Strapless Heart Rate Monitor Watch

I would like to find a bicycle with a built-in computer with sensors in the hand-grips (similar to those on some work-out exercise cycles found in health clubs) that provides feedback on heart rate, calorie burn, distance covered and average speed. I wonder if such a bicycle could include sattelite navigation>

the only bikes with builtin computers are usually stationary exercise bikes
you will need to buy these things and install them on your bike
Garmin makes the best GPS systems, and some are integrated with the other info (ie. mph, cadence, heartrate, etc.)
plan on spending 300 to 500 if you want absolutely everything that is available

I.Patient’s Profile

General Data

NameF.B.
Age59 years old
SexMale
Civil StatusMarried
OccupationHousewife

History of Present Illness

The patient has a known case of Rheumatic Heart Disease (RHD). Patient underwent Mitral Valve Repair (MVR) in 1999 and has been on Coumadin therapy with no regular follow up of bleeding parameters.
Six days prior to admission, patient experienced headache and dizziness, but no consult was made. Instead, patient self-medicated with Bonamine which afforded relief.
Three days prior to admission, headache persisted with increased severity, which prompted patient to seek medical assistance at FEU Hospital. Mobic and Iterax were given.
Few hours prior to admission, patient was noted to have changes in sensorium and relatives decided to seek consult at Philippine Heart Center.
Upon admission, patient was noted to be unresponsive, stuporous, and speechless, with GCS of 7 (E2V1M4).

Past Medical History

The patient has denies any history of Diabetes Mellitus and Hypertension. As mentioned, she had a history of Rheumatic Heart Disease and had Mitral Valve Repair in 1999. She is a non-smoker and non alcoholic drinker.

Nursing Assessment (Problem-Based)

Neurologic:
LOC: drowsy to stuporous, 3-4 mm pupil size anisocoric, with brisk reaction to light; GCS – 9 (E4- Spontaneous eye opening V1- none/mechanical ventilation M4 – withdraws to pain) (+) doll’s eye reflex (+) babinski on right foot (-) corneal reflex, no visual threat

Respiratory
Patient is hooked to a mechanical ventilator through a tracheostomy. Ventilator set-up: 350/30/14/AC/5. (+) crackles on both lung fields. With equal breath sounds.

Cardiac
With atrial fibrillation; fine course, with occasional unifocal PVC’s. HR = 97 BP= 120’s-130’s/60’s-70’s.

Musculo-Skeletal
No contractures noted but there was stiffness noted at the right wrists and both ankle joints; with normal muscle tone and non-spontaneous movement; with severe weakness on both upper and lower extremities.

Hematologic
Latest PTPA: INR = 1.02 Act = 98%

II.Anatomy and Physiology of the Brain

Blood Supply of the Brain

The blood supply of the brain derives from the aortic arch via the right innominate, left common carotid and left subclavian arteries. It includes the conducting and penetrating vessels.
The venous system draining the brain is divided into vertebral veins that receive blood from the cerebellum. The cerebral veins have no valves. All the veins of the brain terminate into dural sinuses.

External Brain Structures

The brain is grossly divided into three main areas: the cerebrum, the brain stem and the cerebellum.
The largest portion of the brain is the cerebrum. It consists of two hemispheres that are connected together at the corpus callosum. The cerebrum is often divided into five lobes that are responsible for different brain functions. The cerebrum’s surface—the neocortex—is convoluted into hundreds of folds. The neocortex is where all the higher brain functions take place.

The cerebellum lies in the posterior fossa, separated from the cerebrum by tentorium cerebelli. It exerts ipsilateral control. It has three principal lobes. The Flocculonodular lobe is part of the vestibular system. It controls muscle tone, equilibrium and body position. The Anterior lobe receives most of the proprioreceptive and interoceptive input from head and body. It controls automatic movements and coordination. The posterior lobe coordinates voluntary movement.

The ventricles

The ventricles are a complex series of spaces and tunnels through the center of the brain. They secrete cerebrospinal fluid, which suspends the brain in the skull. They also provide a route for chemical messengers that are widely distributed through the central nervous system.

Cerebrospinal fluid

Cerebrospinal fluid (CSF) is a colorless liquid that bathes the brain and spine. It is formed within the ventricles of the brain, and it circulates throughout the central nervous system. It fills the ventricles and meninges, allowing the brain to “float” within the skull.

