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HLB Cardiac > Cardiac Rehabilitation > Flashcards

Cardiac Rehabilitation Flashcards

1
Q

What are the key features of the BACPR cardiac rehabiliation definition?

A

1 - cause of CVD needs to be addressed

2 - preserve or resume optimal function

3 - slow or reverse progression of CVD

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2
Q

What is the core component of rehabilitation?

A
  • structured exercise education
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3
Q

What is the peripheral component of rehabilitation?

A
  • psychological support
  • social support
  • lifestyle advice
  • risk factor management
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4
Q

Which core patients should be signed up for cardiac rehabilitation?

A
  • post myocardial infarction
  • coronary artery bypass graft
  • coronary stents
  • chronic heart failure
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5
Q

What are the 3 main aims that cardiac rehabilitation aim to reduce?

A

1 - death

2- MI

3 - rehospitalisation

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6
Q

Does rehabilitation cause better health outcomes?

A
  • cannot say that
  • rehabilitation is associated with better health outcomes
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7
Q

What is the problem with observational data, instead of doing prospective randomised trials?

A
  • patients self select
  • causes patient bias
  • more motivated patients attend so outcomes will be better
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8
Q

Following cardiac rehabilitation what is the target for total cholesterol and LDL?

A
  • total cholesterol = <4mmol/L
  • LDL = <2mmol/L
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9
Q

In patients who attend cardiac rehabilitation, are they more or less likley to be compliant with medication and lifestyle change?

A
  • more compliant with everything
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10
Q

Following cardiac rehabilitation what is the target for blood pressure?

A
  • <140/90 mmHg
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11
Q

In patients who have diabetes and attend cardiac rehabilitation, what are some of the improvements that have been observed?

A
  • improved glucose tolerance
  • reduced serum insulin
  • reduced triglycerides
  • reduced body fat
  • improved compliance
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12
Q

According to the British Association for Cardiac Prevention and Rehabilitation what are the 6 core components of cardiac rehabilitation?

A

1 - health behaviour with education

2 - lifestyle management (exercise)

3 - psychosocial health

4 - medical risk management

5 - long term straegies

6 - audit and evaluation

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13
Q

What is phase 1 of cardiac rehabilitation programme that occurs in the 1st week?

A
  • patient assessed in hospital (pre-discharge)
  • educate misconceptions and questions
  • mobilise
  • individual exercise programme (4-6 weeks)
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14
Q

What is phase 2 of cardiac rehabilitation programme that occurs in weeks 2-6 at patients home?

A
  • personalised exercise programme
  • education and stress management
  • 5-30 minutes of activity around house
  • telephone contact with rehab team
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15
Q

Phase 3 is generally the phase that is classed as a cardiac rehabilitation programme. In phase 3 of the cardiac rehabilitation programme, what occurs in weeks 6 to 9 months in the community setting?

A
  • assessment of exercise programme
  • personalised multi modality exercises
  • health education
  • psycho socia support
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16
Q

Which phase is most commonly referred to as the phase where cardiac rehabilitation programme occurs?

A
  • phase 3
17
Q

What are the 4 sections of a structured exercise programme?

A
  • warm up
  • aerobic exercise
  • resistance exercise
  • cool down
18
Q

When designing a structured exercise programme for patients, how is the intensity of the programme judged?

A
  • Borg scale
  • aim for level 4-6
19
Q

Why is weight management important in CVD?

A
  • increases risk of all mortalities
  • waist circumference is 94 (men) and 80 (women)
  • BMI target is 25-30kg/m2
20
Q

Is it important to encourage patients with CVD to quit smoking?

A
  • yes most important factor in patients with CVD
  • smoking increases mortality
21
Q

As part of the nutrition aim for patients with CVD, what is the calorie intake target and what micro nutrient are they advised to increase more of?

A
  • 2000 - 2500 caloires/day
  • increase dietary fibre (>20g/day)
22
Q

What are the 3 common pyschological distress factors that are common?

A
  • anger
  • depression
  • anxiety
23
Q

What is phase 4 of a cardiac rehabilitation programme?

A
  • life long maintenance
  • unsupervised exercise 2.5 hours/week
  • exercise at 60-70% HR max
24
Q

What are attendance figures (% wise) to cardiac rehabilitation programmes for:

  • all patients who are eligible
  • CABG
  • Myocardial infarctions and stable coronary artery disease
  • Heart failure
A
  • only 50% of eligible patients attend
  • CABG = 70% attendance
  • MIs and stable coronary artery disease = 30%
  • Heart failure = very low
25
Q

What main reasons do patients cite as the reason they dont attend cardiac rehabilitation programmes?

A
  • service organisation
  • delivery of service
26
Q

What is the NHS target for attendance for all those who are eligible for cardiac rehabilitation programmes?

A
  • 85%
27
Q

There are 4 main reasons patient have identified that contribute to the poor organisational aspects of cardiac rehabilitation, what are they?

A

1 - co-morbidities (terminal cancer so pointless)

2 - too ill to take part

3 - apathy (patients cannot be bothered)

4 - lack of home support

28
Q

What are some potential avenues of how cardiac rehabilitation could be improved?

A
  • offer home delivery
  • offer programmes online
  • multi-modality exercise programmes
29
Q

What is a clinical audit?

A
  • quality improvement process
30
Q

What are key performance indicators?

A
  • markers for measuring success
31
Q

According to the British Heart Association how many staff should be part of the multidisciplinary team delivering the cardiac rehabilitation programme?

A
  • _>_3
32
Q

According to the British Heart Association who should be included in cardiac rehabilitation programmes?

A
  • all priority groups
  • posy MI
  • post CABG
  • stable ischaemia
  • heart failure
33
Q

According to the British Heart Association how long should the phase 3 cardiac rehabilitation programme last?

A
  • _>_8 weeks
34
Q

According to the British Heart Association how long should it be before the phase 3 cardiac rehabilitation programme starts in ischaemic heart disease patients?

A
  • 33 days
35
Q

According to the British Heart Association how long should it be before the phase 3 cardiac rehabilitation programme starts in CABG patients?

A
  • 46 days
36
Q

According to the British Heart Association where should the initial cardiac rehabilitation programme be undertaken?

A
  • in hospital
37
Q

According to the British Heart Association following the phase 3 cardiac rehabilitation programme, what should be done after this?

A
  • final assessment
38
Q

Are key performance indicators being delivered equally as effectivley all over the country?

A
  • no
  • deprivation may be an issue

HLB Cardiac (24 decks)

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