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Cardiopulmonary PT > Cardiac Rehab > Flashcards

Cardiac Rehab Flashcards

1
Q

What is the cardiac rehab triad?

A
  • Exercise
  • Behavior modification
  • Education
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2
Q

What is the definition of cardiac rehab? (3 components)

A

Medically supervised program that includes:

  • Cardiovascular conditioning (exercise)
  • Behavior modification
  • Counseling and Education
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3
Q

What is the goal of cardiac rehab?

3 components

A
  • Restore and maintain an individual’s optimal:
  • Physiological health
  • Psychological health
  • Social and vocational functioning
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4
Q

How many deaths in the US are caused by cardiovascular disease?

A

50 %

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5
Q

How many new diagnoses of coronary artery disease are there each year?

A

13.5 million.

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6
Q

How many individuals suffer an MI each year in the US?

A

1.5 million.

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7
Q

On average, of the individuals that eligible, how many receive cardiac rehab?

A

15 %.

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8
Q

What 3 organizations are trying to change rehab standards to increase enrollment in cardiac rehab?

A
  • ACC
  • AHA
  • AACVPR
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9
Q

What 2 methods are used to measure a rehab program’s effectiveness?

A
  • % of eligible patients that are referred to rehab.

- Integration of many health care disciplines into cardiac rehab to maximize quality of care for those in the program.

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10
Q

What 6 diagnoses are covered by medicare for enrollment in cardiac rehab?

A
  • Acute MI
  • Coronary bypass surgery
  • Heart valve repair/ replacement
  • Coronary angioplasty/ stenting
  • Heart transplant
  • Stable angina pectoris
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11
Q

When must the referral be made for the 6 diagnoses?

A

Within a year.

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12
Q

What are 10 health professionals that are involved in the cardiac rehab setting?

A
  • Referring physician
  • Medical director
  • Registered nurses
  • Exercise physiologists
  • Physical therapists
  • Dieticians/ nutritionists
  • Behavioral therapists
  • Social services specialists
  • Pharmacists
  • Health educator
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13
Q

What are the 4 phases of cardiac rehab?

A

Phase 1: Hospital phase
Phase 2: Following cardiac even when insurance covers cost
Phase 3: Following discharge from phase 2 (patient pays out of pocket)
Phase 4: Long-term maintenance

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14
Q

What is the physicians role in cardiac rehab?

A
  • Supervision

- Referral

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15
Q

How many sessions are covered by insurance typically for cardiac rehab? How long is each session?

A
  • 36 sessions

- 1 - 2 hour sessions

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16
Q

What are the 3 goals of the exercise portion of cardiac rehab?

A
  • Improve functional capacity
  • Reduce disability/ morbidity and mortality
  • Lessen activity related symptoms
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17
Q

What are the 3 educational goals of cardiac rehab?

A
  • Identify risk factors
  • Educate patient on management and prevention
  • Medication usage
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18
Q

What determines the use of telemetry monitoring during rehab?

A

RIsk stratification.

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19
Q

What factors are considered when determining risk level?

A
  • Ejection fraction
  • Arrhythmias
  • Depression
  • METs
  • Angina
  • Level of ischemia
  • CHF
20
Q

What are ejection fractions for low, moderate, and high risk patients?

A

Low: Greater than 50 %
Moderate: 40 - 49 %
High: Less than 40 %

21
Q

What are the MET values for each risk group during stress tests?

A

Low: Greater than or equal to 7 METs
Moderate: 5 - 7 METs
High: Less than 5

22
Q

What 4 factors are exercise prescription in cardiac rehab based upon?

A
  • Functional capacity from stress test
  • HR and BP response to exercise
  • Functional goals
  • Orthopedic restrictions/ limitations
23
Q

What 3 aspects are addressed in exercise training in cardiac rehab? How much time is spent doing each?

A

20 - 50 minutes CV conditioning
10 - 15 minutes Resistance Training
5 - 10 minutes Stretching/ Relaxation

24
Q

What 5 measures can be used to determine the intensity of an exercise?

