Cardiac Rehab - CH20 PPT Flashcards
what covers cardiac rehab
medicare and medcaid
who is a candidate for primary prevention care
those at a mod-high risk of developing CVD
– hx or family hx of CVD
main issues with primary prevention
compliance
economic issues
ABCDE of primary prevention
Assess risk
Blood pressure
Cholesterol
Diabetes
Exercise
what should CR programs consist of generally
education
exercise
behavior changes
primary goal of education in cardiac rehab
education in recognition, prevention, treatment
Phases of CR
1 = acute/in-hospital
2 = early outpatient / intensive monitoring
3 = training/maintenance
4 = high-risk disease prevention
explain dichotomy of Phase 2 CR
to qualify for early outpatient
- in acute care, vitals stabilize/meds are titrated
if not, then intensive monitoring
qualification of modified vs unmodified program for CR
modified = if comorbidities are present
main activities completed in acute care
independent bed mobility
ankle pumps
heel slides
quad/glute sets
explain timing of acute care stay
1-3 days
–> try to get as functional for ADLs/movement around home
poor candidates for CR
pt with:
overt heart failure
unstable angina (ACS)
uncontrolled HTN
goals for Phase 1 CR
provision of safe guidelines for progression of activity
pt/family education
positive physiological response
what can be something to educate pt on during phase 1 CR
RPE and how to gauge it w/exercise
specific comorbidities that designate CR as modified
larger infarction
angina/fatigue
resting tachycardia
inappropriate HR increase w/self-care activity
blood pressure not rising or dropping
6-8 PVC in a min
what are McNeer criteria
hemodynamic instability
present comorbidities
angina
explain the phase keep your move in the tube
related to sternal precautions
- UE close to midline during weighted activity and UE WB activity
explain levels of unusual HR increase
> 30 - alerted
50 - contraindicated
BP level of hypertension? indication?
> 210/>110
– treatment contraindicated
what conditions are covered under medicare
MI
HF / Cardiomyopathy
Angioplasty/stent
heart transplant
stable angina / arryhtmias
CABG
valve replacement
comorbid conditions
components of initial assessment
subjective
pt interview
exercise test/6MWT/ or shuttle walk test
physical activity status
quality of life questionnaire
what factors determine the frequency of monitoring/degree of direct supervision
prior clinical course
exercise test
degree of ventricular impairment
initial assessment
risk stratification
what interventions are done in outpatient rehab portion of CR
ther ex
pt instruction
coordination/communication
what ther ex is specifically done in outpatient CR
aerobic exercise training
resistance training
flexibility exercise
