Cardiac Rehab Flashcards
What are the goals of cardiac rehab?
- Reducing CVD morbidity and mortality
- improve physical and psychological function
- enhance quality of life
What are the main phases of cardiac rehab?
- Phase 1: Inpatient
- Phase 2: Early outpatient
- Phase 3: Intensive outpatient
- Phase 4: Independent maintenance
How does the PT develop an individualized exercise prescription in cardiac rehab?
Based on mode, intensity, duration, frequency; monitored through HR, BP, ECG, RPE, symptoms.
What are the indications for cardiac rehab
- Primary CVD:
- MI, CABG, transplant, valve repair, HF.
- Secondary CVD:
- CAD, diabetes, obesity, ESRD.
What are contraindications for cardiac rehab?
- unstable angina
- severe hypertension
- critical aortic stenosis
- acute systemic illness
- uncontrolled arrhythmias
What patient assessments are done in Phase 1 of cardiac rehab?
Vitals, HR, BP, O2 saturation, auscultation, peripheral pulses, self-care ability, readiness for physical activity.
What is the goal of early mobilization in Phase 1?
Improve HR response, BP, oxygen uptake, circulation, ventilation, and reduce morbidity/mortality.
What criteria must be met to advance daily ambulation/activity?
- no new chest pain
- stable creatine/troponin
- no decompensation signs
- stable EKG
How is aerobic exercise structured in Phase 1?
- Frequency: 3x/day
- Intensity: RPE 9-11
- Duration: 3-5 min progressing to 10-15 min
- Mode: walking, stair climbing
What are examples of ADL activities and their METs levels?
- Toileting: 1.5-2.5 METs
- Bathing: 1.5-2.0 METs
- Walking (2-3 mph): 2-3.3 METs
What are the benefits of progressive aerobic exercise in Phase 1?
- increase HR tolerance
- improve BP response
- enhance patient recovery and return to ADLs
What safety measures must be monitored during exercise?
- HR
- BP
- ECG
- symptom reporting (e.g., chest discomfort, dizziness)
- adherence to max HR ranges
What are the expected outcomes of inpatient cardiac rehab?
Prevent bed rest effects, enable continuous walking, safe stair navigation, establish HR and RPE limits.
What discharge planning needs are addressed in Phase 1?
Activity guidelines, exercise prescription, signs to watch for, referrals, setting transition.
What transitional settings exist for cardiac rehab?
Skilled nursing facilities, inpatient rehab facilities, home health care based on patient needs.
What are key components of a patient interview in cardiac rehab?
Admitting diagnosis, symptoms, PMH, social history, employment, risk factors, home setup.
What factors influence readiness for physical activity?
Vital stability, EKG stability, patient’s alertness, understanding of the disease, motivation.
How should PTs educate patients about CVD risk factors?
Discuss modifiable risk factors, disease process, symptom management, and lifestyle changes.
What are the HR guidelines during inpatient cardiac rehab?
Post-MI: HR < 20 bpm above resting;
Post-surgery: HR < 30 bpm above resting;
Max HR < 120 bpm.
What are signs of abnormal responses to physical activity?
Decreased SBP > 10 mmHg, HR outside max range, significant arrhythmias, angina, dyspnea, dizziness.
What are the goals of cardiac rehab?
Reduce CVD morbidity/mortality, improve physical/psychological function, enhance quality of life.
What education topics should be covered during cardiac rehab?
Disease management, risk factor modification, self-monitoring, general activity guidelines.
What are the key elements of a discharge decision tree?
Patient stability, self-care ability, social support, resource availability, healthcare access.
How is patient safety ensured during early mobilization?
Monitor vitals, use gait belts, avoid excessive exertion, check for dizziness/fatigue.
What is the role of family/caregivers in cardiac rehab?
Support patient education, assist with ADLs, reinforce lifestyle changes and rehab goals.
What is the PT’s role in symptom management during cardiac rehab?
Teach recognition of symptoms, provide strategies for management, and adjust activity levels.
How are comorbidities considered during cardiac rehab?
Identify comorbidities in assessments and adjust interventions to prevent complications.
What criteria determine patient readiness for discharge?
Ability to perform ADLs, stable vitals, understanding of exercise limits, safe mobility.
What are realistic expectations for cardiac rehab outcomes?
Improved physical capacity, reduced symptom recurrence, and increased disease awareness.
What communication is required among healthcare providers in cardiac rehab?
Regular updates on patient progress, shared treatment goals, coordinated discharge plans.
What lifestyle modifications are essential for long-term cardiac health?
Diet changes, smoking cessation, regular exercise, stress management, medication adherence.
How are cardiovascular risk factors identified during assessments?
Evaluate history, current health status, lab results, and lifestyle factors.
What factors are considered in the design of a cardiac rehab exercise program?
Patient’s diagnosis, comorbidities, baseline fitness, rehab phase, and safety measures.
How are exercise intensities adjusted during Phase 1 cardiac rehab?
Based on RPE, HR responses, patient tolerance, and absence of symptoms like angina.
What are the criteria for advancing activities in Phase 1?
Stable vitals, no new symptoms, improving functional capacity, safe mobility.
