Exam 2 - ExRx for those with Cardiovascular and Pulmonary Diseases Questions With Correct Solutions, Already Passed!!
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Course
ExRx for those with Cardiovascular and Pu
Institution
ExRx For Those With Cardiovascular And Pu
Where in the blood vessels are clots most likely? - Where there is branching?
Cardiac Rehabilitation (CR)
• Ex and lifestyle interventions
• Currently, ........... insurance reimburses for CR for MI/acute coronary syndrome, CABG, PTCA, stable
angina, valve repair/replacement, CHF, and heart...
Exam 2 - ExRx for those with
Cardiovascular and Pulmonary Diseases
Where in the blood vessels are clots most likely? - Where there is branching?
Cardiac Rehabilitation (CR)
• Ex and lifestyle interventions
• Currently, ........... insurance reimburses for CR for MI/acute coronary syndrome, CABG, PTCA, stable
angina, valve repair/replacement, CHF, and heart transplant.
Injury to the endothelium (many causes) → .......
-2 main causes? - endothelial dysfunction...
-high Blood Pressure (results in higher turbulent flow - excessive pounding on endothelial cells)
-glycosolated haemoglobin = HbA1c (% of Hb that has glycogen attached) (spikes of the glucose rake the
endothelial layer causing it to become damaged)
Endothelial dysfunction causes .....
-5 step process? - -disturbed blood flow which causes
-endothelial cell activation (since the cells have been damaged)
-recruitment of inflammatory cells to vessel wall (WBCs arrive here)
-cell signaling facilitates LDL retention in tunica intima (LDL is used to help the endothelial layer heal but
if too much LDL is retained, it can lead to blood clotting).
-oxidative modification by ROS and inflammatory enzymes
What is the problem with hypertension/diabetes in terms of the effect on endothelial dysfunction? -
Can cause accumulation of lipids as endothelial layer is constantly being damaged
Accumulation of lipids
-5 step process? - ↳ monocytes become macrophages which try to digest mLDL. When the
macrophages cannot digest any more mLDL, they become foam cells
↳Efferocytic program (burying of cells) cannot keep up with source of apoptotic formation
↳Apoptotic cells that aren't being destroyed properly undergo secondary necrosis forming necotic core =
atherosclerotic plaque (purple blob on my pic)
•Unstable and vulnerable to disruption.
2 effects of atherosclerotic plaques developing - -can cause clotting at site of plaque in response
to internal bleeding
-plaque can break off and travel in blood to cause clotting elsewhere
• ..... and ..... (2 phases of CR) - -Medicare/private
-Inpatient and Outpatient
Inpatient Cardiac Rehabilitation: Guidelines
• Current clinical status ..........
• Mobilization
• Identification and provision of information regarding modifiable ..... factors and .....
• Discharge planning with a home ..... and .....
• Referral to .......... CR - -assessment
-risk; self-care
-PA; ADL (activities of daily living)
-outpatient
Inpatient Cardiac Rehabilitation: Guidelines
• ........ Assessments
￮ Note: diagnosis, current medical status, comorbidities, CVD risk factors, personalized goals, as well as
readiness for PA and learning.
• Supervised daily .......
￮ Intermittent ....... or ........ 12-24hrs after MI
,⁃ purpose of this?
⁃ Should include documentation of .....
• Individual education on modifiable ..... factors
￮ After physical ability and psychological willingness is ...... - • Clinical
• ambulation (moving/walking)
￮ sitting; standing
⁃ "prevent" exercise performance decrements
⁃ vital signs
• risk
￮ known
Inpatient Cardiac Rehabilitation: Guidelines
• Before discharge:
￮ Need to know ........ activities (Heavy lifting, climbing stairs, yard work, etc)
￮ Need to have a ..... plan of exercise
￮ Individuals should know how to identify ...... signs and symptoms
￮ Individuals should be strongly encouraged to participate in .......... - -permissible (what they can
do and what they want to do and help them achieve these things)
-safe
-abnormal
-outpatient CR program
American Association of Cardiovascular and
Pulmonary Rehabilitation (AACVPR) Parameters
for Inpatient Cardiac Rehabilitation Daily
Ambulation
- No new or recurrent ....... in previous 8 h
, - Stable or falling ................. (indicative of damage if CK high) and troponin values
- No indication of decompensated (worsening of) .............. (e.g., resting dyspnea and bibasilar rales)
- Normal cardiac rhythm and stable electrocardiogram for previous ..... hours - - chest pain
- creatine kinase
- heart failure
- 8 hours
Indications and Contraindications for Inpatient and Outpatient Cardiac Rehabilitation
*Indications = conditions with which you SHOULD got to CR outpatient*
• Medically ...... postmyocardial infarction
• ...... angina
• Coronary artery ......... graft (surgery)
• Percutaneous transluminal coronary angioplasty - what is this?
• Stable .......... caused by either systolic or diastolic dysfunction
(cardiomyopathy)
• ...... transplantation
• ......... heart disease/surgery
• .......... arterial disease
• At risk for ............. artery disease with diagnoses of diabetes mellitus, dyslipidemia, hypertension, or
obesity
• Other individuals who may benefit from structured exercise and/or
individual education based on ......... referral and consensus of the .......... team - • stable
• Stable
• bypass
• a minimally invasive procedure that opens blocked coronary arteries to improve blood flow to the
heart muscle
• heart failure
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