Exercise testing

Description

Lung Testing (Exercise Testing) Quiz on Exercise testing, created by LeeAnna Shepherd on 18/08/2016.
LeeAnna Shepherd
Quiz by LeeAnna Shepherd, updated more than 1 year ago
LeeAnna Shepherd
Created by LeeAnna Shepherd over 8 years ago
14
0

Resource summary

Question 1

Question
Indications for Exercise Testing Chief complaint of [blank_start]dyspnea[blank_end] on exertion To determine ventilator [blank_start]limitations[blank_end] to work To determine [blank_start]cardiac[blank_end] limitations to work To determine [blank_start]maximum[blank_end] workloads for developing or adjusting exercise plan or [blank_start]activities[blank_end] [blank_start]Disability[blank_end] Purposes
Answer
  • dyspnea
  • limitations
  • cardiac
  • maximum
  • activities
  • Disability

Question 2

Question
Contraindications PaO2 < [blank_start]45[blank_end] on RA PaCO2 > [blank_start]70[blank_end] FEV1 <[blank_start]30[blank_end]% Recent [blank_start]MI[blank_end] Unstable [blank_start]angina[blank_end] 2nd or 3rd degree [blank_start]heart[blank_end] block [blank_start]Rapid[blank_end] ventricular or atrial [blank_start]arrhythmia[blank_end] Orthopedic problems that impairs activity Severe Aortic [blank_start]Stenosis[blank_end] CHF [blank_start]Uncontrolled[blank_end] HTN Neurological Disorders Dissecting [blank_start]Aneurysm[blank_end] Severe Pulmonary [blank_start]Hypertension[blank_end]
Answer
  • 45
  • 70
  • 30
  • MI
  • angina
  • heart
  • arrhythmia
  • Rapid
  • Stenosis
  • Uncontrolled
  • Aneurysm
  • Hypertension

Question 3

Question
Normal response to stress Test Heart rate will [blank_start]increase[blank_end] linearly with increased workload Increased heart rate without ECG changes indicates [blank_start]deconditioning[blank_end] ST depressions >[blank_start]1[blank_end] mm for [blank_start].8[blank_end] seconds indicates ischemia PVCs with exercise are associated with ischemia if >[blank_start]10[blank_end] per [blank_start]minute[blank_end] If systolic blood pressure [blank_start]doesn’t[blank_end] rise, cardiac output is not [blank_start]increasing[blank_end] Respiratory rate, tidal volume and minute volume will [blank_start]increase[blank_end] during testing VCO2 and VO2 will rise together to keep RER near [blank_start].8[blank_end] pH will initially [blank_start]increase[blank_end] but will [blank_start]decrease[blank_end] at anaerobic threshold VD/VT will [blank_start]decrease[blank_end] because of increased [blank_start]perfusion[blank_end] Pulmonary Artery pressure will remain [blank_start]constant[blank_end] in normal patients.
Answer
  • increase
  • deconditioning
  • 1
  • .8
  • 10
  • minute
  • doesn’t
  • increasing
  • .8
  • increase
  • increase
  • decrease
  • decrease
  • perfusion
  • constant

Question 4

Question
Limitations to Exercise testing Ventilatory Limitations @ low/mod workload: Maximum minute ventilation = FEV1 x [blank_start]35[blank_end] Ve/VO2 >[blank_start]30[blank_end] L/LO2 Respiratory [blank_start]Acidosis[blank_end] Increased [blank_start]RER[blank_end] Decrease in O2 Sat [blank_start]Increased[blank_end] PAP Normal [blank_start]ECG[blank_end] and HR
Answer
  • 35
  • 30
  • Acidosis
  • RER
  • Increased
  • ECG

Question 5

Question
Limitations to Exercise testing Cardiac Limitation @ low/mod workload: Significant [blank_start]ECG[blank_end] Changes Diastolic Pressure [blank_start]falls[blank_end] Systolic Pressure does not [blank_start]rise[blank_end] O2 pulse [blank_start]decreases[blank_end] Vt, RR, Ve is less than [blank_start]70[blank_end]% of MMV
Answer
  • ECG
  • falls
  • rise
  • decreases
  • 70