The Meninges

The meninges are layers of tissue that separate the skull and the brain.
The Dura mater is the tough and fibrous membrane. The Arachnoid membrane is the delicate membrane and contains subarachnoid fluid. Pia mater is the vascular membrane.
The subarachnoid space is fprmed by the arachnoid membrane and the pia mater.

Normal Flow of Cerebrospinal Fluid
Cerebrospinal fluid is produced in the Choroid plexuses of the ventricle. It flows from the lateral ventricles to the third ventricle passing through the interventricular foramen. Then it goes through the cerebral aqueduct to the fourth ventricle. From there fluid flows to the subarachnoid cisterns through the foramina of Magendie and Luschka to bathe the cerebral hemispheres. It exits through the saggital sinus to be absorbed by the arachnoid villi.

III.Pathophysiology of Subarachnoid Hemorrhage (SAH)

The term subarachnoid hemorrhage (SAH) refers to extravasation of blood into the subarachnoid space between the pial and arachnoid membranes. SAH comprises half of spontaneous atraumatic intracranial hemorrhages, the other half consist of bleeding that occurs within the brain parenchyma. Intracranial hemorrhage as a whole comprises 20% of all strokes.
Nontraumatic SAH usually is the result of a ruptured cerebral aneurysm or AVM. Blood extravasation into the subarachnoid space has a detrimental effect on both local and global brain function and leads to high morbidity and mortality rates.
The classic clinical picture of SAH is marked by the onset of very severe headache, tagged as the “worst in life”. Other associated signs and symptoms are loss of consciousness, seizures, diplopia and focal neurologic signs.
The early complications of SAH are rebleeding and hydrocephalus. Other complications include vasospasm, neurologic deficits, hypothalamic dysfunction and hyponatremia. Vasospasm from arterial smooth muscle contraction is symptomatic in 36% of patients. Neurologic deficits from cerebral ischemia peak at days 4-12. Hypothalamic dysfunction causes excessive sympathetic stimulation, which may lead to myocardial ischemia or labile detrimental BP. Hyponatremia may result from cerebral salt wasting (SIADH). Nosocomial pneumonia and other complications of critical care may occur.

Pathophysiology Diagram

Pathological Cycle Resulting from Increased Intracranial Pressure

Surgical Treatment

Ventriculo-peritoneal Shunting

The ventriculo-peritoneal shunt diverts CSF from a lateral ventricle or the spinal subarachnoid space to the peritoneal cavity. A tube is passed from the lateral ventricle through an occipital burr-hole subcutaneously through the posterior aspect of neck and paraspinal region to the peritoneal cavity through a small incision in the right lower quadrant.

IV.Nursing Diagnoses

1.Ineffective Breathing Pattern r/t neuromuscular impairment
2.Ineffective airway clearance related totracheobronchial secretions
3.Altered Level of Consciousness r/t decreased cerebral perfusion
4.Impaired Physical Mobility r/t neuromuscular impairment
5.Risk for Injury r/t possible shunt malfunction
6.Risk for Infection r/t post-surgical wound

V.Discharge Care Plan (METHODS)

MEDICATION
•Reinforce importance of medication compliance to patient and her relatives; its time, frequency, duration dosage and route.
•Advice to report unusual manifestations and side effects of drugs to physician.
•Monitor and evaluate effectiveness of medication regimen.

ENVIRONMENT/ EXERCISE
•Instruct patients watcher to provide calm and non stressful environment to prevent stimuli that could lead to seizures and an increase in Intracranial Pressure
•Advice to limit visitors
•Provide environment within normal room and body temperature.
•Maintain safe environment.
•Institute seizure precaution.
•Initiate positional precaution to prevent increase in intracranial pressure.
•Teach patient’s relative to perform passive range of motion exercises on patient’s extremities.

TREATMENT
•Teach patient’s relatives proper shunt care.
•Teach patient’s relatives how to suction properly.

HEALTH TEACHING ON DISEASE PROCESS
•Explain to patient’s relatives regarding patient’s neurological status and disease process, and its manifestations.
•Discuss possible complications of VP Shunt and its signs and symptoms

OUT PATIENT FOLLOW UP
•Inform relatives regarding importance of compliance on follow-up check up.
•In case of continued Coumadin therapy, stress the importance of regular PTPA monitoring.

Diet
•Refer to dietician for dietary instructions.

SPIRITUAL / SEXUAL
•Encourage patient’s relatives to seek spiritual support.
•Encourage patient’s husband on alternative ways on showing affections such as hugs and kisses.

