Wayne has been consistently attending his cardiac rehab sessions 2-3 days a week for the past 4 weeks. During the sessions he has progressed from 15 minutes of walking on a treadmill with an incline to 40 minutes at an RPE of 13/20 not including a 5 minute warmup and cooldown walking on the treadmill without any incline. He has declined to complete any resistance training because he wants to focus on building his endurance back up. He performes a hamstring, quad, and calf stretch at the end of his exercise session before checkout.    On his tenth session Wayne tells you that he would like to give resistance training a try. Wayne only has 1 hour to complete his exercise prescription in cardiac rehab, but is open to exercise on his off days. He reports walking for 30 minutes outside on days he does not attend CR.    How would you adapt Wayne’s exercise program? Clearly identify the FITT for aerobic and resistance training and program it to be realistically completed during a 1 hour CR session AND any guidelines for exercise outside of CR. 

Caleb recovers well enough to be discharged from the hospital. He also begins to undergo additional testing for lung transplantation eligibility. After assessment by the lung transplant team, he is placed on the transplant waiting list with a lung allocation scale of 68. He is unable to continue participating in PR due to his deteriorating condition and begins using supplemental oxygen at home. He also moves into an apartment with his mother, which is closer to the lung transplant center. After 5 months on the wait list, Caleb receives a double lung transplant from an adult male cadaver donor. Following a 14-hour surgery, he is transferred to ICU, place on mechanical ventilation. On day 2 post-op he is weaned from mechanical ventilation and displays no complications or signs of acute organ rejection. On day 4 he is transferred from ICU to a hospital ward. On day 15 he is discharged to his local apartment. Immediately following the procedure, he is placed on immunosuppressant regime including prednisone, tacrolimus, and mycophenolate mofetil.   For the first 3 months post-transplant he is followed by the transplant team for weekly medical checkups and attends a pulmonary rehab program 2-3x a week.   Pre-Transplant 6MWT (5 weeks prior)   Pretest Posttest HR 97 126 BP 136/88 150/92 SpO2% 88 74 RPE- SOB 4 9 REP- leg fatigue 2 7 Total Distance: 390m Rest Breaks: 1 Supplemental O2: Venturi mask, FiO2= 34% Walking aid: rollator   Post-Transplant 6MWT (12 weeks post)   Pretest Posttest HR 84 116 BP 130/84 146/82 SpO2% 95 92 RPE- SOB 0 3 REP- leg fatigue 0.5 7 Total Distance: 530m Rest Breaks: 0 Supplemental O2: none Walking aid: none   Assume your PR program is AACVPR certfied. This means you must address assessment, planning, reassessment, and discharge plans for each of the following components: exercise, nutrition, psychosocial, supplemental oxygen, and other core components/risk factors (as required for individual patients).     Describe how you will assess, plan, and reassess the psychosocial aspect for Caleb in PR? (6pts) What member(s) of the interdisciplinary team is most appropriate to provide education and guidance on this topic? (2pts)

One day, Caleb comes to PR complaining of a worsening productive cough (thick dark green sputum), dyspnea, occasional hemoptysis, fatigue, and weight loss. You encourage Caleb to see his physician or go to urgent care. He follows your instructions and is ultimately admitted to the hospital due to respiratory compromise and an antibiotic resistant Staphylococcus aureus inflection. Additional information from his hospitalization is found below.   Arterial Blood Gases: ·      pH: 7.3 ·      PaCO2: 110 ·      HCO3-: 52 ·      PaO2: 45             Is HCO3- normal or abnormal?

Per textbook, which one is not part of the System Request template?

If Wayne were to develop the following EKG rhythm change from rest to exercise on a treadmill, what would be the most appropriate response?  

If Wayne were to develop the following EKG rhythm change from rest to exercise on a treadmill, what would be an appropriate response?  

You created an exercise program for Wayne that includes resistance training at his request. However, he consistenlty reports NOT completing it. One day he states, ” I want to be stronger, but I just don’t have the time to do it all.”   Write a COMPLEX reflection that could further evoke discussions about change with Wayne. 

Which of the following statements best distinguishes a non-functional requirement from a functional requirement?

In response to Wayne’s onset of worsening symptoms, his physican ordered a resting echocardiogram. Findings suggested normal systolic function with a LVEF of 65%. However, there was severe aortic stenosis moderate aortic regurgitation. A left heart cathererization with magnetic resonance aortography was completed prior to an aortic valve replacement surgery via open heart surgery. There were no complications with the procedure.    Wayne was discharged from the hospital after 3 days and plans to attend phase 2 cardiac rehab.   Which of the following would be considered signs or symptoms of sternal dehiscence (total or partial separation of the sternal wound edges) that medical providers would encourage Wayne to monitor/watch for? (select all that apply)    

Barb is a 60yoa female referred by her physican to your phase II cardiac rehab program due to her CVD risk factor profile and a graded exercise test (GXT) that was positive for ST segment depression. A brief synopsis of Barb’s medical history, recent labs, and GXT are shown below.   Family History: mother had a CABG procedure at age 58; older sister also had a stent placed at age 60 Medications: spironolactone 50mg x 2 daily; amlodipine 100mg x 1 daily Tobacco Use: former smoker; quit 20 years ago   Height: 5′ 3”                Weight: 162lbs                      Waist Circumference: 33in Fasting Blood Glucose 110 mg/dL Urea nitrogen 10 mg/dL Creatinine 1.2 mg/dL Sodium 136 mmol/L Potassium 3.6 mmol/L Chloride 105mmol/L Total Cholesterol 192 mg/dL Triglycerides 195 mg/dL HDL-C 44 mg/dL LDL 102 mg/dL Aspartate aminotransferase (AST) 35 U/L Alanin aminotransferase (ALT) 42 U/L HbA1C 45 mmol/mol   Graded Exercise Test: Resting HR: 80bpm            Supine BP: 138/80            Standing BP: 140/82 Time Speed (mph) Grade (%) HR BP RPE MET Symptoms (0-4 scale) ECG 1 1.7 10 89         .5mm horizontal ST dep. 2 1.7 10 92         .5mm horizontal ST dep. 3 1.7 10 109 154/84 14 4.7   .5mm horizontal ST dep. 4 2.5 12 123         1mm horizontal ST dep. 5 2.5 12 136         1mm horizontal ST dep. 6 2.5 12 152 182/84 19 7.0   1.5mm horizontal ST dep. 7 1.7 0 140         1mm horizontal ST dep. 8 1.7 0 136 166/84       .5mm horizontal ST dep. 9 1.7 0 132         .5mm horizontal ST dep. 10 1.7 0 134 152/84       .5mm horizontal ST dep. 11 Resting seated 115         .5mm horizontal ST dep. 12 Resting seated 107 136/82       NSR   Which of Barb’s lab results were abnormal?