Question 6

Question
Limitations to Exercise testing Poor Conditioning Present with [blank_start]increased[blank_end] HR and low/mod workloads with normal ECG and Vt, RR, Ve <[blank_start]70[blank_end]% MMV Poor Effort Present when ECG, SaO2 and HR are [blank_start]normal[blank_end] and anaerobic threshold is [blank_start]not[blank_end] achieved and Ve <[blank_start]70[blank_end]% MMV
Answer
  • increased
  • 70
  • normal
  • not
  • 70

Question 7

Question
Workload: Amount of [blank_start]energy[blank_end] being generated by patient during exercise. Measure in kilopond meters (kpm) Power: Amount of [blank_start]work[blank_end] per minute. Measure in [blank_start]watts[blank_end]. 1 watt = 6.12 kpm/min Metabolic Equivalents (METS) – Unit that measures O2 [blank_start]consumption[blank_end] per kg of body weight. 1 met = 3.5 mL/O2/kg (normal at rest) VO2 is measured during test and [blank_start]divided[blank_end] by pt weight in kg, then divided by 3.5 to get METS. Anaerobic Threshold – Level of exercise or VO2 at which [blank_start]anaerobic[blank_end] metabolism will begin to supplement aerobic metabolism. Lactic acid increases, pH decreases, HR is stable, Ventilatory equivalent for O2 and CO2 changes. O2 Max – [blank_start]Work[blank_end] continues to increase but [blank_start]VO2[blank_end] does not.
Answer
  • energy
  • work
  • watts
  • consumption
  • divided
  • anaerobic
  • VO2
  • Work

Question 8

Question
Steady State Vs Multistage Testing Steady State – Pt is exercised at [blank_start]submaximal[blank_end] level for 5-8 minutes at 50-[blank_start]75[blank_end]% of max load. (220-age = max HR) Once that target is reached, timing begins, measurements are made during final [blank_start]1[blank_end]-[blank_start]2[blank_end] minutes. Multistage – Workloads are [blank_start]increased[blank_end] and measurement made at the end of each [blank_start]stage[blank_end] (increase at 15 watts/min) <50 watts – [blank_start]low[blank_end] 50-100 watts – [blank_start]medium[blank_end] >100 watts – [blank_start]high[blank_end] 200 watts [blank_start]too[blank_end] high for stress testing. Can be changed every [blank_start]1[blank_end]-[blank_start]6[blank_end] minutes by increasing [blank_start]speed[blank_end], grade, or [blank_start]resistance[blank_end]. To verify treadmill is at a 10% incline – take a [blank_start]30[blank_end]” carpenter’s level and place on treadmill. The High end should be [blank_start]3[blank_end]” above the low end. 3” Rise / 30” run = 10 Set workload at [blank_start]10[blank_end] – [blank_start]15[blank_end] watts/min to reach 100 -150 watts in 10 min.
Answer
  • submaximal
  • 75
  • 1
  • 2
  • increased
  • stage
  • low
  • medium
  • high
  • too
  • 1
  • 6
  • speed
  • resistance
  • 30
  • 3
  • 10
  • 15

Question 9

Question
Stress Test without Gas Analysis (Multistage) Prepare Patient: 12 lead [blank_start]ECG[blank_end] – resting. Hx and physical exam. Informed consent Equipment: Treadmill, cycle or step Pt is stressed until [blank_start]Max[blank_end] HR achieved or pt develops [blank_start]symptoms[blank_end] that indicate to stop. Workload should gradually be [blank_start]decreased[blank_end] and pt monitored until vitals return to [blank_start]normal[blank_end] Stress testing with Gas Analysis (Steady State) Pt is prepared and stressed at [blank_start]sub[blank_end] maximal level for 5-8 minutes Expired gas is collected near [blank_start]end[blank_end] of each stage and during final [blank_start]1[blank_end] – [blank_start]2[blank_end] minutes of testing Collected using: Volume Spirometer, pneumotach, or breath by breath analysis. Measurement Includes: Exhaled [blank_start]Volume[blank_end], Temperature, Time of collection, respiratory [blank_start]rate[blank_end], [blank_start]Fe[blank_end]O2, [blank_start]Fe[blank_end]CO2 Allows for calculation of: [blank_start]Minute[blank_end] ventilation, Vt, [blank_start]VO2[blank_end], CO2 Production, Respiratory Exchange [blank_start]Ratio[blank_end], VE/VO2, VE/VCO2
Answer
  • ECG
  • Max
  • symptoms
  • decreased
  • normal
  • sub
  • 1
  • 2
  • end
  • Volume
  • rate
  • Fe
  • Fe
  • Minute
  • VO2
  • Ratio

