Phase 2 Cardiac Rehab (pt. 1) Flashcards
(34 cards)
when does phase 2 begin
when pt enters MI program or open heart program
when does pt enter an MI program
4 weeks post MI
when does pt enter open heart program
2 weeks post open heart
goals of phase 2 rehab
prevent effects of prolonged bed rest (4 days)
improve fxn, fitness and potential ability to work
absolute contraindications to phase II exercise (1)
resting SBP > 200 mmHg, DHP > 110 mmHg
profound orthostatic hypotension
O2 sat < 86%
PaO2 < 60
acute pulmonary embolism
profound orthostatic hypotension
drop in BP > 20 mmHg w/ symptoms
absolute contraindications to phase II exercise (2)
digoxin toxicity
any profound symptoms
rapid/prolonged arrythmias
significant peri/myocarditis
pericardial effusion
profound symptoms
nausea, dyspnea, lightheadedness
absolute contraindications to phase II exercise (3)
poor SBP response to exercise
acute phleb
acute hypoglycemia or metabolic disorder
pending lab tests
acute MI (<2 days after MI)
absolute contraindications to phase II exercise (4)
new ECG signs and symptoms of MI
suspected or known dissecting aneurysm
signs of emotional distress
profound CHF (S3)
what does phase II cardiac rehab program consist of
36 visits or 18 weeks/event
pt seen 2-3x a week
cardiac dx that qualify for phase II rehab
MI (w/in 1 yr)
open heart (w/in 6 months)
stent (w/in 6 months)
repair of great vessel (w/in 6 months)
cardiac transplant)
cardiac dx that qualify for phase II rehab (2)
angina (proof of ischemia)
LVAD
cardiac myopathy
CHF
pacemaker
cardiac dx that do NOT qualify for phase II rehab
CAD (w/ no event or proof of ischemia)
over time limits
angina with no proof of ischemia
cardiac assessment for phase II rehab
fxnal steady state
6 minute walk test
fxnal steady state
HR every minute
BP and RPE every 4 min
3 stages, 4 min each
6 min walk test
less than 300 m is poor indicator for short term survival
what is exercise prescription is determined by
initial assessment findings
results of stress test/FSS
MD orders
extent of dz process
other contributing factors
goal for modified program
advance activity levels from 40-50% to 75% of predicted max
increase 5% every 2 weeks
modified program warm up
5-10 min or warm up and cool down
what RPE should we start at –> modified program
11 and finishes at end of cardiac rehab with 13 RPE
exercise –> modified program
20 minutes of exercise exclusive of warm-up and cool down to start
work up to 45 minutes of exercise exclusive of warm-up and cool down to start
when should you increase exercise intensity –> modified program
1 MET every 2 weeks
progressing HR % –> modified program
weeks 1-2 (50%)
weeks 3-4 (55%)
weeks 5-6 (60%)
weeks 7-8 (65%)
weeks 9-10 (70%)
weeks 11-12 (75%)
