Phases Of Cardiac Rehab

Question 1

Effects of dobutamine on heart and what receptors does it target

Answer 1

B1, B2, a1. It is inotropic and chronotropic. It Increases CO, SV

Question 2

Two of the most commonly used pharmacologic stress tests

Answer 2

Dobutamine stress echo

Thallium scintigraphy with dipyridamole or adenosine

Question 3

How many METs is sexual intercourse

Answer 3

3-4

Question 4

Sexual intercourse is as physically intense as _________

Answer 4

Climbing 2 flights of stairs. If a patient can do this, they can have sex

Question 5

Which phase is the maintenance phase

Answer 5

Phase 3/4

Question 6

What does graded exercise testing assess?

Answer 6

Ability to tolerate increased physical stress

Question 7

What uses more METs, using a bedside commode or using a bedpan?

Answer 7

Using a bedpan requires more METs (4.7) than bedside commode (3.6)

Question 8

Most of the ADLs in the home environment require less than how many METs?

Answer 8

4

Question 9

How many METs is mopping the floor

Answer 9

2-4

Question 10

3 different exercise testing with imaging

Answer 10

1. Exercise echo
2. Exercise nuclear imaging
3. Exercise pharmacologic stress testing

Question 11

How many METs is regular speed walk (3mph)

Answer 11

3-4

Question 12

Advantage of treadmill exercise testing

Answer 12

Physiologic stress

Question 13

HR and BP parameters for phase 1

Answer 13

Don’t let HR go above 120 or below 50. Don’t let SBP to decrease more than 10-20mmHg for first few days.

Question 14

BP absolute contraindication for cardiac rehab

Answer 14

> 200/110

Question 15

How many METs is propelling wheelchair?

Answer 15

2-3

Question 16

What kind of change in BP during stress testing is an absolute indication to stop exercise testing?

Answer 16

Since BP normally increases when exercising, a decrease in SBP by > 10 = STOP!!

Question 17

Bruce Protocol

Answer 17

Go up by 2-3 METs per stage

Question 18

AHA suggests heart rate limit of ____ to ____ bpm for patients not on beta-blocking agents or Borg RPE of ____ to ____

Answer 18

30-140 bpm

RPE of 13-15

Question 19

It is not recommend to have sexual intercourse for how long after an MI?

Answer 19

2 weeks

Question 20

Mobilization after cardiac surgery must progress asap to prevent what three things?

Answer 20

Decubitus, pneumonia, dvt

Question 21

Which phase is the most closely monitored phase

Answer 21

Phase 2

Question 22

When would you use an arm ergometer for exercise testing

Answer 22

For amputees

Question 23

Timing of the phases

Answer 23

Phase 1: 1-14 days
Phase 2: 3-6 mths
Phase 3/4: lifetime

Question 24

A slow stroll is how many METs?

Answer 24

1.5-2

Question 25

Advantage of a cycle ergometer

Answer 25

Can get better quality ekg because arms and thorax aren't moving

Question 26

How many METs is regular slow walk? (2mph)

Answer 26

2-3

Question 27

2 periods of phase 1

Answer 27

Acute period - in the CCU | Subacute period - transfer from CCU to tele or medical floor

Question 28

Which phase is outpatient period immediately after inpatient

Answer 28

Phase 2

Question 29

Patients who are able to tolerate how many METs can resume normal sexual activities?

Answer 29

5-6

Question 30

Which phase is during the inpatient period

Answer 30

Phase 1

Question 31

What type of exercise must be avoided in acute period of phase 1

Answer 31

Avoid isometrics, valsalva, and raising the legs above the heart.

Question 32

Who gets pharmacologic stress testing

Answer 32

People unable to do exercise stress testing

Question 33

What METs are tolerated in subacute period of phase one?

Answer 33

3-4 METs

Question 34

How many METs is jogging?

Answer 34

9

Question 35

Activities of what METs are allowed in the acute period of phase 1?

Answer 35

1-2 METs, passive ROM

Question 36

During phase 1, if you're on a beta blocker, do not let HR do what?

Answer 36

Increase more than 20bpm above resting rate.

Question 37

When doing graded exercise testing, at what METs do you start, and how much do you increase?

Answer 37

Start at 2 METs and increase by 1 MET at each stage

Question 38

What kind of patients is bruce protocol used in

Answer 38

Patients who are medically stable and have functional capacity of 10 METs

Question 39

What type of exercise should be done in acute period of phase 1?

Answer 39

Light isotonic exercises