (arrhythmias risk) selective serotonin reuptake inhibitors (SSRIs) - ANSWER-antidepressants to treat depression, anxiety, and some personality disorders increase serotonin *side effects:* mild bradycardia, orthostatic hypotension, and prolongation in intraventricular conduction time -may demonstrate QRS lengthening or prolonged QT intervals vasodilators - ANSWER-treat recurrent angina coronary artery disease reduce exertion if symptoms become present, avoid extreme heat/cold, reduce emotional stress, and avoid large meals prior to exercise higher risk of hypotensive episodes with postural changes w/exercise, RPE scale to monitor exercise! 1. nitrate and nitroglycerin 2. direct peripheral vasodilators nitrates and nitoglycerin - ANSWER-widen blood vessels -decrease in vascular resistance and increase in BF can decrease rest/exercise BP direct peripheral vasodilators - ANSWER-treat hypertensive crisis, used in acute congestive heart failure, and decrease systemic BP -decreases vascular resistance or venous return and cardiac output can decrease rest/exercise BP tranquilizers - ANSWER-major or minor induce relaxed state increased risk of drowsiness, dizziness, perspiration, and dry mouth (monitor closely!) 1. major 2. minor major tranquilizers - ANSWER-neuroleptics or antipsychotics treat schizophrenia and severe paranoia disorders minor tranquilizers - ANSWER-benzodiazipenes treat anxiety can be addictive, even at prescribed dosages if taken for long period of time -withdrawal process can be painful or life-threatening: nausea, pain, flu-like symptoms, and seizures blood modifiers - ANSWER-blood thinner must avoid vigorous activity falls and injuries can cause serious internal bleeding *safe exercises:* walking, swimming, bicycling -if fall or injury occurs, seek medical attention immediately! 1. anticoagulants 2. antiplatelets anticoagulants - ANSWER-prevent blood from forming dangerous clouts resulting in stroke -prolongs clot formation no effect on rest/exercise HR and BP antiplatelets - ANSWER-frequently used after angioplasty with stent placement and valve replacement surgery decrease platelet aggregation and inhibiting thrombus formation w/in arterial circulation -lengthens times to form blood clot no effect on rest/exercise HR and BP when used in therapeutic doses caffeine - ANSWER-variety of plants, dietary sources, and non prescription meds -coffee, tea, chocolate, and many soft drinks quickly absorbed in stomach and peaks in blood within 1-2 hours *physiological effects: -increased HR and BP 47
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