PT Interventions 4

Question 1

Contraindications for cardiac rehab: angina

Answer 1

Unstable

Question 2

Contraindications for cardiac rehab: BP

Answer 2

SBP over 200 at rest

DBP over 110 at rest

Question 3

Contraindications for cardiac rehab: BP fluctuation

Answer 3

Orthostatic BP drop of more than 20

Question 4

Contraindications for cardiac rehab: arrhythmias

Answer 4

Uncontrolled

Question 5

Contraindications for cardiac rehab: cardiac block

Answer 5

3rd degree heart block without pacemaker

Question 6

Contraindications for cardiac rehab: clotting

Answer 6

Recent embolism

Thrombophlebitis

Question 7

Contraindications for cardiac rehab: ECG

Answer 7

Resting ST segment depression or elevation over 2 mm

Question 8

Contraindications for cardiac rehab: heart failure

Answer 8

Uncompensated CHF

Question 9

What does Phase I cardiac rehab consist of?

Answer 9

• pt and family education
• self-care evaluation
• continuous monitoring of vital signs
• group discussions
• low-level exercise

Question 10

How long does Phase I cardiac rehab typically last?

Answer 10

3-5 days

Question 11

Phase I cardiac rehab: should d/c exercise if HR

Answer 11

Over 130 bpm, or more than 30 bpm over RHR

Question 12

Phase I cardiac rehab: d/c if DBP is above

Answer 12

110 mm Hg

Question 13

Phase I cardiac rehab: d/c if SBP decreases

Answer 13

d/c if SBP decreases more than 10 mm Hg

Question 14

When may active UE and LE exercise begin after CABG/infarction

Answer 14

24 hrs after CABG

2 days after MI

Question 15

Phase I cardiac rehab: exercise should progress from sitting to standing (METS)

Answer 15

1-4 METs

Question 16

Phase I cardiac rehab: aerobic exercise intensity

Answer 16

RPE less than 13 (6-20 scale)

Post-MI: HR less than 120 bpm or 20 bpm over RHR

Post-surgery: less than 30 bpm above RHR

Question 17

Phase I cardiac rehab: aerobic exercise duration

Answer 17

Intermittent bouts of 3-5 mins

Progress to 10-15 mins continuous

Question 18

Phase I cardiac rehab: aerobic exercise frequency

Answer 18

1st 3 days: 3-4x per day

After 3 days: 2x per day with increased duration

Question 19

Phase I cardiac rehab: expected outcomes

Answer 19

• prevent negative effects of bedrest
• walk 5-10 mins continuously
• walk down and up one flight of stairs independently
• know safe HR and RPE limits
• recognize abn s/s
• return to ADLs within limits imposed by dz
• prep pt and home support to optimize recovery

Question 20

Phase I cardiac rehab: inpatient or outpatient?

Answer 20

Inpatient

Question 21

Phase II cardiac rehab: inpatient or outpatient

Answer 21

Outpatient

Question 22

Phase II cardiac rehab includes

Answer 22

• prescribed exercise
• cardiac risk factor modification
• education
• counseling on diet and dz management

Question 23

When does Phase II cardiac rehab begin/end?

Answer 23

Immediately after hospitalization

Lasts up to 12 weeks

Question 24

What is recommended for pts entering an OP cardiac rehab program? (Diagnostic)

Answer 24

Exercise test with ECG

Question 25

For low risk pts with known stable CAD, how many sessions of ECG and BP monitoring and medical supervision is recommended?

Answer 25

6-12 sessions

Question 26

How many sessions of ECG and BP monitoring are recommended for those at moderate to high risk and/or unable to self-regulate or understand recommended activity levels?

Answer 26

≥ 12 sessions

Question 27

Recommended end point to cease activity during IP and OP cardiac rehab (angina)

Answer 27

Rating of ¼ on scale

Question 28

Angina in cardiac rehab: when should the pt be taken to the nearest emergency center?

Answer 28

Angina not relieved by:

• termination of activity OR
• 3 sublingual nitroglycerin tablets (1 taken even 5 minutes)

Question 29

Angina: exercise target HR fore aerobic exercise training

Answer 29

≥ 10 bpm below the known ischemic or anginal threshold