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Cardiopulm > Cardiac Rehab > Flashcards

Cardiac Rehab Flashcards

1
Q

Effects of cardiac rehab

A
  1. reduces body weight
  2. unloads the heart
  3. improves cardiac function
  4. (maybe) changes in lifestyle
  5. modifies RF
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2
Q

Cardiac Rehab Phase I:

acute/inpatient

A

immediately upon becoming medically stable

monitored

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3
Q

Cardiac Rehab Phase II:

subacute/rehab/conditioning

A

immediately upon d/c

monitored

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4
Q

Cardiac Rehab Phase III:

training or intensive rehab

A

outpatient

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5
Q

Cardiac Rehab Phase IV:

A

maintenance

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6
Q

Phase I initial assessment

A
  • Hx
  • family interview
  • physical exam
  • quality of ADLs
  • ROM, Strength, Gait
  • sternal precautions
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7
Q

phase I physical exam:

A
  • BP
  • HR
  • auscultation
  • neuropathy
  • edema
  • JVD
  • skin color
  • wound care
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8
Q

Phase I exercise tolerance

A
  • monitored BP 3-5 min
  • pt slowly walked by therapist 25-50 ft w/rest break
  • if no unusual HR, BP, or EKG then walk is repeated and lengthened according to subjective feelings, HR, BP, and EKG
  • activity progressed as long as patient tolerates exercise
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9
Q

Phase I treatment

A
  • start slow
  • use short duration multiple times per day
  • warm up and cool down
  • <120 BPM
    OR
  • 20-30 BPM increase
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10
Q

Phase I: when to stop treatment

A
  1. unusual HR increase
  2. . inappropriate BP response
  3. SP > 210
  4. DP >110
  5. 10 mmHg or more drop in DP w/exercise
  6. presence of symptoms
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11
Q

Common symptoms in Phase I cardiac rehab that signal to stop treatment

A
  1. angina
  2. dyspnea
  3. excessive fatigue
  4. mental confusion/
    5/ dizziness
  5. excessive fatigue
  6. pallor
  7. cyanosis
  8. cold sweat
  9. EKG abnormalities
  10. Arrhythmias
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12
Q

Phase I goals

A
  1. initiate return to independence w/ADLs
  2. counteract deleterious effects of bed rest
  3. provide med surveillance during ADLs
  4. provide pt/family edu about disease process, CV monitoring, CPR, exertional intolerance, energy conservation
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13
Q

Activities to consider for Phase I

A
  • self care
  • arm and leg AROM
  • very light weights
  • independent transfers
  • bedside sitting to ambulation to stairs
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14
Q

Amount of METs by D/C of cardiac rehab phase I

A

3-5 METs

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15
Q

Phase II goals

A
  1. improved exercise tolerance
  2. pt edu
  3. RF reduction/secondary prevention
  4. Return to work
  5. promote psychological, behavioral, and edu improvement
  6. 9-10 METs
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16
Q

Phase II exercise plan

A
  • individualized
  • fraction of HRR:
    HRmax = 207 ((.7)age)
17
Q

Phase II establishing intensity

A

keep HR below levels that

  1. elicit symptoms
  2. cause dyspnea
  3. elicit plateauing or decreasing SBP
  4. elicit EKG abnormalities
  5. elicit arrhythmias of >6/min
18
Q

Phase II endurance training zone RPEs

A

11-13

19
Q

Phase II strength training zone RPEs

A

15-17

20
Q

Phase II abnormal response to exercise

A
  1. SBP 240
  2. DBP > 110
  3. Systolic hypotension
  4. > 20 BPM drop
  5. unusual HR response
  6. signs and sympoms
  7. ECG abnormalities
21
Q

Phase II resistance training

A
  1. begin 5 weeks post MI, 8 weeks post CABG, 2 weeks post PCTA
  2. 30-50% of !RM
  3. 8-10 reps 2-3x/wk with day of rest between
  4. large muscle groups
  5. control weights
  6. breathe/exhale during effort
  7. RPE 11-13
  8. 10-12 reps/1-2 sets
  9. 2-3 x / week
  10. smooth, controlled, full ROM
  11. balance exercise between muscle groups
  12. core str
  13. avoid gripping handles tightly
22
Q

Phase II components

A
  • flexibility
  • warm up/cool down
  • 4 vs 2 extremity exercise
  • frequency (2-3/week)
  • duration (20 min up to 60 min)
23
Q

Phase III

A
  • 3-6 months post event
  • HEP
  • Community exercise programs
  • may or may not be seen 1/week
  • No ECG monitoring
  • Self monitoring
24
Q

Phase III goals

A
  1. achieve 50-80% of HRR on treadmill test
  2. 3-4 sessions/week
  3. > 45 min per session
25
Q

Cardiac Rehab Phase IV

A
  • HEP
  • Self Monitoring
  • Environmental concerns
  • Adherence
26
Q

Exercise after cardiac stenting

A
  1. avoid vigorous exercise and heavy lifting short period post procedure
  2. consult physician
  3. cardiac rehab

Cardiopulm (20 decks)

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