LAB TEST & VALUES
BP 120/80 mmHg ; HTN if 140/90 ; Postural HoTN if SBP drops >20mmHg or standing SBP <100mmhg
HR 60-90 bpm ; 40-60 bpm if AV nodal rhythm (as in SA heart block)
RR 12-20 ; Hyperpnea = increase both rate and depth ; Tachypnea =increase rate only
Pediatric Vitals Low BP (110/60) with high HR (120±50) and RR (30-60)
SaO2 95-99% ; Rx if O2 <88%>O2 80-110 mmHg ; decrease c/ COPD ; increase c/ hyperventilation
PaCO2 35-45 mmHg ; increase c/ COPD ; decrease c/ pregnancy, PE, anxiety (hyperventilation)
pH 7.35-7.45 ; increase c/ hyperventilation, vomiting ; decrease c/ DM, COPD, RF (K+)
K+ 3.5 - 4.5 ; increase K+ = mm flaccidity, decrease HR, tall peaky T
Na+ 135-145 ; increase Na+ = HTN, tachycardia
Ca2+ ; increase Ca2+ = increase heart activity, decrease mm tone ; decrease Ca2+ = mm spasm, cramp, tetanus
PT/PTT 15/40 sec ; PT Tx CI'd if >2.5 x normal value or >30sec ; PT extrinsic ; PTT intrinsic
INR 09-1.1 ; <2.0>2.0 = check with attending pr to Tx ; >3.0 = risk of hemarthrosis c/ activities ; 2.0-3.0 may be normal for pt. c/ anti-coagulant
Bleeding Time 2-10 min
WBC (Leukocytes) 5,000-10,000 ; decrease c/ aplastic anemia or B12 (FA) deficiency (infection related anemia) ; ~5000 light activity only ; <5000 style="color: rgb(0, 102, 0);">RBC (Erythrocytes) 4-6 million ; increase significantly c/ polycythemia
Hct (% RBC in bld) 37-52% ; >25% light activities only ; <25% style="color: rgb(0, 102, 0);">Hgb 12-18 g/dL ; <8> = expect decrease Ex tolerance and Ex may be C/I ; if tachycardia + fatigue = light activities only
Platelet 150K - 450K ; decrease c/ chemotherapy or anemia ; 30-50K MOD activities only ; 20-30K light activities only ; <20k style="font-weight: bold; color: rgb(153, 0, 0);">
LIPID PANEL:
Cholesterol <200>240 high risk
HDL 35-60 ; <35>60 negative risk
LDL <100-160>6.0 high risk ; <0.5-3.0 style="color: rgb(0, 102, 0);">Triglycerides <165>≤200-126 ; fasting glc should be 100-125 ; >250 hyper ; fasting >200 = DM ; <60 style="color: rgb(0, 102, 0);">BMI 18.5-24.9 ; 25-30 over weight ; >30 obesity ; >40 morbid obesity
CARDIAC FUNCTION VALUES
MET 3.5mLO2/kg-min ; VO2 max / 3.5 = MET
RPP = HR x SBP ; increase myocardial oxygen demand with increase HR or increase BP ; thus keeping Ex intensity low or Rx such as calcium-Ch blocker to protect from further injury by keeping th heart workload low
SV = 70mL ; 120-50
CO = ~6mL/min ; CO = SV x HR (0.7 x 60-90)
EF = 60-70% ; EF = SV/LV EDV ; should be at least 0.55 to have sufficient output ; increase LV EDV + decrease SV = indicates CHF ; EF <20 severe heart failure
MAP = 70-110 mmHg ; (SBP+2DBP)/3 ; if <60 may cause ischemia
Ex RX
Intensity is the primary mode to improve cardiovascular endurance and strength training
duration is the primary mode to improve pulmonary aerobic endurance traning
Str Trng : decrease resting BP decrease Rxn time increase mm endurance
CV Endurance Trng : to have aerobic effect allow rhythmic contraction of mm ; ≥ 70% HRMAX ; 13-16/20 RPE (somewhat hard – hard) ; talk test
Pulm Aerobic Trng : cardiac hypertrophy c/ normal respiratory func. ; increase Hgb = increase O2 delievery ; increase CO (SV) ; decrease HRREST decrease BPREST
PFT
COPD Decrease FVC, FEV1, FEV1/FVC ; Increase RV to <70% style="color: rgb(0, 102, 0);">RLD Decrease FVC, FEV1 ; Normal or increase FEV1/FVC; decrease all capacities