A
  • HR and BP response
  • Target HR calculated using stress test
  • RPE
  • MET level
  • Ischemic/ anginal threshold
25
Q

What intensity should aerobic exercise function within using HR?

A

70 - 85 % max

26
Q

How often should aerobic exercise be done? (initially, and progression)

A
  • 3X/week to start
    progress to
  • 5-6X/week
27
Q

What duration should an aerobic exercise last?

A

20 - 50 minutes.

28
Q

What muscle groups should be targeted for aerobic exercise?

A

Large muscle groups

29
Q

Using the borg scale, what number corresponds to:

  • No exertion at all?
  • Light?
  • Somewhat hard?
  • Very hard?
  • Maximal exertion?
A

No exertion: 6
Light: 11
Somewhat hard: 13
Maximal exertion: 20

30
Q

What type of aerobic exercise should be prescribed to a patient with low exercise capacity?

A
  • Interval training

- Short periods of exercise with rest periods

31
Q

What variables can be used to modify exercise modalities for aerobic exercise?

A
  • WB vs NWB
  • UE vs LE
  • Full body
32
Q

What are 5 benefits of resistance training?

A
  • Increased strength
  • Increased functional capacity
  • Balance
  • Independence
  • Quality of life
33
Q

What are 6 factors positively influenced by exercise? (4 medical, 2 psychosocial)

A
  • Blood pressure
  • Glucose levels
  • Lipid profiles
  • Body weight
  • Stress/ anxiety
  • Depression
34
Q

What are the 4 broad educational topics covered in cardiac rehab education (classroom setting)?

A
  • Nutrition topics
  • Behavioral topics
  • Clinical/ medical topics
  • Exercise/ other
35
Q

What 4 factors can affect a patient’s learning needs?

A
  • Age
  • Cultural aspects
  • Education level
  • Learning style
36
Q

How can barriers to learning be addressed?

A

Create a creative, enjoyable, and interactive environment.

37
Q

What are 3 activities the cardiac rehab unit has done to raise awareness about nutrition?

A
  • Supermarket tours
  • Cooking demonstrations
  • Food festivals
38
Q

What are 7 workshops that cardiac rehab offers?

A
  • Diabetes outpatient education
  • Cardiac yoga
  • Resistance training
  • Weight loss programs
  • Fitness challenges
  • Breaking barriers
  • Brown bag series
39
Q

What are 3 types of one-on-one consultations provided by cardiac rehab?

A
  • RN
  • Exercise physiologist
  • Nutritionist
40
Q

What are 6 behavior modifications targeted by cardiac rehab?

A
  • Smoking cessation
  • Stress management
  • Weight management
  • Diabetes management
  • Depression/ anxiety
  • Exercise compliance
41
Q

Describe the 6 step continuum of care model?

A
  • Initial assessment
  • Evaluation of risk factors
  • Goal setting
  • Plan of care
  • Plan implementation
  • Outcomes evaluation
42
Q

What are the 5 stages of change?

A
  • Precontemplation (not thinking about it)
  • Contemplation
  • Preparation
  • Action
  • Maintainence
43
Q

What is motivational learning?

A
  • Patient-centered counseling intervention that enhances motivation by exploring and resolving ambivalence.
44
Q

What are the 4 key principles of motivational interviewing?

A
  • Express empathy
  • Develop discrepancy
  • Roll with resistance
  • Support self-efficacy
45
Q

What are 5 benefits of cardiac rehab to the health community as a whole? ($$$$$)

A
  • Reduced risk of fatal MI
  • Decreased need of meds because of reduced angina symptoms
  • Decreased hospitalizations
  • Decreased physician visits
  • Decreased ER visits
46
Q

What are 7 patient benefits of cardiac rehab?

A
  • Improved strength/ endurance
  • Better knowledge of disease/ prevention
  • Adherence/ lifestyle changes
  • More compliance with meds
  • Self-esteem/ confidence
  • Quality of life
  • Reduced morbidity and mortality

Cardiopulmonary PT (10 decks)

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