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Boards Prep- Cardiovascular > Cardiac Rehab > Flashcards

Cardiac Rehab Flashcards

1
Q

Average length of hospital stay for uncomplicated MI

A

3-5 days

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2
Q

Phase 1- exercise/activity goals and outcomes

A
  1. initiate early return to independence; typically after 24hrs or until pt is stable for 24 hours; monitor tolerance
  2. counteract deleterious effects of bed rest
  3. help allay anxiety and depression
  4. provide additional medical surveillance of pts
  5. provide pt and family ed
  6. promote risk factor modification
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3
Q

Phase 1- Program components

A
  1. ADLs
  2. selected arm and leg exercises, early supervised ambulation
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4
Q

initial activities in phase 1

A

low intensity (2-3 METs); progressing to > 5 METs by discharge

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5
Q

post MI activity guidelines

A

limited to 70% HRmax and/or 5 METs until 6 weeks post MI

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6
Q

Phase 1 duration

A

short exercise session, two to three times a day
- gradually duration is lengthened and frequency is decreased

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7
Q

Phase 1 post surgical pt guidelines

A
  • typically are progressed more rapidly than post-MI; unless was a peri-op MI
  • lifting activities are restricted generally for 6 weeks
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8
Q

patient and family education goals for phase 1

A
  1. improve understanding of cardiac disease, support risk factor modification
  2. teach self-monitoring procedures, warning signs of exertional intolerance
  3. teach concepts of energy costs, fatigue monitoring, general activity guidelines, activity pacing, energy conservation techniques, HEP
  4. provide emotional support and assist with referral to social work as needed
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9
Q

Who may benefit from HEP during phase 1

A

low risk patients

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10
Q

phase 1 - unsupervised HEP for low risk patients

A

gradual increase in ambulation time: goal of 20-30 mins, 1-2 times per day at 4-6 weeks post-MI

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11
Q

Phase 1 - elderly homebound patient HEP

A

this population may benefit from a home cardiac rehab program

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12
Q

in order for patients in phase 1 to do HEP, what should they be?

A
  1. skilled in self-monitoring procedures
  2. recommend family training in CPR and AED; emergency lifeline for some patients
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13
Q

eligible patients for phase 2 cardiac rehab

A
  1. MI/acute coronary syndrome
  2. CABG
  3. PCI
  4. stable angina
  5. hear valve surgical repair or replacement
  6. heart or heart/lung transplantation
  7. heart failure
  8. PAD may not be covered by insurance but this population would benefit from supervised exercise program
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14
Q

Exercise goals for phase 2

A
  1. improve functional capacity
  2. progress toward full resumption of activities of daily living, habitual and occupational activities
  3. promote risk factor modification, counseling as to lifestyle changes
  4. encourage activity pacing, energy conservation; stress importance of taking proper rest periods
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15
Q

who benefits from an outpatient phase 2 cardiac rehab?

A

pts at risk for arrhythmias with exercise, angina, other medical problems
- due to the availability of ECG monitoring, trained personnel, and emergency support

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16
Q

what can help in risk factor modification and lifestyle changes during phase 2 of cardiac rehab?

A

group camaraderie and support of program participants

17
Q

phase 2 frequency

A

2-3 sessions/wk

18
Q

phase 2 duration of sessions

A

30-60 mins with 5-10 mins of warm up and cool down

19
Q

modes of training in phase 2

A

programs may offer a single mode of training or multiple modes using a circuit training approach; also includes strength training

20
Q

suggested exit point of phase 2

A

9 MET functional capacity
(5 MET capacity is needed for safe resumption of most daily activities)

21
Q

during phase 2, when can you begin strength training

A
  • after 3 weeks of cardiac rehab
    OR
  • 5 weeks post-MI or 8 weeks post-CABG
22
Q

progression of strength training in phase 2

A
  • begin with elastic bands and light hand weights (1-3lbs)
  • progress to moderate loads; 12-15 comfortable repetitions
23
Q

what is phase 3 of cardiac rehab

A

community exercise programs (postacute, post discharge from phase 2)

24
Q

exercise goals and outcomes from phase 3

A
  1. improve and/or maintain functional capacity
  2. promote self-regulation of exercise programs
  3. promote lifelong commitment to risk factor modification
25
Q

location of phase 3

A
  • community centers
  • YMCA
  • clinical facilities
26
Q

entry level criteria for phase 3

A
  • functional capacity of 5 METS
  • clinically stable angina
  • medially controlled arrhythmias during exercise what
27
Q

is the progression of phase 3

A
  • from supervised to self-regulation of exercise
  • to 50-80% of functional capacity
  • 3-4 times/wk
  • 45 mins or more/session
28
Q

what is required during phase 3

A

regular medical check ups and periodic GXT

29
Q

when is discharge from phase 3

A

typically in 6-12 months

30
Q

goals of resistance training

A
  • improve muscle strength and endurance
  • enhance functional independence
  • decrease cardiac demands during daily activities
31
Q

patient criteria for resistance training post-MI

A

permitted if remain under 70% HRmax or 5 METs for 6 weeks post MI
- be cautious of valsalva

32
Q

criteria for resistance training post cardiac surgery

A
  • LE resistance training can be initiated immediately, in the absence of peri-op MI
  • UE training should be avoided until soft tissue and bony healing has occurred: 6-8 weeks
33
Q

criteria for resistance training post-transcatheter procedure

A

minimum of 3 weeks following procedure and 2 weeks of consistent participation in a supervised cardiac rehab insurance training program

34
Q

exercise prescription for resistance training

A
  1. start with low resistance (1 set of 10-15 reps); progress slowly
  2. resistance can include: weights (50% or more of 1RM), elastic bands, light cuff and hand weights, wall pulleys
  3. RPE should range from 11-13
  4. RPP should not exceed that prescribed during endurance exercise
35
Q
A

Boards Prep- Cardiovascular (21 decks)

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