activity and fatigue pt 1

1. Benefits of exercise - heart health - muscle atrophy - insulin sensitivity - release endorphins - lungs and brains - improve self esteem - lower rates of mortality - exercise is the normal 2. activity tolerance amount you can perform without hurting yourself 3. intolerance ex like trying to put a triple A battery into a TESLA it doesn't work 4. fatigue - subjective feeling - lack of energy - battery that needs to be recharged 5. fatigue can be - physiologic - psychological - pathologic - pharmacological - unknown 6. physiologic ex - heat wave - working 12 hr shift 7. psychological ex monotony (lack of variety) 8. pathologic ex cancer 9. pharmacological ex chemotherapy 10. unknown ex 1 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb - CFS - very vague - non specific syndrome 11. Myalgic encephalmoyelitis (ME) aka chronic fatigue syndrome 12. ME - aches + pains in muscles - pain in joint w/o swelling or erythema - new or more severe headaches - recurring sore throat - night sweats/chills - new sensitivities/allergies to substances like food or noise - tenderness in neck/armpit lymph nodes - all self reported, non specific symptoms 13. acute fatigue - rapid onset - < 4 weeks - from short term sleep loss or heavy exercise 14. chronic fatigue - > 6 months - ME disabling fatigue - nonspecific symptoms 15. chronic fatigue associated w chronic diseases - fibromyalgia - depression - IBS 16. CFS/ME 3 symptoms required for diagnosis - SAS - alterations in sleep - dec ability to participate in activities that were common before disease ( > 6 2 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb months) - inc symptoms following physical or mental activity that were not present prior to disease 17. treatment for CFS/ME - education - emotional support - treatment of symptoms - overall management - structured activity program 18. CFS education awareness of condition can be validating 19. CFS emotional support support group/ involve community 20. CFS treatment of symptoms eliminate factors like - late caffeine consumption - doom scrolling 21. CFS overall management - eating well - getting right nutrients 22. CFS structured activity program - inc depression w less structure - ex covid 23. Musculoskeletal nursing interventions - encourage active ROM in lower limbs - repositioning every 2 hrs - pt can engage in assisted resistance training esp in lower legs prevents clots 24. Musculoskeletal potential consequences pt 1 - lower limbs tend to atrophy - fast twitch muscles (arm + legs) are lost quicker but slow twitch also lost - dec glycogen storage which is what feeds muscles 3 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb - cortisol release breaks down muscle - Unsteadiness due to back muscle and stabilizing muscle being broken down 25. Musculoskeletal potential consequences pt 2 - tendons, ligaments, cartilage require movement to stay healthy - contracture is a permanent shortening of tissue - bone - blunted baroreceptors 26. Musculoskeletal contracture - these can happen very quickly (<8 hrs) w immobility - foot drop caused by contracture or deformity 27. Musculoskeletal bone - osteoclasts breakdown bone - compact and cancellous bone types are both lost during immobility - yellow marrow (fattier) inc w immobility - red marrow 28. Musculoskeletal blunted baroreceptors baroreceptors see low blood volume —> tell arteries to dilate —> stand up; sudden rush of blood/increased vol —> no slowing of sudden flow of blood bc still dilated (rain stick analogy 29. cardiovascular postural hypotension where blood pressure drops significantly when a person stands up from a sitting or lying position 4 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb 30. cardiovascular cardiac muscle atrophy - SV dec causing cardiac muscle to atrophy - even small ankle movements could help this 31. stroke volume decrease caused by ANP diuresis in kidneys dec plasma volume and therefore blood volume 32. Cardiovascular postural hypotension nursing intervention - have patient sit first and dangle legs for a while - after have them stand slowly to prevent dizziness 33. Cardiovascular cardiac muscle atrophy nursing intervention - promote early movement when possible for pt - include calf pump exercises to help venous return + help maintain stroke volume 34. Cardiovascular potential consequences - postural hypotension - cardiac muscle atrophy - water loss + cardiac reconditioning - diastolic vol dec then SV dec - CRP + cystatin C inc - hematocrit inc and eryhtrocyte count dec 35. Water loss and cardiac deconditioning - no encouragement of lymph to blood to circulate - blood shifts from legs to chest - inc in sodium excretion by kidneys 5 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb 36. blood shifts from legs to chest - inc in intracardiac pressure - ANP is then released which inc urine output and dec blood volume, causes ADH to make the body hold onto water. - ADH and ANP usually work well together but during bedrest, it is disrupted 37. Increase in sodium excretion by kidneys So much dehydration and orthostatic hypotension 38. Respiratory effects - decreased tidal volume - decreased forced vital capacity - decreased residual volume - mucus pooling - costovertebral joints stiffen 39. decreased tidal volume - Due to structural changes to ribcage and costovertebral joints in supine position, more pressure put on lungs - 78% of tidal exchange is due to motion of the ribcage, weight of body on ribcage reduces tidal volume 40. Decreased Forced vital capacity (FVC) - due to airway obstruction (mucus) and loss of elastic recoil during structural changes in supine position - abdominal organs shift upwards and weigh on diaphragm 41. Decreased residual volume due to organ shift putting pressure on diaphragm and inc pulmonary blood volume 42. mucus pooling 6 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb - due to gravity - reduction in mucus + reduction in airway size leads to labored breathing - great risk for respiratory tract infection (RTI) 43. Respiratory nursing interventions - Coughing and deep breathing every hour - Adjust their position (Fowler position) with a pillow or headrest - Spirometer - Listen to music in bed for patients, it can help with happiness - Get out of bed as much as possible 44. respiratory other Potential consequences - Loss of plasma volume leads to increased blood viscosity - Decrease in oxygen carrying capacity on RBC - VO2 max reduction - Virchows Triad 45. Virchows Triad - venous stasis - hyper-coagulability - blood vessel damage - when all 3 together the risk of DVT inc 46. venous stasis reduced skeletal muscle pump 47. Hypercoagulability poor blood flow and pooling leads to clots 48. blood vessel damage warfarin helps with this 49. Virchow's triad causes for a great risk of - embolisation w DVT - clots can move to heart + kill 7 / 8 activity + fatigue part 1 Study online at https://quizlet.com/_hq4atb 50. reproductive - Dec in circulating sex hormones - Active sex life helps a stable menstrual cycle - Reduction of estrogen and androgens which can hurt bone health - Reduce ability to get pregnant