Phases Of Cardiac Rehab Flashcards
Effects of dobutamine on heart and what receptors does it target
B1, B2, a1. It is inotropic and chronotropic. It Increases CO, SV
Two of the most commonly used pharmacologic stress tests
Dobutamine stress echo
Thallium scintigraphy with dipyridamole or adenosine
How many METs is sexual intercourse
3-4
Sexual intercourse is as physically intense as _________
Climbing 2 flights of stairs. If a patient can do this, they can have sex
Which phase is the maintenance phase
Phase 3/4
What does graded exercise testing assess?
Ability to tolerate increased physical stress
What uses more METs, using a bedside commode or using a bedpan?
Using a bedpan requires more METs (4.7) than bedside commode (3.6)
Most of the ADLs in the home environment require less than how many METs?
4
How many METs is mopping the floor
2-4
3 different exercise testing with imaging
- Exercise echo
- Exercise nuclear imaging
- Exercise pharmacologic stress testing
How many METs is regular speed walk (3mph)
3-4
Advantage of treadmill exercise testing
Physiologic stress
HR and BP parameters for phase 1
Don’t let HR go above 120 or below 50. Don’t let SBP to decrease more than 10-20mmHg for first few days.
BP absolute contraindication for cardiac rehab
> 200/110
How many METs is propelling wheelchair?
2-3
What kind of change in BP during stress testing is an absolute indication to stop exercise testing?
Since BP normally increases when exercising, a decrease in SBP by > 10 = STOP!!
Bruce Protocol
Go up by 2-3 METs per stage
AHA suggests heart rate limit of ____ to ____ bpm for patients not on beta-blocking agents or Borg RPE of ____ to ____
30-140 bpm
RPE of 13-15
It is not recommend to have sexual intercourse for how long after an MI?
2 weeks
Mobilization after cardiac surgery must progress asap to prevent what three things?
Decubitus, pneumonia, dvt
Which phase is the most closely monitored phase
Phase 2
When would you use an arm ergometer for exercise testing
For amputees
Timing of the phases
Phase 1: 1-14 days
Phase 2: 3-6 mths
Phase 3/4: lifetime
A slow stroll is how many METs?
1.5-2
Advantage of a cycle ergometer
Can get better quality ekg because arms and thorax aren’t moving
How many METs is regular slow walk? (2mph)
2-3
2 periods of phase 1
Acute period - in the CCU
Subacute period - transfer from CCU to tele or medical floor
Which phase is outpatient period immediately after inpatient
Phase 2
Patients who are able to tolerate how many METs can resume normal sexual activities?
5-6
Which phase is during the inpatient period
Phase 1
What type of exercise must be avoided in acute period of phase 1
Avoid isometrics, valsalva, and raising the legs above the heart.
Who gets pharmacologic stress testing
People unable to do exercise stress testing
What METs are tolerated in subacute period of phase one?
3-4 METs
How many METs is jogging?
9
Activities of what METs are allowed in the acute period of phase 1?
1-2 METs, passive ROM
During phase 1, if you’re on a beta blocker, do not let HR do what?
Increase more than 20bpm above resting rate.
When doing graded exercise testing, at what METs do you start, and how much do you increase?
Start at 2 METs and increase by 1 MET at each stage
What kind of patients is bruce protocol used in
Patients who are medically stable and have functional capacity of 10 METs
What type of exercise should be done in acute period of phase 1?
Light isotonic exercises
