pretest considerations for healh appraisal - ANSWER-systematic approach in screening clients for: signs and symptoms, family history, risk factors for disease informed consent - ANSWER-an agreement to do or allow something to occur, made with an awareness of relevant facts, including: procedures, risks, benefits, limitations, and discomforts -legal and ethical document -often paired with release of liability form Par-Q - ANSWER-used for screening Physical Activity Readiness Questionnaire minimal standard for moderate intensity exercise 7 questions; if answered "yes" to any question, then require to get medical release form from healthcare provider physician referral - ANSWER-safeguard for high risk clients who may compromise health with exercise without medically trained staff -physician's name, stating diagnosis, and exercise perscription risk stratification - ANSWER-assigns individuals to low, medium, or high risk based on presence of conditions ACSM risk stratification matrix - ANSWER-makes recommendations based upon low, moderate, or high risk clients positive risk factors - ANSWER-family history of disease cigarette smoking hypertension hyercholesterolemia/dyslipidemia impaired fasting glucose obesity sedentary lifestyle family history of disease - ANSWER-myocardial infarction, coronary revascularization, or sudden death before age 55 in males and 65 females (1st degree relatives) cigarette smoking - ANSWER-currently smoking or quit withing 6 months, or exposed to 2nd hand smoke over 6 months hypertension - ANSWER-clients currently taking antihypertensive medication and/or confirmed (2 separate occasions) 140/90 BP or higher hypercholesterolemia/dyslipdemia - ANSWER-clients currently taking lipid lowering medication and/or those with total serum cholesterol >200 mg/dL, or high density lipoprotein cholesterols of 0.35 mg/dL impaired fasting glucose - ANSWER-fasting blood glucose > or equal to 110 mg/dL (2 separate measurements) obesity - ANSWER-BMI > or equal mg/m^2 or waist girth exceeding approximately 39.4 inches sedentary lifestyle - ANSWER-those not meeting recommended amount of physical activity (at least 30 minutes of physical activity at a moderate intensity 40-60%, at least 3 days a week for at least 3 months) negative risk factors - ANSWER-high serum HDL cholesterol: >60 mg/dL emerging risk factors - ANSWER-inflammatory markers: reactive C protein (CRP) and fibrinogen low risk - ANSWER-men <45>45, women >55, or those who meet the threshold for 2 or more risk factors A) current medical examination and exercise testing prior participation- not necessary for moderate but recommended for vigorous exercise B) physician supervision of exercise tests- not necessary for submax but recommended for maximal tests high risk - ANSWER-1 or more signs and symptoms listed or a known cardiovascular, pulmonary, or metabolic disease A) current medical examination and exercise testing prior participation- recommended for moderate or vigorous exercise B) physician supervision of exercise tests- recommended for submax or maximal tests exercise testing steps - ANSWER-M.R.I.P.L. medical history risk factor assessment interpreting the data (cardio endurance, muscle strength/endurance, flexibility, body comp) prescribing exercise program lifestyle counseling stress test - ANSWER-usually only recommended by physician if the client has symptoms of coronary artery disease, or significant risk factors for CAD do NOT do vigorous exercise with: - ANSWER-clients with diagnosed or present cardio diseases, congenital abnormalities, and/or hereditary abnormalities: hypertrophic cardiomyopathy coronary arter abnormalities aortic stenossi signs/symptoms of cardiovascular and pulmonary disease - ANSWER--pain, discomfort, distress in areas that may be due to ischemia (chest, neck, jaw, arms, etc.) -shortness of breath at rest or mild exertion -dizziness or syncope -edema, especially ankle -tachycardia, or other arrhythmic occurrences (known heart murmur) -orthopnea or paroxysmal dyspnea -intermittent claudication -unusual fatigue or shortness of breath with ADLs ischemia - ANSWER-an inadequate blood supply to an organ or part of the body, especially the heart muscles. -can result in heart attack, can by silent intermediate condition of CAD edema - ANSWER-puffy swelling of tissue from the accumulation of fluid -common in arms, hands, legs, ankles, and feet, face, abdomen *symptoms:* swelling of tissue directly under skin, stretched or shiny skin, skin that pits after being pressed, increased abdominal size -remove salt from clients diet may help with swelling -can be sign of underlying disease (heart failure, kidney disease, cirrhosis of liver etc.) orthopnea - ANSWER-ability to breathe only in an upright position -difficulty breathing in supine position -usually indicative of left ventricular dysfunction paroxysmal dyspnea - ANSWER-sudden, recurring episode of difficult breathing -asthma angina - ANSWER-heart pain -insufficient supply off blood *symptoms:* chest pain/discomfort, pain in neck shoulder back arms or jaw, nausea, fatigue, sweating, shortness of breath, anxiety, dizziness stable angina - ANSWER-most common type