Cardiac Rehab Flashcards
(35 cards)
A resting ST segment depression or elevation greater than what is a contraindication for cardiac rehab?
> 2mm
Is uncompensated heart failure a contraindication for cardiac rehab?
YES
How long do phase 1 and phase 2 cardiac rehab last?
Phase I: 3-5 days
Phase 2: up to 12 weeks
Before beginning cardiac rehab a patient should have no new or reccurent chest pain or no new significant or abnormal heart rhythm or ECG changes in how long?
8 hours
Phase I cardiac rehab should be discontinued if the following are seen with…
- Heart Rate
- DBP
- SBP
- ventricular/atrial dysrhythmias
- heart block
- signs of ischmia
- > 130 BPM or >30 bpm above resting heart rate ****
- DBP >110
- decrease in SBP >10
- significant ventricular or atrial dysrhythmias
- 2nd or 3rd degree heart block
- angina, marked dyspnea, and ECG changes suggestive of ischemia
What MET level should a patient be exercising at in Phase I?
progressive level walking (2-3 METS)
or
waling up and down steps or treadmill walking (3-4 METS)
What should the RPE be during Phase I? What should heart rate be post infarction heart rate vs. post surgery heart rate during phase I exercises?
RPE <13 (6-20)
Post Infarction: heart rate <120 BPM or <20 bpm above rest
Post Surgery: <30 BPM above rest
Duration of phase I exercise?
bouts of 3-5 minutes progressing to 10-15
Frequency Phase I?
first 3 days: 3-4 times per day
After three days: 2x per day with increased duration
For low risk patients with known stable coronary artery disease how many sessions of ECG and BP monitoring and medical supervision are recommended?
6-12 sessions
For moderate to high risk patients with known stable coronary artery disease how many sessions of ECG and BP monitoring and medical supervision are recommended?
usually >12 sessions
A rating of what on the Angina scale is the recommended end point to cease activity during cardiac rehab?
What should the patient do at this point?
1
scale 1-4
patient should discontinue activity and rest in sitting or recumbent position and be encouraged to use medications as directed
When should a patient be transported to nearest medical center if angina is not relieved?
if angina not releived by termination of activity or by 3 sublingual nitroglycerin tablets (one taken every 5 minutes)
Exercise should be how BPM below the known ischemic or anginal threshold?
> 10 beats per minute below
Exercise should be discontinued during phase II cardiac rehab if the what happens to the following…
- HR
- SBP
- DBP
- ST segment
- heart block
- ventricular dysrhthmias
- angina
- plateau or decrease in HR with increased work
- SBP plateaus or falls withi increase work or SBP ?250
- DBP >115
- > 1mm ST segment depression
- 2nd or 3rd degree heart block
- ventricular dysrhythmias
- angina or other symptoms of cardiovascular insufficiency
How is upper and lower target heart rate calcuated using the Heart Rate Reserve (HRR) or Karvonen formula?
use 40% for low and 85% for high
Lower THR: [(HRmax-HRrest)x40%] + HR REST
Higher THR: [(HRmax-HRrest)x80%] + HR REST
How is HRmax calcuated?
220-age
What is 1 MET equivalent to?
1 MET is energy expended while sitting quietyly
AKA 3.5 mLO2/kg/min
How is a Lower and Upper MET level established?
SAME THING AS KARVONEN OR HERAT RATE RESERVE (HRR)
Lower MET: [(METmax-METrest)x40%] + HR REST
Higher MET: [(METmax-METrest)x80%] + HR REST
What are 3 major situations in which HR cannot be used to regulate intensity?
- After heart transplant
- patients taking beta blockers
- no exercise testing done prior to cardiac rehab
An RPE of what corresponds to a 40-85% of max capacity?
12 to 16 (somewhat hard to hard) corresponds to 40-85% of max capacity
What are appropriate RPE ranges early in rehab vs. later?
Early: 11 to 13
Late: 14 to 16
Duration of rehab during
- the first month
- 3 to 4 months
- after 6 months
- 15 to 20 minutes
- 25 to 30 minutes
- 40 minutes or longer
How many days per week during Phase II?
3 to 5 days
