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Delayed growth and puberty
Rehabilitation considerations for pts with pituitary dysfunction
Encouraged to ambulate within 24 hrs of sugery
Increased awareness for signs of hypoglycemia
Bilateral carpal tunnel syndrome-hyperpituitarism
Orthostatic hypotension- hypopituitarism
Bilateral heminopsia- hypopituitaryism
Hypofunctioning of the adrenal cortex
Shock and Death if left untreated
Proximal muscle weakness
Myalgia, Trigger points
Increased menstural bleeding
Increased hair loss
Thyroid gland overactive
Mild enlargement of the thyroid (goiter)
Diabetes Type 1
5-10% of all cases
KETOACIDOSIS can OCCUR
Insulin injection, exercise, diet
Diabetes Type 2
Onset Over 40 years old
90-95% all cases
Insulin production variable
Weightloss oral insulin exercise diet
Left upper quadrant pain
Right upper quadrant
Left lower quadrant
Right Lower Quadrant
Exercise recomendations during pregnancy
Mild to moderate exercise
Avoid exercise in the supine position after the first trimester
Ensure an adequate diet/hydration
Absolute Contraindications to exercise during pregnancy
Pregnancy induced HTN
Preterm rupture of membrane
Preterm labor during prior or current pregnancy
Persistent second and third trimester bleeding
Intrauterine growth retardation
Maternal heart disease, thyroid disease, or serious respiratory disorder
Maternal type 1 diabetes
Precautions to exercise during pregnancy
Musculoskeletal complains and pain
Extreme obesity or extreme underweight
Respiratory changes during pregnancy
Tidal volume and minute ventilation increase. Total lung capacity is unchanged
15-20% increase in oxygen consumption as a natural state of hyperventilation occurs to meet oxygen demands.
Dyspnea is present with mild exercise.
Pressure on the inferior VC
Occurs in late pregnancy esp in the supine position because of compression by the uterus just below the diaphragm.
In some cases the decline in venous return can result in a decrease in cardiac output which may lead to
sypine hypotensive syndrome.
BP during pregnancy
Decreases in the first trimester.
Slight decrease of systolic BP and a greater decrease in diastolic BP
Then increases after mid pregnancy to reach preppregnant levels 6 weeks after.
Heart during preganancy
Increases in size
Elevated because of the diaphragm
Heart Rate During pregnancy
Increases 10-20 beats per min returns to normal 6 wees after delivery.
Cardiac output during pregnancy
Most synificantly increased when in Left side lying. In which the uterus places the LEAST PRESSURE ON THE AORTA.
Stretch and pressure on the pudendal nerve occurs during labor as the babies head travels through the birth canal
Stretch can be as much as 20% total length of the nerve.
Innervates the pelvic floor.
Energy needs during pregnancy
Extra 500 calories if exercising
300 in not exercising
Do not exceed _ of supine positioning
5 min after the first trimester to avoid vena cava compression by the uterus.
Discontinue exercise and contact a physician if
Persistant pain in the chest, pelvic girdle or low back
Leakage of amniotic fluid
Uterine contractions that last beyond the exercise sessions
Decreased fetal movements
Irregular heart beat
Swelling/pain in the calf
Unsafe postures and exercises during preganancy
Leg lowering exercises
Knee-chest position with buttocks elevated about heart- air embolism
Fire Hyrdrant and Quadruped hip extension should be performed with caution only going to physiologic end range.
Unilateral WB positions.
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