Cardiac Rehab

Question 1

Goals of Cardiac rehab

Answer 1

1. to significantly reduce the risk of another cardiac event
2. to prevent the worsening of a heart condition already present
3. to improve a pt’s outlook on life
4. to provide the support needed to make important lifestyle changes.

Question 2

Coronary artery disease:

Answer 2

Hardening of the coronary arteries that can lead to a type of chest pain, pressure or discomfort known as angina

Question 3

Recent heart attack

Answer 3

MI or open heart surgery

Question 4

High blood pressure

Answer 4

Hypertension

Question 5

Congestive heart failure

Answer 5

a condition in which the heart cannot pump efficiently enough to meet the body’s demand for oxygen

Question 6

Recent ballon angioplasty

Answer 6

a catheter based procedures in which a blocked artery is widened

Question 7

various circulation disorders

Answer 7

know its a diagnosis that may need cardiac rehab

Question 8

Pacemaker

Answer 8

a device implanted in the chest to monitor and if necessary, correct an abnormally slow heartbeat.

Question 9

Benefits of cardiac rehab:

Answer 9

• better chance of avoiding disability & returning to work
• Decreased risk of a recurrence of the heart problem, including MI
• Decreased risk of death due to heat disease
• Fewer episodes of reduced bloom flow to the heart cardiac ischemia
• Improved physical functioning & strength
• Less need for heart- related meds
• Lower blood pressure
• Lower levels of low-denssity lipoproteins LDL’s, cholesterol & fats in the blood (tryiglycerides)
• Relief from depression, fear & anxiety
• Slowed development, or even reversal, of hardening of the arteries atherosclerosis.
• Weight loss.

Question 10

Phase one:

Answer 10

In patient:
-Location/ frequency
~ in hospital
~usually BID

Question 11

Intensity: Phase 1

Answer 11

1 Borg perceived Exertion scale

2. No physical training.. exercise activity Done only to prevent de-conditioning
3. MET’s 2-5 (usually not > 3.5)

Question 12

Borg Perceived Exertion Scale:

Answer 12

Fairly light range (9-11)

-Scale from 6-20

Question 13

MET’s Phase 1

Answer 13

2-5 Usually not >3.5
MET= Metabolic Equivalent
~1 MET is the amount of oxygen consumed at rest, or the amount of WORK done by the body at rest.

Question 14

Duration: Phase 1

Answer 14

• as tolerated by pt

- Depends a great deal on pt’s pre-morbid status

Question 15

Types of exercises/ Activities used (Phase 1)

Answer 15

• ROM exercises
• Monitored ambulation
• Self-care activities
• Light LE exercises
• Progress to light UE exercises
• Education concerning: life style modifications & training how to monitor vital signs… Cont. on next slide

Question 16

Education concerning: (Phase 1)

Answer 16

• Recognizing signs & symptoms of fatigue
• Depression & other feelings often felt by people with heart problems or following surgery
• New physical limitations (weight restrictions- the maximum amount of work/activity that a physician decides a pt can do.
• Stress management techniques that help people relax instead of getting overly tense, frustrated or angry
• Identification of coronary risk factors and advice on how to reduce them
• Heart- damaging effects of smoking & strategies for quitting
• Importance of a heart-healthy diet and dietary strategies for reducing fat and cholesterol levels
• Weight loss
• Social support for lifestyle changes( quitting smoking) support groups
• CPR training
• Meds

Question 17

Phase Two:

Answer 17

Out patient:

1. Location:
   - cardiac rehab facility with extra sessions at home
2. RN & MD must be on site
3. Pt’s are monitored while @ the facility- max of 5 pt’s per HCP
4. Diagnoses of MI, stable angina & CABG are paid by insurance

Question 18

Frequency: Phase two

Answer 18

Usually 3x per week at facility & another 2-3 times a week at home: walking program

Question 19

-Borg scale: phase 2

Answer 19

“somewhat hard” -“hard” 12-16

Question 20

-Max heart phase two

Answer 20

30 bpm above resting heart rate OR 50% to 85% of max. HR depending on pt’s level of conditioning/ reconditioning.

Question 21

Will not exercise if resting systolic BP >_____ or Diastolic BP > ______
Phase two

Answer 21

200
100
Can vary depending on the source of info, check with MD

Question 22

METS: Men/ Women

PHase two

Answer 22

Men: 5.5
Women: 4.5-5 ( rarely greater than 5.5 or 6 METS)

Question 23

______ rate should return to normal/resting value within ____ minutes of cessation of _______ or activity.
Phase two

Answer 23

Heart
5 minuets
exercise

Question 24

________ _______ should return to normal resting value within _____ to _____ minutes after stopping exercise or activity.
Phase two

Answer 24

Blood pressure

5 to 7 min.

Question 25

Duration:Phase two

Answer 25

20-40 minutes of aerobic activity to pt tolerance 20 min is ideal minimum. - 12 weeks or 36 sessions whichever comes first ( reimbursed by Medicare) - Very important to have a warm up & cool down period

Question 26

Types of exercises/ activities used: large mm gouts: Phase two

Answer 26

- Treatmill - Walking track - Stationary Bicycle - UE Ergometer - Light UE exercise - Stair stepper - HEP

Question 27

What happens after cardiac rehab?

Answer 27

People often finish a cardiac rehab program with all the oho-on-on attention, the support from fellow participants and cheering from the healthcare professionals., & then have trouble continuing to exercise on their own.

Question 28

People are encouraged to:

Answer 28

- Avoid temptation to completely give up on exercising just because they missed a day - Either join an exercise group, or start a walking group in their own neighborhood - Find ways of being more active during the day, such as parking a little further away from the store & getting a good walk - Make exercise a routine that is done on the same days at the same times - Try different types of exercise: swimming, biking, walking, water aerobics and so forth - Pace themselves without pushing to the point of chest pain or severe SOB - Can stay at a cardiac rehab facility as a private pay pt.

Question 29

Heart pt's who ________ are only a _______ as likely to have another heart attack as those who do ______ _______

Answer 29

Exercise 3rd not exercise.

Question 30

Those who exercise have about a _____% greater chance of avoiding a _______ trip to the _______ in comparison with those who do Not _________

Answer 30

70% return hospital exercise