BP 120/80 mmHg ; HTN if 140/90 ; Postural HoTN if SBP drops >20mmHg or standing SBP <100mmhg
HR 60-90 bpm ; 40-60 bpm if AV nodal rhythm (as in SA heart block)
RR 12-20 ; Hyperpnea = increase both rate and depth ; Tachypnea =increase rate only
Pediatric Vitals Low BP (110/60) with high HR (120±50) and RR (30-60)
SaO2 95-99% ; Rx if O2 <88%>O2 80-110 mmHg ; decrease c/ COPD ; increase c/ hyperventilation
PaCO2 35-45 mmHg ; increase c/ COPD ; decrease c/ pregnancy, PE, anxiety (hyperventilation)
pH 7.35-7.45 ; increase c/ hyperventilation, vomiting ; decrease c/ DM, COPD, RF (K+)
K+ 3.5 - 4.5 ; increase K+ = mm flaccidity, decrease HR, tall peaky T
Na+ 135-145 ; increase Na+ = HTN, tachycardia
Ca2+ ; increase Ca2+ = increase heart activity, decrease mm tone ; decrease Ca2+ = mm spasm, cramp, tetanus
PT/PTT 15/40 sec ; PT Tx CI'd if >2.5 x normal value or >30sec ; PT extrinsic ; PTT intrinsic
INR 09-1.1 ; <2.0>2.0 = check with attending pr to Tx ; >3.0 = risk of hemarthrosis c/ activities ; 2.0-3.0 may be normal for pt. c/ anti-coagulant
Bleeding Time 2-10 min
WBC (Leukocytes) 5,000-10,000 ; decrease c/ aplastic anemia or B12 (FA) deficiency (infection related anemia) ; ~5000 light activity only ; <5000 style="color: rgb(0, 102, 0);">RBC (Erythrocytes) 4-6 million ; increase significantly c/ polycythemia
Hct (% RBC in bld) 37-52% ; >25% light activities only ; <25% style="color: rgb(0, 102, 0);">Hgb 12-18 g/dL ; <8> = expect decrease Ex tolerance and Ex may be C/I ; if tachycardia + fatigue = light activities only
Platelet 150K - 450K ; decrease c/ chemotherapy or anemia ; 30-50K MOD activities only ; 20-30K light activities only ; <20k style="font-weight: bold; color: rgb(153, 0, 0);">
LIPID PANEL:
Cholesterol <200>240 high risk
HDL 35-60 ; <35>60 negative risk
LDL <100-160>6.0 high risk ; <0.5-3.0 style="color: rgb(0, 102, 0);">Triglycerides <165>≤200-126 ; fasting glc should be 100-125 ; >250 hyper ; fasting >200 = DM ; <60 style="color: rgb(0, 102, 0);">BMI 18.5-24.9 ; 25-30 over weight ; >30 obesity ; >40 morbid obesity
CARDIAC FUNCTION VALUES
MET 3.5mLO2/kg-min ; VO2 max / 3.5 = MET
RPP = HR x SBP ; increase myocardial oxygen demand with increase HR or increase BP ; thus keeping Ex intensity low or Rx such as calcium-Ch blocker to protect from further injury by keeping th heart workload low
SV = 70mL ; 120-50
CO = ~6mL/min ; CO = SV x HR (0.7 x 60-90)
EF = 60-70% ; EF = SV/LV EDV ; should be at least 0.55 to have sufficient output ; increase LV EDV + decrease SV = indicates CHF ; EF <20 severe heart failure
MAP = 70-110 mmHg ; (SBP+2DBP)/3 ; if <60 may cause ischemia
Ex RX
Intensity is the primary mode to improve cardiovascular endurance and strength training
duration is the primary mode to improve pulmonary aerobic endurance traning
Str Trng : decrease resting BP decrease Rxn time increase mm endurance
CV Endurance Trng : to have aerobic effect allow rhythmic contraction of mm ; ≥ 70% HRMAX ; 13-16/20 RPE (somewhat hard – hard) ; talk test
Pulm Aerobic Trng : cardiac hypertrophy c/ normal respiratory func. ; increase Hgb = increase O2 delievery ; increase CO (SV) ; decrease HRREST decrease BPREST
PFT
COPD Decrease FVC, FEV1, FEV1/FVC ; Increase RV to <70% style="color: rgb(0, 102, 0);">RLD Decrease FVC, FEV1 ; Normal or increase FEV1/FVC; decrease all capacities
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