EHR522 Week 1 Tutorial PDF

EHR522: Exercise for Metabolic and Renal Conditions Tutorial One: Scope of Practice Introduction: Diabetes has no current cure and must be managed with a combination of exercise, diet and medications. As a result, it involves a lot of self-management on the part of the client. Diabetics are usually...

EHR522: Exercise for Metabolic and Renal Conditions Tutorial One: Scope of Practice Introduction: Diabetes has no current cure and must be managed with a combination of exercise, diet and medications. As a result, it involves a lot of self-management on the part of the client. Diabetics are usually provided with education and resources to assist them. If left unmanaged, or through disease progression, numerous complications can arise. These complications require the involvement of a number of health care providers depending on the aetiology. The same is true for the progression of renal dysfunction. Given the complications associated with diabetes and renal disease it is highly likely that you will be interacting with a number of different health professionals when managing clients. Your client may have been referred to you by a GP or Dietitian for example, or you may end up referring your client on to another health professional. You will see clients at various stages of disease and various times of life. In this week’s tutorial, we will examine the roles of different health care providers in the treatment and management of metabolic and renal diseases. These professionals can include: • • • • • • • • • • • • • • General Practitioners Dietitians Exercise Physiologists Diabetes Educators Pharmacists Physiotherapists Endocrinologists Specialist Nurses Bariatric Physicians Nephrologists Cardiologists Optometrists Podiatrists Psychologists Activity 1 Looking at the list above, select five (5) of the professionals and describe their role in treating or managing diabetes or renal disease. You may find information in your Clinical Exercise Physiology Textbook (Ehrman) or at the following link: https://www.diabetesaustralia.com.au/living-withdiabetes/just-been-diagnosed/health-care-team/ to assist. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. EP - prescribing exercise - role of exercise in diabetes is to manage blood glucose levels and improving glucose uptake - in renal disease (high blood pressure and hypertension is a side effect .............................................................................................................................................................. of this so EP can assist in the lowering of BP levels Endocrinologist - hormone specialist - review medications .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. Activity 2: While we will be examining Risk Stratification later this semester, I would like you all to be aware of the ESSA Pre-Exercise Screening Tool, the Department of Health risk assessment tool for diabetes and QKidney Risk Calculator (see links at the end of this tutorial). The reason for this is that when you are undertaking pre-exercise screening for a client, you may end up identifying areas of their health which may need to be managed by another health care professional. For example, you may have a client referred to you after recent surgery. When performing your initial health screening, they may present with health risks that they were unaware of. What would you do? Who do you think you would refer your client to? What if they had elevated blood glucose and a BMI>30? Who would you refer them to in that instance? What if they had high blood pressure or elevated blood glucose levels of which they were unaware? Using the following client scenarios, perform risk assessments using the ESSA Pre-Exercise Screening Tool, the Department of Health Risk assessment tool for diabetes and QKidney Risk Calculator. Once you have done that, answer the following questions: Client 1: Mark: age 40, BP 140/100mmHg, smoking status – Yes, Total Cholesterol 5.3mmol/L; HDL 0.9 mmol/L, fasting blood glucose level – 6.7mmol/L, Ht – 180cm, Wt – 106kg, Waist – 99cm; Father died of heart attack aged 61, Accountant from China - appears to be pre diabetic What health risks does Mark present with?: .......................................................................................... - High BP slightly abnormal lipid ................................................................................................................................................................ profile overweight ................................................................................................................................................................ smoking and most likely sedentary lifestyle Name three other health care professionals you may refer Mark to and why: .................................... ................................................................................................................................................................ - GP - Diabetes educator ................................................................................................................................................................ Dietician ................................................................................................................................................................ ................................................................................................................................................................ Client 2: Bruce, age 50, BP – 150/90mmHg, smoking status – Yes, Total Cholesterol – 5.5mmol/L; HDL 1.0mmol/L, blood glucose level – 6.5mmol/L, Ht 178cm, Wt 120kg, WC – 104cm; Rheumatoid arthritis; Father – stroke aged 71 (survived), Mother died of cancer 68, Centrelink clerk, no other activity, Australian of European decent. What health risks does Bruce present with?: ......................................................................................... Text ................................................................................................................................................................ ................................................................................................................................................................ Name three other health care professionals you may refer Bruce to and why: ................................... Text ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ Client 3: Louise, age 60; BP 130/85mmHg, smoking status – N, TC 4.5mmol/L, HDL 1.9mmol/L, blood glucose level – 7.2mmol/L, ht 165cm, Wt 68kg, WC – 88cm; mother died of breast cancer, aged 48, father had stroked, aged 75, died aged 82; had gestational diabetes; walks & goes to Curves 2 x/w, complains that she cannot see properly at night so doesn’t like walking or driving in the evenings. What health risks does Louise present with?: ........................................................................................ Text ................................................................................................................................................................ ................................................................................................................................................................ Name three other health care professionals you may refer Louise to and why: .................................. Text ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ Client 4: Anna, age 50, BP 140/95mmHg, smoking status – N, TC 6.0mmol/L; HDL 0.9mmol/L, blood glucose level – 7.0mmol/L, Ht 160cm, Wt 90kg, WC – 96cm; both parents had diabetes, both deceased, walks the dog daily. Used to do strength training but feels weak in legs and tingly feet so doesn’t like to do it anymore. What health risks does Anna present with?: .......................................................................................... Text ................................................................................................................................................................ ................................................................................................................................................................ Name three other health care professionals you may refer Anna to and why: .................................... ................................................................................................................................................................ Text ................................................................................................................................................................ ................................................................................................................................................................ ................................................................................................................................................................ References: Ehrman (2022) – Chapter 7 – Diabetes ESSA Pre-Screening Tool https://www.essa.org.au/Public/ABOUT_ESSA/Pre-Exercise_Screening_Systems.aspx Diabetes Health Care Team Information https://www.diabetesaustralia.com.au/living-with-diabetes/just-been-diagnosed/health-care-team/ AUSDRISK tool (Diabetes Risk Calculator) https://www.health.gov.au/resources/apps-and-tools/the-australian-type-2-diabetes-riskassessment-tool-ausdrisk/tool Renal Disease Risk Calculator http://www.qkidney.org/