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Cardio Pulm: quiz 3 > Exercise Guidelines For Cardiovascular Disease > Flashcards

Exercise Guidelines For Cardiovascular Disease Flashcards

1
Q

Goal of cardiac Rehab

A

Enable patients to resume active and productive lives within imposed limitations

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2
Q

Specific objectives of cardiac rehab

A
  • restoring optimal physiologic, psychosocial and vocational status
  • Prevention of progression or reversal of disease
  • reduction of risk of SD and reinfarction
  • Alleviation of symptoms
  • Patients become responsible and autonomous for their medical treatment and lifestyle charge
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3
Q

Diagnosis Candidates for cardiovascular disease

A
  • MI
  • CABG
  • Stable Angina Pectoris
  • Silent Ischemia
  • Valve Replacement
  • High risk for CHD
  • Congenital heart defects
  • Cardiac arrhythmia
  • Transplant –> heart and lung
  • Secondary and tertiary Prevetion
  • PAD
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4
Q

What is included in the multidisciplinary program

A
  • Medical treatment
  • Nutritional counseling
  • Smoking cessation
  • Risk stratification
  • Stress management
  • Hypertension management
  • Control of diabetes or dyslipidemia
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5
Q

Phase 1 of cardiac rehab is during what period and last how long?

A

-In- patient period

Lasts about 3 days (until discharge)

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6
Q

What is the goal of phase 1

A

Counteract the deleterious physiological effects of BED REST and prevent a “cardiac Cripple” from emerging

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7
Q

What type of activities are performed phase 1?

A

-Low level functional activities

Passive ROM to active ROM and progress to walking and stairs

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8
Q

When is phase 2 for cardiac rehab and how long does it last?

A

Out patient phase

-3 months duration

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9
Q

What is the goal of phase 2 cardiac rehab

A

Increase FUNCTIONAL and CARDIOVASCULAR efficiency of the patients

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10
Q

How is cardiac rehab monitored for phase II

A

Telemetry

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11
Q

Exercise for phase II rehab?

A

Individual exercise prescription for each patient

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12
Q

When is phase III and how long does it last?

A
  • Supervised phase

- 4-6 months duration

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13
Q

Goal of phase III

A

To decrease supervision of exercise program and to promote self-regulation of said program

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14
Q

How it phase III monitored?

A

Heart Rate (NO telemetry)

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15
Q

When is phase IV and how long does it last?

A

Unsupervised phase

Lifetime in duration

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16
Q

Phase IV goal

A

Maintain the lifestyle the lifestyle changes acquired in cardiac rehab

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17
Q

What is the exercises of phase IV

A

Client exercises on own

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18
Q

Exercise reduces what ?

A

long-term mortality

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19
Q

Exercise may retard what process?

A

atherosclerotic

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20
Q

exercise causes what type of change in lipid profile?

A

postive change

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21
Q

Exercise increase cellular sensitivity to?

A

insulin

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22
Q

Exercise causes a modification of?

A

TABP

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23
Q

Exercise does what to platelet adhesiveness?

A

decrease

24
Q

Exercise does what to fibrinolysis ?

A

enhance

25
Q

Exercise does what to PNS outflow

A

increase

26
Q

Exercise causes a little change in what? but has a significant change in what?

A

Little in central

significant in peripheral parameters

27
Q

Exercise does what to ECG abnormalities ?

A

decrease

28
Q

Exercise causes an increase in VO2 max for MI? CABG? AP? severe LVD?

A

MI: 11-56%
CABG: 14-66%
AP: 32-56%
Severe LVD: 20%

29
Q

what is superior to percutaneous coronary intervention?

A

EXERCISE AND DIET

30
Q

Exercise promotes?

A

vascular stability

31
Q

exercise improve vascular what?

A

wall inflammation and endothelial

32
Q

What are contraindication/ Precautions ?

A
  • RHR> 100!
  • Unstable angina
  • Unstable dysrrhythmias
  • serious heart block
  • Unresolved CHF
  • Uncontrolled HTN
  • PE
  • Cardiogenic shock
  • Severe physical or emotional impairment
  • Moderate to severe aortic stenosis
  • Uncontrolled atrial or ventricular dysrhythmias
  • Active pericarditis or myocarditis
  • Uncontrolled DM
  • Hh below 7
  • Pulmonary HTN
33
Q

what is the Frequency & duration of exercise for phase I?

A

5-7 days per week

15 mins BID

34
Q

Intensity of Phase I (MI & CABG)

A

MI: 20 BAR
CABG: 30 BAR

35
Q

what are phase I patients told to do when they go home?

A

WALK

36
Q

What should be evaluated in phase II-III?

A
  • cardiac stress test
  • Laboratory studies
  • PFT if pull involvement
37
Q

Frequency and duration of phase II-III

A
  • 3-5x per week with weekend of evening walks

- 20-45 minutes of aerobic

38
Q

What should the karvonen be for phase II and III

A

II: 50-70%
III: 70-80%

39
Q

MHR is what?

A

peak HR off of stress test

40
Q

What is the calculation fro Karvonen?

A

[(MHR-RHR)x …..%] + RHR

41
Q

What is RPE?

A
  • rate of perceived exertion –> BORG SCALE

- subjective measurement of the exercise response (psychophysiologic measurement)

42
Q

when can RPE be used?

A

Only in conjunction with the THR and other objective measurement variables

43
Q

Intermittent Training

A
  • rest periods of less than 1 min btw modalities
  • alternating leg and arm exercises
  • achieve a higher intensity level with less leg fatigue
  • Allows for more diverse activities
  • Permits different muscle groups to be stressed
  • Ischemic signs monitored more carefully during rest periods
44
Q

When are Ischemic signs monitored more carefully

A

during rest periods

45
Q

cool down consists of?

A

low level walking then stretching

46
Q

Walking decreases what?

A

cardiac output slowly and prevents syncope

47
Q

when can resistance training be performed for a MI or CABG?

A

min of 5 weeks; 4 weeks in a supervised program

48
Q

when can resistance training be performed after a PTCA

A

at least 2 weeks in a supervised program

49
Q

Monitoring

A
  • Impairments
  • Vital signs
  • ECG changes
  • Psychosocial
  • Daily
  • Modalities
  • Medication changes
  • Alcohol or caffeine
  • THR
50
Q

impairments that are being monitored include?

A
  • VO2 max

- Lipid profile (total cholesterol, HDL, LDL, triglycerides, risk factors)

51
Q

vital signs that are being monitored include?

A
  • RHR

- RBP

52
Q

Psychosocial that is being monitored are

A
  • return to work
  • Stress level
  • Coping mechanisms
53
Q

Stress testing for cardiac

A
  • Determination of human maximal capacity for physical work
  • Detection or confirmation of ischemic heart disease (in “healthy”)
  • assessment or treatment procedures for patient with ischemic heart disease
  • Evaluation of cardiac dysrhythmias and the risk of cardiac sudden death
  • Prescription for exercise
54
Q

what is important to know for stress test?

A
  • hyperventilation prior to test
  • Resting vitals
  • meds
  • medical history
  • length of test
  • reason for termination
  • ECG
  • BP
  • MAX HR prior to symptoms
55
Q

what are some things you should take into consideration ? (4)

A
  • ARM bike (shoots up BP)
  • Aquatic therapy (can be okay… too hot)
  • Sternal precautions
  • DM

Cardio Pulm: quiz 3 (5 decks)

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