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2) Cardiopulm > 8) Exercise Guidelines (Cardiac Rehab) > Flashcards

8) Exercise Guidelines (Cardiac Rehab) Flashcards

1
Q

Cardiac Rehab

A

Enables pt’s to resume active & productive luves w/in imposed limitations

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2
Q

What are the goals of cardiac rehab?

A
  • Restore optimal physiological, & vocational status
  • Alleviate sx’s
  • Prevents progression of disease
  • Reduce risks of SD & reinfarct
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3
Q

What pt’s are candidates for cardiac rehab?

A
  • MI
  • CABG
  • PTCA/Stents
  • Valve Replacement
  • Heart/Lung Transplant
  • Stable Angina
  • Silent Ischemia
  • High Risk for CHD
  • Congenital heart defect correction
  • CHF
  • Arrythmias
  • PAD
  • 2° & 3° prevention
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4
Q

What does cardiac rehab consist of?

A
  • Exercise Therapy
  • Risk Factor Management
  • Psychological changes
  • Behavioral Changes
  • Lifestyle Changes
  • Education
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5
Q

What can a pt do if they can climb 2 flights of stairs?

A

Have sex w/their normal partner

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6
Q

What does phase 1 rehab involve?

A

Low-level fxnl activities such as PROM, AROM, & amb

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7
Q

Phase 1 Rehab

A

In-pt lasting about 3 days (until d/c) to counteract the deleterious physiological effects of bed rest & prevent a “cardiac cripple” from emerging

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8
Q

What needs to be evaluated in phase 1 rehab?

A
  • Contraindications

* MD Clearance

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9
Q

Frequency of phase 1 cardiac rehab

A

5-7days/wk, 15min bid

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10
Q

Intensity of phase 1 cardiac rehab

A

20 BAR for MI; 30BAR for CABG

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11
Q

What is the pt told to do when they get home from phase 1 cardiac rehab?

A

To walk

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12
Q

Phase 2 Cardiac Rehab

A

Out-pt phase focused on incr pt’s fxnl & CV efficiency; Lasts about 3 months

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13
Q

What is used to eval a pt in phase 2 cardiac rehab?

A
  • Cardiac stress test
  • Lab studies
  • PFT if pt has pulmonary involvement
  • Repeat stress test at end
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14
Q

Frequency of phase 2 cardiac rehab

A
  • 3-5x/wk of 20-45min of aerobic activity

* Evening walks are encouraged

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15
Q

What is the intensity of phase 2 cardiac rehab?

A
  • 50-70% of karvonen HR–>Incr monthly by 5% to a max of 80%

* BORG

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16
Q

Exercise prescription implications for phase 2 cardiac rehab

A 
Intermittent Training
    *Warm-up for 5min w/low level amb
    *Rest for <1min in between devices
    *Alternate leg &amp; arm exercises
    *
17
Q

Resistance training implications for phase 2 cardiac rehab

A
  • Wait until 5wks post-MI or CABG; Pt should be supervised for at least 4wks
  • Wait until 3wks post-PTCA & other procedures; Pt should be supervised for at least 2wks
  • No evidence of problems w/CHF, severe valve disease, uncontrolled HTN, or unstable sx’s
18
Q

Phase 3 Cardiac Rehab

A

Supervised phase lasting 4-6wks to decr supervision of exercise program & to promote self-regulation of the program

19
Q

How are pt’s monitored during phase 3 cardiac rehab?

A

HR

20
Q

Intensity of phase 3 cardiac rehab

A

70-80% of Karvonen HR

21
Q

Phase 4 Cardiac Rehab

A

Unsupervised phase lasting forever to maintain lifestyle changes acquired in cardiac rehab

22
Q

What are the benefits of exercise?

A

*

23
Q

What measures are used to monitor a pt’s progress?

A
  • VO2max
  • Lipid profile
  • Vitals
  • ECG Changes
  • THR
  • Psychosocial
  • Alcohol
  • Daily ECG, RGR, RBP, peak BP, & adverse rxn’s
  • Duration, intensity, & adjusted work load
24
Q

Why are stress tests done?

A
  • Determine max capacity for physical work
  • Detect/confirm ischemic heart disease in apparently healthy pt’s
  • Assess pt’s w/cardiac pathologies
  • Exercise prescription
25
Q

What is important to know about a pt’s status?

A
  • Hyperventilation prior to the test
  • Resting vitals
  • ECG Changes
  • BP response
  • HR max prior to any sx’s
  • Meds
  • MHx
  • Length of test
  • Reason for termination
26
Q

Considerations for cardiac rehab

A
  • UBE makes BP spike
  • Aquatic Therapy–>Temperature indications but generally not good to do
  • Sternal pxns–>Don’t pick up >5lbs & no driving
  • DM

2) Cardiopulm (16 decks)

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