Use new client intake form to qualify client -Assess compatibility, goals, scope, style, schedule -Exchange contact info and schedule preferences -Discuss medical considerations and limitations; assess risk and need for medical release form -Schedule initial client consultation -Provide service intro package - ANSWER Components of Initial Contact/Interview Prep -Process, preparation- what to wear, eat and expect -Day, time, length of next meeting -Remind them about returning completed forms -Allow them to contact you or ask questions - ANSWER What should be communicated to the client about the initial consultation? -AHA/ACSM Health/Fitness facility pre-participation screening questionnare, PAR-Q, informed consent, medical clearance form, waiver, trainer-client contract, HIPAA, organizational procedures and policies - ANSWER What must be completed by client prior to initial client interview? All health history, especially any heart problems or signs and symptoms of CVD -Other diseases such as diabetes, asthma, muscle issues -Recent hospitalizations, illness, diagnoses, or surgical procedures -Work history, espe physical demands -Lab findings such as plasma glucose, serum lipids and lipoproteins, or other significant abnormalities -Previous physical exam findings such as murmurs, clicks, gallops, and other unusual cardiac and vascular findings; as well as abnormal pulmonary findings, high BP and edema -If they are on prescriptions -Risk factors for CVD - ANSWER What does a health/medical history include? PAR-Q or AHA/ACSM Health/Fitness facility pre-participation screening questionnare -CVD risk factor assessment and classification by qualified health/fitness, clinical exercise, or health care professionals -Medical evaluation including a physical exam and stress test by a qualified health care provider - ANSWER What does pre-participation health screening include? -Discomfort (angina, ischemia) in chest, neck, jaw or arms that may result from ischemia -Shortness of breath and rest or with mild exertion -Dizziness or loss of consciousness (syncope) -Bilateral ankle edema -Palpitations or tachycardia -Intermittent claudication (pain in a muscle with inadequate blood supply, usually a result of atherosclerosis)-stressed by exercise -Known heart murmer -Unusual fatigue or shortness of breath with usual activities - ANSWER Signs and symptoms of cardiovascular, metabolic or pulmonary disease -Recent change in ECG suggesting significant ischemia, recent myocardial infarction within two days, or other acute cardiac event -Unstable angina -Uncontrolled cardiac dysrhythmias -Symptomatic, severe aortic stenosis -Uncontrolled, symptomatic heart failure -Acute pulmonary embolos or pulmonary infarction - ANSWER Absolute contraindications to exercise testing -Acute myocarditis or pericarditis -Suspected or known dissecting aneurysm -Acute systemic infection, accompanied by fever, body aches or swollen lymph glands - ANSWER More absolute contraindications to exercise testing -Left main coronary stenosis -Moderate stenotic valvular heart disease -Electrolyte abnormalities -Severe arterial hypotension with SBP> 200, DBP>110 at rest -Tachy/bradydysrhythmias -Hypertrophic cardiomyopthy, or other forms of outflow track obstruction - ANSWER Relative contraindications to exercise testing -Neuromotor, musculoskeletal or rheumatoid disorders that are exascerbated by exercise -High degree AV block -Ventricular aneurysm -Uncontrolled metabolic disease such as diabetes, thyrotoxicosis -Chronic infectious disease such as HIV -Mental or physical impairment leading to inability to exercise adequately - ANSWER Relative contraindications to exercise testing, continued Increase in muscle size from remodeling of proteins- increase of muscle cell size - ANSWER Hypertrophy Muscle wasting. Can occur after prolonged immobility or can be from a disease - ANSWER Atrophy Increase in number of muscle cells or fibers - ANSWER Hyperplasia Medical clearance is recommended when: -An individual has known CV, metabolic or renal disease and is asymptomatic OR -An individual has any signs or symptoms of CV, metabolic or renal disease, regardless of disease status - ANSWER For an inactive person who does not participate in regular exercise, when is medical clearance recommended? Following medical clearance, light to moderate intensity exercise is recommended. May gradually progress as tolerated following ACSM guidelines. - ANSWER After a medical clearance for an inactive person who either has known CV/metabolic/renal disease and is asymptomatic, or an individual who has any signs or symptoms of CV/metabolic/renal disease, regardless of disease status, how should that individual be progressed in an exercise program? NO - ANSWER Does an individual need medical clearance who is not diagnosed with CV, metabolic or renal disease, and shows no symptoms of the above? No medical clearance is needed before beginning an exercise program. It is recommended to start with light to moderate exercise and gradually progress to vigorous intensity exercise, following ACSM guidelines. - ANSWER How would a trainer progress an individual with no diagnosis or signs or symptoms of CV, metabolic or renal disease? The client should discontinue exercise immediately and obtain medical clearance before continuing exercise at any intensity - ANSWER If a patient is already exercising regularly, but has signs or symptoms of CV, metabolic or renal disease, regardless of diagnosis or not, should the client continue exercising? They may continue moderate intensity exercise without medical clearance, but if they want to progress to vigorous intensity exercise it is recommended to get medical clearance first. - ANSWER If a patient has a known history of CV, metabolic or renal disease, but no current signs or symptoms (ie they are stable), should this patient continue exercising? True - ANSWER T/F a client would be classified as low risk who has absence of ventricular dysrhymias during exercise testing and recovery, absence of angina or other significant symptoms such as shortness of breath, light-headedness, or dizziness during exercise testing and recovery, and has presence of normal hemodynamics such as appropriate increases and decreases in HR and SBP during exercise testing and recovery

 

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