Question 10

Question
Stress Testing with Gas Analysis and ABG ABG is performed [blank_start]same[blank_end] time as gas analysis Inability to stabilize arm for [blank_start]puncture[blank_end] is a problem. Arterial line would be [blank_start]preferred[blank_end] Indicated for patients with primary [blank_start]pulmonary[blank_end] problems Additional measurements: Physiologic [blank_start]Deadspace[blank_end], [blank_start]VA[blank_end], VD/Vt, [blank_start]Cardiac[blank_end] Output
Answer
  • same
  • puncture
  • preferred
  • pulmonary
  • VA
  • Cardiac
  • Deadspace

Question 11

Question
Bruce Protocol: Workload is increased every [blank_start]3[blank_end] minutes. Borg Scale: Scale of 1 – [blank_start]20[blank_end]. Modified Borg Scale: 1 – [blank_start]10[blank_end]
Answer
  • 3
  • 20
  • 10

Question 12

Question
Specific Reasons for ending exercise test [blank_start]2[blank_end]mm elevation in [blank_start]ST[blank_end] segment Inverted [blank_start]T[blank_end] waves Presence of large [blank_start]Q[blank_end] waves Vtach or [blank_start]SVT[blank_end] Multifocal [blank_start]PVC[blank_end] 2nd or 3rd degree heart block [blank_start]changes[blank_end] Exercise induced right or left bundle branch block [blank_start]Angina[blank_end] that progresses with testing Sweating and pallor Systolic pressure >[blank_start]250[blank_end] or diastolic >[blank_start]100[blank_end] Systolic Pressure does not [blank_start]increase[blank_end] or falls[blank_start]10[blank_end] as workload increases Lightheadedness Cyanosis Nausea Muscle [blank_start]Cramps[blank_end] Hyperventilation
Answer
  • 2
  • ST
  • T
  • Q
  • SVT
  • PVC
  • changes
  • Angina
  • 250
  • 100
  • 10
  • increase
  • Cramps

Question 13

Question
Tidal Volume Loops Plotted on top of [blank_start]FVC[blank_end] loop [blank_start]IC[blank_end] during exercise is used to position the loop on top of [blank_start]resting[blank_end] loop Normal response to exercise will demonstrate a decrease in [blank_start]IRV[blank_end] and [blank_start]ERV[blank_end] in order to increase Vt and Ve
Answer
  • FVC
  • IC
  • resting
  • IRV
  • ERV

Question 14

Question
Pt with Hypoxemia Monitor titration with pulse ox If resting SpO2 is low do O2 titration at [blank_start]rest[blank_end] before exercise titration
Answer
  • rest

Question 15

Question
6 Minute Walk test Pt is to walk as far as possible in [blank_start]6[blank_end] minutes Pt can slow down or rest if needed. Record Symptoms and SpO2 during [blank_start]rest[blank_end] stop Terminate test if significant [blank_start]angina[blank_end], mental confusion or SpO2 <[blank_start]85[blank_end]%
Answer
  • 6
  • rest
  • angina
  • 85

Question 16

Question
Safety Do a HX for [blank_start]contraindications[blank_end], Physical [blank_start]Exam[blank_end], [blank_start]ECG[blank_end] and [blank_start]ABG[blank_end]
Answer
  • contraindications
  • Exam
  • ECG
  • ABG
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