Question

This assignment is due at the beginning of class on Thursday, April 11. The assignment must be typed and is worth 60 points. Each exercise prescription should follow the FITT principle and include an aerobic, resistance and flexibility prescription Case Study 1 June is a 70 year old female who will be entering your Phase II Cardiac Rehab. class today. Her medical history is as follows: Cardiac History: Anterior MI with PTCA & stent placement to the left circumflex artery on 2/18/19. Other medical history: Hypertension, hyperlipidemia, past smoker- quit 5 years ago. Medications- Lipitor, Coumadin, Enteric coated aspirin, Toprol, Nitroglycerin as needed. Graded Exercise Test: Not available 1. Describe the use and side effects of the drugs June is prescribed. Would any drug side effects affect June's exercise prescription? 2. Write an exercise prescription for June. Case Study 2 Ethel is a 72 year-old female who is coming to your Pulmonary Rehab. Program for the 1s time. Her history is as follows: Medical History: COPD, Chronic bronchitis, past smoker-2 packs per day x 50 years- quit 3 weeks ago, Type II Diabetes, Hypertension Medications: Atenolol, Glucotrol, Lasix, Albuterol inhaler, Serevent inhaler, and Flovent inhaler. As an exercise physiologist in Pulmonary Rehab, list information and assessment you would want to obtain from Ethel before her first bout of exercise. 1. 2. Write an exercise prescription for Ethel.

Answer 1

CASE STUDY 1

1.Lipitor- (Atorvastatin calcium) lower the bad cholesterol and fat and rises the good cholesterol in the blood.It works by the amount of cholesterol made by the liver

• side effects-constipation,diarrhea,fatigue,heart burn,head ache.

Coumadin-This medication used to treat blood clots and to prevent new clots from forming in your body.

• side effects-Nausea,loss of appetite,abdominal pain

Enteric coated aspirin-IT prevent blood clots,this reduces the risk of stroke and heart attack

• Side effects-heart burn,bleeding,difficulty in hearing,ringing in the ears,dizziness and dark urine

Toprol-It is a beta blocker used to treat chest pain,heart failure,and high blood pressure.

• side effects-allergic reactions,mood disorders,low blood sugar

Nitroglycerine-This medication is used to relive chest pain,in people that have a certain heart conditions like coronary artery disease.

• Side effects-headache,dizziness,nausea,vomiting,tachycardia,flushing,rashes

2.Exercise prescription

• Get doctors clearance to do exercise first
• perform a gradual 5 minutes warm up to allow you heart and blood vessels to adapt exercise
• Avoid over exerting yourself in vigorous  exercises
• pushing too hard can cause a sharp spike in your heart rate and blood pressure which might cause the stent to collapse.
• keep exercise slow and steady
• Limit your exposure to environmental stressors like cold ,heat and strong winds.
• Aerobic exercises- that incorporate the large musculature of the body

CASE STUDY 2

1.Before starting exercises provide information about

What type of exercise can do each day?

How often can do exercise?

What activities to be avoided ?

• Gradually increase the activity level,especially if you have not been exercise regularly
• Remember to have fun during exercises
• Wait at least 2 hours after eating meal before exercising
• Take 5 minutes warm up before starting exercise
• Schedule exercises in to your daily routine
• keep exercise record
• Breath out slowly and gently through pursed lips
• Try to inhale for 2 seconds and exhale for 4 seconds.try to breath out twice as long as you breath in.
• When you experience shortness of breathing during activity it indicates your body needs more oxygen.If you slow your rate of breathing and concentrate on exhaling through pursed lips you will restore oxygen to your system more rapidly
• During walking start short walk,stop and rest whenever you are short of breath
• count the number of steps you take while you inhale.Then exhale for twice as many steps.
• While climbing stair step while exhaling with pursed lips.

Exercise Prescription

Exercise can be divided in to 3 basic steps

Stretching-Stretching the arms and legs before exercising helps to prepare the muscles for activity,prevent injury and muscle strain

Cardio vascular or aerobic -This type of exercises strengthen the heart and lungs,and improves the body's ability to use oxygen

Strengthening-Repeated muscle contractions until the muscles become tired.Strengthening of upper body helpful in COPD as it may help to strengthen the respiratory muscles

CASE STUDY 3

1.A few restrictions in the physical activity for the first 6-8 weeks following surgery in order to allow the time for the breast bone to heal ,they are

• do not lift the objects heavier than 10 pounds
• do not push or pull the objects heavier than 10 pounds
• do not attempt to sit ups ,pull ups,and push ups
• Discontinue any activity that cause pain
• do not drive the car
• After discharge restriction to activities like contact sports

Exercise prescription

Warm up-limbering and stretching activities

Peak activity-Cycling,rapid walking,swimming

Cool down-A repeat of slow stretching and walking.