XI.Bibliography

Nolte, J. The Human Brain: An Introduction to Its Functional Anatomy, Fifth Edition., Mosby, 2002. ISBN: 0-323-01320-1

Stoler, D. Coping with Mild Traumatic Brain Injury, Avery Penguin Putnam, 1998. ISBN: 0895297914

Human Anatomy and Physiology, Fifth Edition., 2000. ISBN: 0805349898.

Zuccarello, M. and McMahon, N. “Subarachnoid Hemorrhage”. www.mayfield.com, June 2004.

Rinkel GJ, Prins NE, Algra A. “Outcome Of Aneurysmal Subarachnoid Hemorrhage In Patients On Anticoagulant Treatment.” www.pubmed.gov, August 28, 2000.

Newton, Todd R., Subarachnoid Hemorrhage. Emedicine from WebMD. www.emedicine.com., December 19, 2005.

Males do not ever get pre-eclampsia, and you'd be hard-pressed to find it in a 59 year old. It is a disease of pregnancy.

This question is unintelligible.

If you have a REAL question, you'll get real help. You won't find anyone here willing to do your assignment for you.

Im taking a 45 min spin/cycle class for beginner/intermediates and im wondering how I can tell how many calories im buring during that class, also I have a hr monitor- is there a way based on my heart rate to find the calories burned???
i have a heart rate monitor -i said that above, how do i tell from that?
does anyone here take spin classes, how do you think its better or worse than tredmill- same time & distance & all??

Get a heart rate monitor - that's the most accurate way to tell.

You can also try www.caloriesperhour.com which will tell you how many calories you can burn doing certain exercises, but it's just a guesstimate based on your height/weight/age. HRM is the way to go. I have a Polar F6 and love it.

Technorati Tags: Strapless Heart Rate Monitor Watch

My husband is 30 years old and has hemocromatosis (high iron blood disorder) This is the results of his holter monitor that he wore for 24 hours. Can any work out what it is saying?

Heart Rates, Min was 37 bpm at 3am, Maximum was at 183bpm at 5.30am. 1323 Beats in Tachycardia, 6744 beats in bradycardia - 1.84 seconds MAX R-R at 2.50am.

Superventriculars (S,J,A) - 321 isolated, 2 Couplets, 202 Bigeminal Cycles, 19 Runs totalling 131 beats, 35 beats longest run 102 bpm at 5.25am. 7 Beats fatest run at 160bpm at 5.23am.

Venticulars - 1 isolated, 0 couplets, 0 bigeminal cycles, 0 running totaling o beats.

The tachycardia listed above was factitious as the software frequently read tall T waves adn R waves or SVE's.

Does anyone have any ideas what these numbers mean?

Thanks for you opinion!

I will do my best

slowest HR is 37 beats per minute
fastest HR was 183 beats per minute

normal HR for adults 60-100
although it may be normal for someone to have a lower or higher HR without meaning something is wrong.

HR below 60 is bradycardia
HR above 100 is tachycardic

He had 1323 beats that were above the rate of 100 beats per minute

6744 beats with a HR below 60

R-R means the tracing that the monitor produces, the highest or lowest (depending on which lead the tracing is being read in) point of the heartbeat 1.84 seconds is the time elapsed between the two R waves, thus measuring the HR

supraventricular- means originating from above the ventricals

He had 321 isolated (PAC) premature atrial contractions
2 couplets meaning a pair or two consectutive PAC's ( normal beat, fast beat, fast beat)
202 bigeminal cycles ( normal beat, fast beat, normal beat, fast beat…….)
19 runs totaling 131 beats ( a run is three or more consective not normal beats) in your husbands case out of the 19 runs the abnormal beats totaled 131 beats
35 abnormal ( fast in your husbands case) consectutive beats in a row was the longest run
During the fastest run the HR got as high as 160 beats per minute

Ventriculars- is a wider complex rhythm and originates lower in the heart that generally result in a slower HR but not always

your husband had only one premature ventricular beat

It goes on to read that the results of the tachycardia were not real due to the machine picking up the T wave reading as a R wave, as I explained the R wave is the tallest point of the EKG reading and if the T wave ( the hump that follows after the R wave) is amplified for some reason ( bad hookup, lead position, machine misreading, or body movement) it will read the HR wrong and sometimes the rhythm.

