Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiopulmonary > Cardiac Rehab > Flashcards

Cardiac Rehab Flashcards

1
Q

A cardiac rehabilitation (CR) program in the outpatient setting is a multidisciplinary program

A
  • of exercise, education, & lifestyle modification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 problems with primary prevention of CVD

A
  • Compliance
  • Lack of payment for services by medical insurance companies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the criteria for metabolic syndrome

A
  • Low levels of HDL cholesterol: <50 for women & <40 for men
  • Elevated blood sugar levels: ≥126
  • High blood pressure: consistently 130/85 or higher
  • Excess weight in abdomen: ≥40 in for men and ≥35 in for women
  • Hypertriglyceridemia: >150
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors affected by primary prevention

A

-Reduction of total cholesterol to high-density lipoprotein (HDL) ratio
- Reduction in low-density lipoprotein (LDL) cholesterol
- Improvement in aerobic capacity and exercise tolerance
- Reduction in body mass index (BMI)
- Reduction in resting blood pressure in prehypertensive and hypertensive individuals
- Improved glucose tolerance and insulin sensitivity
- Improved feeling of wellbeing and improved stress tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ABCDE primary prevention strategies for ASCVD (atherosclerotic cardiovascular disease)

A
  • Assess risk
  • Antiplatelet therapy
  • Blood pressure
  • Cholesterol
  • Cigarette smoking
  • Diabetes
  • Diet & weight
  • Exercise
  • Economic and social factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ASCVD risk enhancers

A
  • Family Hx of premature ASCVD
  • Primary hypercholesterolemia
  • Chronic kidney disease
  • Metabolic syndrome
  • Conditions specific to women
  • Chronic inflammatory conditions
  • Ethnicity
  • Persistently elevated triglycerides (≥175)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which smoking cessation methods are FDA approved

A
  • Patch
  • Gum
  • Lozenge
  • Nasal spray
  • Oral inhaler
  • Bupropion
  • Varenicline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk enhancers for diabetes

A
  • Long duration (≥10 yrs DM II & ≥20 yrs DM I)
  • Albuminuria ≥30
  • eGFr <60
  • Retinopathy
  • Neuropathy
  • ABI <0.9
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe normal, elevated, stage I, and stage II blood pressures

A
  • Normal: <120/80
  • Elevated: 120-129/<80
  • Stage I hypertension: 130-139/80-89
  • Stage II hypertension: ≥140/90
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Non-pharmacological interventions for hypertension

A
  • Weight loss
  • Healthy diet
  • Reduced intake of dietary sodium
  • Enhanced intake of dietary potassium
  • Physical activity: aerobic, dynamic resistance, isometric resistance
  • Moderation in alcohol intake: reduce to ≤2 drinks/wk for men and ≤1 drink/wk for women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Components of a CVD rehabilitation program

A
  • Education in the recognition, prevention, & treatment of CVD
  • Reduction of risk factors
  • Dealing with psychologic & behavioral factors influencing recovery
  • Progressive physical activity
  • Vocational/return to leisure activities counseling
  • ADL and functional training
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the phases of cardiac rehabilitation

A
  • Phase I: acute or in-hospital phase
  • Phase II: early outpatient/intensive monitoring
  • phase III: training & maintenance phase
  • Phase IV: reserved for high risk pts in a disease prevention program
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the acute/in-hospital phase

A
  • Early mobilization
  • Poor candidates: uncontrolled HTN, healthy pts, unstable heart issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A modified CR program is indicated for patients who are designated as complicated for one or more of these reasons:

A
  • Large infarction clinically, although stable after 2-3 days
  • Resting tachycardia (100 bpm) or inappropriate HR increase with self-care activities
  • BP failing to rise or decreasing with self-care activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications with acute MI per McNeer Criteria for modifying CR program

A
  • Poor ventricular function
  • Significant ischemia with low-level activity
  • Cardiogenic shock
  • Ventricular tachycardia and/or fibrillation
  • Atrial flutter or fibrillation
  • Second- or third-degree atrioventricular (AV) block
  • Persistent sinus tachycardia (HR >100 at rest)
  • Persistent systolic hypotension (systolic BP <90 mm Hg at rest)
  • Pulmonary edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long do you follow sternal precautions and when can pts start lifting

A
  • Restricted immediately after surgery for 6-12 weeks
  • Pts should be empowered to resume load bearing ADLs at their own pace immediately after surgery
17
Q

