Interventions for cardiac conditions Flashcards
During exercise testing, should the patient be on their dosage of medication?
Yes- You want to see how they perform on their medication
EKG monitoring for every session of treatment is used during which phase of cardiac rehab?
Phase II:
- Is a supervised program 6-8 wks
- the GOAL is to increase exercise capacity to 5 METS (A brisk Walk)
Cardiac Rehab phase II is a supervised 6-8wk program consisting of EKG monitoring, increasing exercise capacity to 5 METS, and what two other factors?
- Performing an exercise test prior to rehab
- Patient education on HR, exercise, symptoms
Phase II consists of several components, what are the physical Activity Core components?
- EVALUATION: assess current Physical Activity level and readiness to change behaviors.
- INTERVENTIONS: Advice, support, counseling, follow up
- EXPECTED OUTCOMES: increased participation in physical activity and aerobic fitness, well being.
What are the Exercise Training Core components of phase II cardiac rehab?
- EVALUATION: Symptom limited exercise test to monitor HR, rhythm, s/s, perceived exertion, capacity
- INTERVENTIONS: Individual exercise program, FITT and Progress
- EXPECTED OUTCOMES: Increased aerobic capacity, strength, flexibility and reduced symptoms, improved risk factor profile, and improved QOL
The following are outcomes for which phase of cardiac rehab?
- Goal is to exceed 8 METS or 2 times energy requirements of work
- Training effects are expected
- No cardiac symptoms
- EKG is used sometimes or when increasing activity parameters
- pts learn self-monitoring of HR and symptoms
Phase III Outcomes
Phase IV of cardiac rehab consists of what two objectives?
- Unsupervised program
- Community based
What is an appropriate expected outcome of a cardiac rehab program?
- Improved exercise tolerance
- Return to work
- improved quality of life
- Decrease risk factors (weight loss, diet, stop smoking)
Your patient requires constant EKG monitoring, which phase of cardiac rehab are they?
Phase II
Exercise training greatly effects ejection fraction.
True or False
False: Exercise training has little effect on ejection fraction
Do elderly patients have exercise trainability similar to that of younger patients?
YES!
You have a patient 4 weeks post MI, can you safely begin a resistance program?
NO, must be a minimum of 5 weeks post MI, including 3 weeks in cardiac rehab
You have a patient who is 8 weeks post CABG, can you begin a resistance training program in cardiac rehabilitation?
YES- min of 8 weeks post CABG, including 3 weeks of rehab.
Resistance training for cardiac rehab is defined as what percentage of 1RM?
> 50%
You have a patient who is difficult to work with and has a poor exercise capacity. Will education, counseling, and behavior modification improve their exercise capacity?
NO!
You are assessing a patient with a nasty wound on the lower calf and capillary refill of big toe is >8 seconds. What is a probable diagnosis for this patient?
PVD: poor wound healing and poor vascular perfusion of lower leg.
You suspect that your patient is having lower limb problems, and you suspect PVD. What test could you have them perform to help confirm your hypothesis?
Active Pedal Plantarflexion (APP) Intermittent CLaudication test.
or
ABI
You have a patient with PAD (peripheral artery disease), what type of exercise prescription is appropriate?
Ambulation to modest to moderat pain (grade 1 or 2 on claudication scale), rest, repeat for 30-60 minutes a day.
Typical outcome measures for PAD/PVC include?
ICD- initial claudication distance ACD-absolute claudication distance Self reporting walking limitations Peak vo2 QOL
THe following are characteristics of individuals with symptomatic what?
- Adult age 65
- Peak VO2 is 50% of age-predicted normal
- ICD (initial claudication distance) 110 meters
- Sedentary
PAD
What are effective interventions for PAD?
Medication to control risk factors
Medication to improve claudication
Surgery
EXERCISE TRAINING! (home, supervised, dynamic)
The following drugs are used to treat which disease?
Cilostazol, Pentozifylline, and L-carnitine
PAD/PVD