I hope this helps

The stationary type. So what do I look for when I buy one (apart from the price). I need something that monitors heart rate OR pulse rate, BUT what else should I be looking for??
Do we get folding cycles out there for storage? (coz space is a bit of an issue)…

Do you have back or knee problems? If so, you might want to compare the fit and shape of the bicycle. A more recumbent bike (where you sit like a chair) will be easier on your back. A bike where you lean forward more will allow you to go faster and get a better workout but it undoubtedly puts more strain on the lower back. I personally prefer more recumbent bikes.
Also, the knee should never be straight, always bent even all the way around when you pedal. There's a good picture of this in the link below.

I have now been to three different GPs about my weight gain but none of them will take me seriously. I am a 27 year old female, 164 cm, and I weighed 54-55 kilos this time last year.
Since then I have started gaining weight really rapidly and now weight 68-70 kilos. I have been exercising regularly (3-4 times of high intensity activity a week - I have a Polar heart rate monitor to keep track of what I do) and I watch what I eat but it makes no difference.
I started taking the antidepressant drug Zoloft shortly before this weight gain started. I'm sure this is what must be causing it. But the doctors all say 'no no, you just need to eat better and exercise more'. ARGH! Idiots! Consequently I stopped the antidepressant anyway, about a month ago, but have still put on another kilo in that time.
I just don't know what to do! Is there something I should be demanding of my doctors? Should they be testing for something. And is there anything I can do to stop it in terms of medications?

Zolft can cause you to gain weight that is a known fact. if you are eating right and exercising like you say the weight should be coming off though.

two other reasons for the weight gain might be a thyroid problems - a blood test can check for that.
and PolyCystic Ovary Syndrom which is very common among women in you age group. this can be found by using Ultasound. It causes your body to store fat and not burn calories correctly and also you might have noticed a change in your periods.

just two thoughts.

I am a45 year old female who weighs 159lbs and I'm 5'6" and a UK size 14. I have been going to the gym for the past six weeks, three mornings a week, walking 6.3kmh for 40-60 minutes, recliner cycling for 20minutes at 78-83rpm acheiving 4km in approx 12-20minutes and then a short regime of weights for arms, legs and shoulders and then swimming thirty lengths of a 20 metre pool. I also go to an hour of Pilates one hour a week to tone up. I haven't reduced my calorie intake ASWELL as doing this exercise as I have yoyo dieted for years and what to get off that treadmill. This time I wanted to reduce by upping the exercise. I wear a heart rate monitor and know I don't cheat so why aren't I losing weight or inches? Any ideas? Thank-you.

Sometimes if you exercise alot and more than you are use to doing it will cause you to gain muscle. You have probably lost weight but are adding muscle so it doesn't seem like you are losing anything. If you keep up at the rate you are going you will definitlely see a difference soon.

My friend and I are working on a school project and we decided to do it on a watch having to do with health care. Any suggestions would be nice. We aren't 100% sure what to do it on but we were thinking of an advanced medical watch for diabetics, Alzheimer's, hearing impaired, seniors, heart attacks, strokes, asthma and that had info on the patient, told the time and date (of course), told the heart rate blood sugar, had a button to alert ambulance, had a GPS system. Maybe for athletics too? Pretty much a crazy computer in a watch. What else to add though..we need to add some more really good healthcare things? It's a crazy future watch. The idea sounds crazy but maybe not in the future O_O!

this could be a really great tool for diabetics with poorly controlled blood sugar. it could alert them when their sugar gets too high so that they don't forget to take their medicines. also, if it could have a chip in it with memory, it could be a really helpful tool for the doctors of diabetic patients so that the doctors could observe patterns in the patients blood glucose relative to meals, activities, sleep, etc.

In your experience which is more effective & in what ways? Also Is there a way to estimate calories burned based on your heart rate monitor?

The one you enjoy most will work best for you. Your more likely to do it.

Cycling does it for me I use it for transport, to get out of the house and to sticky beak around the neighborhood. It is also easier on the joints. Riding to a regular destination helps to stick at it.

There is an algorithm to calculate calories used from heart rate. It is quite complicated and not very accurate. You need to know, your height, weight, body mass index, your temperature, ambient temperature, Ambient pressure, height above sea level etc etc etc.

Many heart rate monitors have a simplified calorie counter built in. (if you want a guide.)

My tip is to concentrate on enjoying what you are doing. The weight comes off just the same. Doing calculations and computations doesn't burn many calories at all.