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CHAPTER 4. CARDIAC, VASCULAR, AND PULMONARY SYSTEMS

A 72-year-old patient has been diagnosed with atrial flutter and pneumonia and is resting in his room in the inpatient hospital. The physical therapist is going to evaluate the patient and is doing a chart review. In examining the patient’s ECG/EKG cardiac strips, which of the following would indicate the patient’s cardiac diagnosis?

A. Sawtooth pattern

B. Prolonged PR interval

C. Absence of P wave

D. Elevated ST segment

The answer is A.

  • Sawtooth patterns are a hallmark sign of atrial flutter.

  • Prolonged PR interval is indicative of block at the SA or AV node.

  • Absence of a P wave indicates lack of SA activity.

  • Elevated ST segment indicates MI or ventricular involvement.

A 65-year-old patient is being seen at a Phase I cardiac rehabilitation program. She is being monitored for exercise response and tolerance. Which of the following symptoms would necessitate the ceasing of exercise activity?

A. RPE of 9 (6-20 scale)

B. Diastolic BP that remains the same level at rest and with exercise

C. Persistent dyspnea and diaphoresis

D. HR increases to 15 beats/min over resting rate

The answer is C.

  • A patient exhibiting persistent dyspnea (difficulty breathing) and diaphoresis demonstrates inadequate compensation for exercise demands.

  • RPE of 9 represents a “fairly light” exertion perception from the patient.

  • Diastolic BP may remain the same level or may slightly elevate during exercise due to vasodilation response due to increased cardiac output, which may maintain diastolic BP, slightly decrease, or slightly increase with increased work.

  • Increase of 15 beats/min can be within an expected range of increased HR with exercise.

A physical therapist assistant is helping to conduct a community health education class for patients at risk for developing heart disease. One of the participants raises the question of cholesterol levels on her blood panel laboratory results and wants to understand better how the “bad” cholesterol links to atherosclerosis and CAD. Which would be the correct response?

A. Elevated levels of high-density lipoprotein increase the risk of developing CAD.

B. Elevated levels of low-density lipoprotein increase the risk of developing CAD.

C. All cholesterol is bad, and totals should be below 200 mg/dL.

D. Cholesterol is not an important factor in the risk for developing CAD, and the triglycerides should ...

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