Cardiac Rehab Session 7 Flashcards
Define cardiac rehab
A supervised program to help patients recover from MI, heart sx, minimally invasive procedures like stunting, risk factors like CAD or angina, HF
Core components of cardiac rehab
CV risk reduction, healthy behaviors, reduction of disability
Goals of cardiac rehab
- decrease stay in hospital to 3-5d
- early mob
- assessment
- prep for d/c
- home care prep
- referral to OP rehab
Components of initial assessment
- Past medical hx
- Signs and symptoms
- Employment
- Risk factor assessment and plan for intervention
- Current Meds
Cardiac Rehab CANNOT
- Reverse atherosclerotic process
- Decrease myocardial ischemia
- Have much effect on ejection fraction
- Reverse effects of lung dz
Indications for cardiac rehab
- Stable angina (no pain for >8hrs)
- Control of dangerous dysrhythmias
- Control of myocardial insufficiency
- Labs trending for normal
- Compensated HF
- s/p cardiac sx
Contraindications for cardiac rehab
- Unstable angina
- Dangerous arrhythmias
- Uncompensated HF
- Embolism
- Metabolic instability
- Critical lab values
Precautions to activity (monitor closely)
- Low ejection fraction (
Limitations to activity (HR) (MI)
- HR 20 bpm > resting
- Resting HR > 120bpm
- Resting HR
Limitations to activity (HR) (Sx patient i.e. s/p CABG)
- HR 30 bpm > resting
- RPE > 13
- Sternal precautions
Importance of activity
- prevents bed rest complications
- improve cardiac and pulmonary function
- prevent secondary chest infection
- prepare for d/c through self care
- monitor abnormal responses to activity
Sternal precautions (s/p 0-8 weeks)
- No lifting more than 10 lbs
- No shoulder flexion > 90 degrees
- Keep hands in visual field
- No driving
- No pushing or leaning
Psychosocial considerations for cardiac rehab
- Type A
- Poor eating
- Anxiety about exercising
- Forced sedentary lifestyle
- Impact of family / enablers
- Denial which may lead to non-compliance
- Grief
- Depression
- lifestyle changes take work
- Readiness to change
- Old habits hard to break (smoking)
- Autonomy
- Impact of fear
Safety considerations in clinic
- Patients are fit for cardiac rehab
- Proper monitoring
- All personnel BLS and AED certified
- Emergency procedures specified
- Warm up and cool down!
What is VO2 peak and when is it most effective
peak oxygen intake. Closely related to cardiac output. Most effective when working large muscle groups in rhythmic pattern