Relative contraindications to continuing exercise in phase I CR program

A
  • Unusual HR increase: >50 bpm increase with low level activity
  • BP indicative of HTN: >210/>110
  • Drop in systolic BP >10 with low level exercise
  • Sx with activity: angina, excessive dyspnea/fatigue, mental confusion or dizziness, severe leg claudication
  • Signs of pallor, cold sweat, ataxia
  • Changing lung sounds with activity
  • ECG abnomalities
18
Q

Conditions that may be addressed with CR program

A
  • Myocardial infarction
  • Heart failure
  • Angioplasty and/or stent
  • Heart transplant
  • Stable angina
  • CABG
  • Valve replacement
  • Comorbid conditions
  • Poor ejection fraction
  • Cardiomyopathy
  • Serious arrhythmias
19
Q

When would insurance not cover cardiac rehab

A
  • Cardiac rehab in the wake of procedures to implant a pacemaker or implantable cardioverter defibrillator (ICD)
  • Coverage after HF is limited to pts with a “compromised ejection fraction” which affects about half of the population with HF
20
Q

Secondary prevention of CVD in outpatient setting

A
  • Should consist of aerobic exercise training, resistance training, & flexibility exercise
  • Specificity of exercise
21
Q

What is the commonly accepted range of training HR

A
  • 70-85% of maximal heart rate
  • 50-85% of maximal oxygen consumption
22
Q

Components of exercise prescription for aerobic training

A
  • Intensity: commonly using HR, RPE, and/or signs and symptoms
  • Mode of exercise
  • Continuous aerobic training: warm-up, peak interval phase, and cool-down
  • High intensity interval training: alternating bouts of moderate & vigorous intensity exercise
  • 4 versus 2 extremity exercise: combined produces higher max oxygen consumption
  • Duration individualized
  • Circuit training: keeps the HR elevated
23
Q

Exercise duration for aerobic train is individualized and based on several factors

A
  • Length of disability
  • Reduced activity as a result of the acute event
  • Premorbid activity level & neuromuscular capability
24
Q

Patients can progress based on tolerance of the activity in several ways

A
  • Increasing the duration of exercise
  • Increasing the intensity of exercise
  • Changing the mode of exercise
25
Q

What are the 5 social determinants of health

A
  • Education access and quality
  • Health care access and quality
  • Neighborhood and built environment
  • Social and community context
  • Economic stability
26
Q

Considerations for nutritional care for management of CVD risk factors

A
  • Specific lipid abnormality
  • Cultural background
  • Lifestyle/preferences
  • Any pertinent comorbidities: diabetes, renal disease
27
Q

____________ is a significant risk factor for coronary artery disease, heart failure, and arterial fibrillation

A
  • Obesity
28
Q

Major ASCVD events

A
  • Recent acute coronary syndrome (within last 12 mo)
  • Hx of MI
  • Hx of ischemic stroke
  • Symptomatic peripheral arterial disease
29
Q

High risk conditions for future ASCVD events

A
  • Age ≥65
  • Heterozygous familial hypercholesterolemia
  • Hx of prior coronary artery bypass surgery or PCI outside of the major ASCVD events
  • Diabetes
  • HTN
  • Chronic kidney disease
  • Current smoking
  • Persistently elevated LDL despite max tolerated statin therapy & ezetimibe
  • Hx of congestive heart failure
30
Q

Strategies to motivate lifestyle changes in secondary prevention/management of risk factors

A
  • Education
  • Strong leadership & a team approach
  • Enthusiasm
  • Development of a good relationship b/w therapist & patient
  • Reinforcing self-management & self-monitoring techniques (RPE, HR limits)
31
Q

_____________________ assesses effectiveness in providing patient care & the subsequent improvement in quality of care

A
  • Outcome evaluation
32
Q

Follow-up assessment should be performed and discussed with the patient at least ________ times per month during the subacute and intensive rehabilitation phases.

A
  • 2 times per week
33
Q

Criteria for discharge

A
  • Anticipated goals and desired outcomes have been achieved.
  • Patient declines to continue intervention.
  • Patient is unable to progress toward goals because of medical or psychosocial complications.
  • Patient fails to make reasonable progress toward goals because of nonadherence to the home program.
  • Patient fails to attend scheduled appointments.
  • Patient lacks willingness or ability to participate.
34
Q

Safety precautions in the CR setting include

A
  • Avoiding exercise within 1-2 hours after meals
  • Avoiding isometrics and breath holding with exercise
  • Adding warmup & extended cool-down periods of 15 minutes or more with strenuous exercise
  • Seeing showers brief & not at a hot or cold temperature (keep legs active)

Cardiopulmonary (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions