• Subject Name : Nursing

Evaluation and Assessment of Blood Pressure - Learning Experience 1

I found that with the inclusion of mild to moderate exercises the blood pressure tends to regulate in the body. This can be observed as a normal cardiovascular response of the body towards exercises. However, this spike in the blood pressure returned back to normal on rest. This is a direct reflection of my sound cardiovascular functioning and status (Wolsk, 2017). Systolic pressure was found to rise with the heartbeat, whereas, the diastolic blood pressure, varied as observed occurring during deviation in heart rate readings monitored during exercises.

The person in the case study is a hypertensive and also has a higher age limit. For this person the most recommended for of exercises are aerobic exercises. Aerobic exercises however, put an additional pressure on the heart to perform more, but in the long run it can help with regulation of cardiovascular parameters (Ferrari, 2017). For this person a moderate intensity exercises will be the best possible exercise regimen. The following protocol can be followed:

  • Warm-up session- This can be included of dynamic stretching of large group of body muscles. It will help in increasing the heart rate of the subject in the given case scenario.
  • Walking on the treadmill- This can be done for about 15-20 minutes. The person can either walk on it normally or can do a brisk walking in the last 5 minutes. The duration and intensity of the walking in the treadmill can be increased progressively.
  • Cool down session- This is helpful in lowering down the increase in the heart rate attained during peak exercises. This is also crucial from the point of view of cramping of large group of muscles.
  • Stretching- This can be done for leg muscles, focusing on calf muscles mainly.

Along with aerobic group of exercises, the person can be given a protocol of resistance training as well (Anunciação, 2016). This is important from the point of view of promoting muscles strengths as well along with building its endurance. This can be done two times per week, along with the aerobic exercises, to be done at least five times in a week. Some of the recommended exercises can be as follow:

  • Leg extension
  • Leg curls
  • Bench press
  • Dumbbell shoulder exercises
  • Triceps kickback exercises
  • Bicep curls
  • Side crunches
  • Back abdominals

All of these group of muscle exercises can be followed by a cool down period of static stretches, covering both upper and lower body muscles.

Evaluation and Assessment of Blood Pressure - Learning Experience 2

The list of contradictory exercises done in the past can include the following:

  • Bench press- This exercise is mainly done in an arched back position. It puts an additional pressure in the lumbar spine of the body. This exercise can also exert an additional pressure on the lower limb. If the person is not able to maintain a good balance and a strong hold of the ground with their feet, a jerk can cause a snapping injury to the spine. For doing this exercise optimally, the back as well as the lower body should be strongly supported and should be maintained in a 90-degree angle positioning. Doing this exercise in expert’s company is also mandatory (Vera, 2018).
  • Military press- This exercise also places an additional stress on the body as the spine is arched back in this exercise. The exercise has a potential risk of developing lumbar spondylosis in the person and thus, leading to more complications.
  • Back hyperextension- In this exercise, the majority of the back portion is left unsupported. If the person loses balance and there is an unsupported and ballistic movement of the spine. It can lead to snapping injury of the spine caused due to hyperextension of spine beyond the restricted range (Ronai, 2019).
  • Chest fly- This includes the hyperextension of the shoulder muscles and pectorals muscles in particular. If the person is having an instability in the shoulder joint, it can lead to an injury to the acromioclavicular joint due to excessive traction placed on the joint (Beck, 2017).

Evaluation and Assessment of Blood Pressure - Learning Experience 3

These above-mentioned exercises are all to be done at an advance level. Usually in an exercise setting, these exercises are asked to be done by the people at a very early age, without having a detailed knowledge about the person’s mental and physical health level. The strength to perform such strenuous exercises, should not be there in each individual. The exercise regimen should be based on increasing the joint flexibility, before subjecting the person to strength training exercises. The focus should also be highlighted on engaging the person in developing strength and endurance of the person, so that they can get acclimatize to the slow and progressive exercise regimen, designed in sync with the person’s individual limits and considerations. The exercise regimen should also be inclusive of various other activities such as yoga, thia-chi, meditation, Zumba and other recreational activities.

Evaluation and Assessment of Blood Pressure - Learning Experience 4

Between males and females, females are more likely to have knee problems. From the anatomical point of view, the Q angle between femur and tibia in the women knee is greater than the Q angle in males. This leads the knee to be predisposed to a greater amount of stress and torsion. This biomechanical aspect of knee joint is a potential factor to cause knee injury in females and thus, leading to a higher incidence of knee problems. Patellar tracking is a condition in which patella, also commonly known as knee cap shifts from its anatomical position, causing instability in the knee joint and in the movement of lower leg. It can lead to severe injury if left untreated. The main reason for this condition is weak thigh muscle or due to any traumatic injury (Şener, 2019). The most preferred choice of exercise for correcting this condition, can be considered to be quadriceps strengthening. This is also useful in strengthening the tendons and ligaments around the knee joint.

