Cardio

Question 1

How many MET stages are there and what numerical form do they take?

Answer 1

6 and they are listed in Roman Numerals

Question 2

List the MET level ranges with their corresponding stages:

Answer 2

Stage I 1.0-1.4
Stage II 1.4-2.0
Stage III 2.0-3.0
Stage IV 3.0-3.5
Stage V 3.5-4.0
Stage VI 4.1+

Question 3

List the “sit to stand” stages:

Answer 3

Stage I- seated activities
Stage II- seated activties
Stage III- seated to standing activities
Stage IV- standing activities
Stage V- standing activities
Stage VI- standing activities

Question 4

Stage I activities and range

Answer 4

1.0-1.4 METs
ADLs: self-feeding, wash hands and face
Mobility: bed mob., transfers
Leisure/IADLs: table games, reading, radio, light handwork
Exercise: all extremeties in supine or neck and lower extremities seated

Question 5

Stage II activities and range

Answer 5

1.4-2.0 METs
ADLs: seated shaving and grooming, seated sponge bath, dressing
Mobility: unlim. sitting, slow ambulation
Leisure/IADLs: seated crafts, painting, sewing, knitting
Exercises: seated exercises to all extremities, no isometrics

Question 6

Stage III actvitities and range

Answer 6

2.0-3.0
ADLs: seated showering in warm water
Mobility: wheelchair mobility, brief standing, walking limited distance ~2mph
Leisure and IADLs: begin very light chores tasks such as folding clothes. Piano/typing. Card playing
Exercise: light stationary biking, progressive ambulation on 0% grade/incline

Question 7

Stage IV activities and range

Answer 7

ADLs: same as stage III but in standing, including standing warm shower
Mobility: unlimited walking ~3mph, <2 flights of stairs
Leisure and IADLs: light chores – vacuuming, dusting, sweeping, laundry, light gardening, home management, driving. Slow canoeing, candlepin bowling, golf putting
Exercise: mild resistance, treadmill, cycling ~6mph

Question 8

At what MET level do pt discharge from Phase 1 of cardiac rehab?

Answer 8

3.5

Question 9

Stage V activities and range

Answer 9

3.4-4.0 METs
Mobility: walk ~3.5mph, cycle ~8mph, stairs as tolerated
Leisure and IADLs: medium chores – washing dishes, washing clothes, ironing, hanging clothes, making beds, home repair and home management. Golfing with bag cart, slow swimming
Exercise: increased extremity repetitions in standing, 7-10# seated weights, 2-4% grade on treadmill

Question 10

Stage VI activities and range

Answer 10

4.1+ METs
ADLs: Standing hot shower. Sex can resume at 5.0 METs.
Leisure and IADLs: most chores – make beds, mopping, raking. Slow dancing and slow skating, swimming, volleyball, table tennis, golf carrying clubs
Mobility: walk ~4mph, cycle ~10mph, stairs
Exercise: 10-15# seated weights, 5-6% grade on treadmill

Question 11

5-7 METs

Answer 11

“heavy”
brisk walking
digging in the garden, shoveling, lifting 50-100 lbs

Question 12

7-10+ METs

Answer 12

“very heavy”
jogging (7-8)
running (8-9)
sprinting (10+)
basketball
digging ditches

Question 13

What are the 2 main models used for cardiopulmonary diseases?

Answer 13

MOHO
CMOP-E

Question 14

HR, RR, O2sat, BP typical vitals

Answer 14

HR: 60-100
BP: 120/80
O2: 95% or greater
RR: 12-18

Question 15

What are some critical lab values and what should you do?

Answer 15

elevated electrolytes (NA, K, CL, CA)
elevated troponin
elevated INR, platelets, hemoglobin and hemocrit
d/c therapy and alert doctor

Question 16

What vital signs indicate a problem?

Answer 16

BP +/- 20
below 90% O2
RR over 20

Question 17

How many cardiac rehab phases are there?

Answer 17

Three phases

Question 18

Phase I cardiac rehab

Answer 18

hospital
NO ISOMETRICS
monitor vitals
task grading
pt education on precautions
MET 1.4-3.4

Question 19

Phase II cardiac rehab

Answer 19

outpatient
3.5-5.0
strengthening PREs and endurance training
work conditioning/hardening
risk factor modification/pt education

Question 20

Phase III cardiac rehab

Answer 20

MET 5+
stress tests/cardio follow up