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CardioPulm > Exam 2: Wk 3: Prescription of Exercise and Interventions for Cardiovascular Patients > Flashcards

Exam 2: Wk 3: Prescription of Exercise and Interventions for Cardiovascular Patients Flashcards

1
Q

Loss of VO2 is approx ______ per decade? ____ METS

A

5ml/kg*min

1.5-2 METS

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2
Q

Independence requires VO2 at ______

A

18ml/kg*min

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3
Q

Mortality risk is decreased by ____for every 1-MET increase in VO2

A

17%

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4
Q

Walking ___min a day decreases mortality by ___%

A

15 min a day by 14%

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5
Q

Hemoglobin lab value that you shouldnt exercise with

A

<7

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5
Q

Containdications for MAX Exercise Testing

A
  • acute MI within 2 days
  • Myocarditis, Endocarditis, Pericarditis (inflammation around the heart)
  • Acute PE or DVT
  • Decompensated Heart Failure
  • Unstable Angina
  • ST elevation or depression
  • Inverted T wave
  • V FIb
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6
Q

S&S of dysrhythmias

A
  • flutter or pounding chest
  • lightheaded, dizzy
  • ataxia
  • confusion
  • dyspnea
  • diaphoresis
  • pale/gray and clammy
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7
Q

relative contraindications: resting hypertension

A

systolic>200 mmHg
diastolic >110 mmHg

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8
Q

cardiac rehab

A

coordinated sum of interventions required to ensure the best physical, psychological and social conditions so pts w/ chronic or post acute CV disease may, BY THEIR OWN EFFORTS, preserve or resume optimal functioning in society, and through improved health behaviors, slow or reverse progression of disease

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9
Q

What type of PTs benefit the most from cardiac rehab

A
  • stable angina
  • stent placement; post angioplasty
  • post MI
  • CHF
  • heart transplant, CABG, Valve Replacement
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10
Q

Phases of Cardiac Rehab

A

Phase I: IP (covered by insurance)

Phase II: OP w/ EKG monitoring (covered by good plans 1-8-12wks)

Phase III: OP; less monitoring

Phase IV: independent maintenance (not covered)

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11
Q

Inpatient Rehab Goals: PHASE I

A
  • Mobilize ASAP to prevent effects of bed rest
  • Educate on risk factors, CAD, ex intolerance
  • progress activity (4 MET level)
  • prepare to return home
  • independent in HEP
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12
Q

Responsibilities of the PT

A
  • assess physiologic responses
  • supervising the exercise program
  • accurately charting and recording the pts program and tx response
  • pt and family edu
  • prepare for discharge
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13
Q

Phase I: No exercise if HR is

A

> 120 bpm if medical tx (MI)

> 130 bpm if surgical

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14
Q

Phase II

A

1-2 wks after discharge from MI, CABG, PCI

3 visits /wk for 12wks

  • closely supervised
  • group exercise
  • GXT
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14
Q

If you cant use HR (bc of cardiac transplants, pacemakers, beta blockers), what would you use?

A

RPE 12-13
or an increase of 2 or 3 on 7-20 borg scale

15
Q

What is the functional capacity met level for phase III cardiac rehab

A

at least 5 METS

16
Q

Phase III structure

A
  • no direct medical supervision
  • less structure
  • more individualized
  • self monitoring
17
Q

Phase IV structure

A
  • for maintenance or improvement from Phase I and II
  • not supervised by PT
  • program set by PT
18
Q

Resistance Exercise Parameters

A
  • large muscle groups
  • light weight for 20 reps
  • if pt can do 30, increase rate

*less resistance for lesser BP response and strain on CV system

19
Q

Phases of Cardiac rehab exercise examples

A

Phase 1: constant intensity treadmill, cycle, rowing

Phase 2: varying intensity swimming, running, biking

Phase 3: game activity so intensity varies; sports LOW RISK PTS

20
Q

HIIT

A

interspersing intervals of exercise at greater than 85% of peak HR or workload w periods of low intensity of rest

21
Q

Why is HIIT better than MICE (mod intensity continuous activity) >

A
  • HIIT elicits greater changes in VO2Peak
  • HIIT appears safe and better tolerated
  • HIIT mimics short and long term peripheral and central adaptations
  • like walking and then going up a flight of stairs (more functional)
22
Q

Low Volume HIIT parameters and examples

A

<15 min
30 sec intervals-60 sec
60-80 min/wk
71% training response and higher
adherance

Examples: walking, side stepping, seated marching, seated dealing cards, reaching activities

23
Q

according to research, when should you start HIIT with a CVP patient?

A

after successful completion of 12-18 sessions of a supervised early CR program (PHASE II)

24
Q

Median sternotomy

A

midline incision: sternal notch to base of sternum

25
Q

common symptoms post CABG

A
  • increased fatigue
  • decreased MAX aerobic capacity
  • impaired gas exchange
  • shoulder pain
  • back pain
  • TTP and itching
  • pain during activity
26
Q

Activity limitations following CABG

A

decreased upright staning tolerance
impaired balance
impaired functional mobility (walking, transfers, stairs)

27
Q

Participation restrictions following CABG

A
  • adls and work
  • family roles and responsibilities
  • recreation and leisure activities
  • community life
  • intimate relationships
  • QoL
28
Q

Sternal Complications

A
  • dehiscence,
  • infection
  • sternal instability
29
Q

Sternal Instability Scale

A

0: clinically stable sternum - normal w no motion
1: minimally separated sternum - slight increase in mvmt
2: partial separated sternum
3: completely separated sternum - entire length

30
Q

Sternal Precautions

A
  • completely or partially decrease use of arms during everyday stress
  • prevent skin shear

no pushing, pulling, lifting >10 lbs
no bilateral shoulder flexion of abd >90
no driving
no prone
no bilateral UE ext past neutral

31
Q

How long post op can you scar massage

A
  • 6 wks assuming incision is fully healed
  • perpendicular, circular, and parallel
32
Q

Bed Mobility post cabg

A

be able to explain it

33
Q

airway clearance w CABG

A

upright position w pillow
hugg coughing/splinting coughing

34
Q

we want to gradually increase endurance tolerance to ____ HRR during phase 1

A

40-80%

35
Q

You’re doing great!

A

No, seriously! You know so much already!!

36
Q

What scale is better than RPE for patients with heart disease

A

dyspnea scale

CardioPulm (17 decks)

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