Evaluation and Assessment of Blood Pressure - Learning Experience 5

People suffering from asthma and emphysema can develop COPD. People having a genetic predisposition to this condition are also likely to develop the disease. Cystic fibrosis is also a condition that might end up in the person developing COPD.

The most common form of drugs can be as follow:

  • Short-acting bronchodilators.
  • Long-acting bronchodilators.
  • Corticosteroids (available in the form of inhalers).
  • Methylxanthines (these medications help in muscle relaxation and are anti-inflammatory in nature).
  • Combination drugs

Moderate intensity of aerobic exercises will be the best option for someone with mild to moderate level of COPD (Sawyer, 2020). These exercise regimens can be done for 30-40 minutes, five times per week. It can be inclusive of exercises such as cycling, swimming, brisk walking. Mainly considering rhythmic group exercises for targeting the larger group of body muscles such as calves, biceps, triceps etc.

Exercises done at an intensity of 3-4 METS, can be deemed as moderate-intensity exercises (Byrd, 2019). It is quite feasible to do these exercises for any individual, even with certain restrictions such as age, clinical conditions etc. Exercises done at an intensity of 5-6 METS, can be deemed as vigorous intensity exercises (Byrd, 2019). This can only be done by athletes, who have a strong cardiovascular functioning and can get their resting heart rate back to normal, within short span of time after attaining a peak.

References for Evaluation and Assessment of Blood Pressure

Anunciação, P. G., Farinatti, P. T., Goessler, K. F., Casonatto, J., & Polito, M. D. (2016). Blood pressure and autonomic responses following isolated and combined aerobic and resistance exercise in hypertensive older women. Clinical and Experimental Hypertension38(8), 710-714. https://doi.org/10.1080/10641963.2016.1200601

Beck, B. R., Daly, R. M., Singh, M. A. F., & Taaffe, D. R. (2017). Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. Journal of Science and Medicine in Sport20(5), 438-445. https://doi.org/10.1016/j.jsams.2016.10.001

Byrd, B. R., Keith, J., Keeling, S. M., Weatherwax, R. M., Nolan, P. B., Ramos, J. S., & Dalleck, L. C. (2019). Personalized moderate-intensity exercise training combined with High-Intensity Interval Training Enhances Training responsiveness. International Journal of Environmental Research and Public Health16(12), 20-88. https://doi.org/10.3390/ijerph16122088

Ferrari, R., Umpierre, D., Vogel, G., Vieira, P. J., Santos, L. P., de Mello, R. B., ... & Fuchs, S. C. (2017). Effects of concurrent and aerobic exercises on postexercise hypotension in elderly hypertensive men. Experimental Gerontology98, 1-7. https://doi.org/10.1016/j.exger.2017.08.012

Ronai, P. (2019). Exercise Recommendations for Cardiac Persons with Chronic Nonspecific Low Back Pain. Journal of Clinical Exercise Physiology8(4), 144-156. https://doi.org/10.31189/2165-6193-8.4.144

Sawyer, A., Cavalheri, V., & Hill, K. (2020). Effects of high intensity interval training on exercise capacity in people with chronic pulmonary conditions: A narrative review. BMC Sports Science, Medicine and Rehabilitation12, 1-10. https://doi.org/10.1186/s13102-020-00167-y

Şener, O. A., & Durmaz, M. (2019). Effect of Sport Training and Education on Q Angle in Young Males and Females. Journal of Education and Training Studies7(7), 17-21. https://doi.org/10.11114/jets.v7i7.4133

Vera, J., Jiménez, R., Redondo, B., Cárdenas, D., & García-Ramos, A. (2018). Fitness level modulates intraocular pressure responses to strength exercises. Current Eye Research43(6), 740-746. https://doi.org/10.1080/02713683.2018.1431289

Wolsk, E., Bakkestrøm, R., Thomsen, J. H., Balling, L., Andersen, M. J., Dahl, J. S., ... & Gustafsson, F. (2017). The influence of age on hemodynamic parameters during rest and exercise in healthy individuals. JACC: Heart Failure5(5), 337-346. 10.1016/j.jchf.2016.10.012

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