Cardiac Rehab

Front 1

Exercise tolerance and rehab

Back 1

-improves exercise tol without sig cardiovascular complications or other adverse outcomes

Front 2

strength training

Back 2

-improves skeletal muscle strength and endurance in clinically stable coronary pts
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Front 3

Class I

Back 3

-pts with cardiac dz but without resulting limitations of physical activity
-ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain

Front 4

Class II

Back 4

-pts with cardiac dz resulting in slight limitation of physical activty
-they are comfortable at rest
-ordinary physical activity results in fatigue, palpation, dyspnea or anginal pain

Front 5

Class III

Back 5

-pts with cardiac dz resulting in marked limitation of physical activity
-they are comfortable at rest
-less than ordinary physical activity results in fatigue, palpitaiton, dyspnea or anginal pain

Front 6

Class IV

Back 6

-pts with cardiac dz resulting in inability to carry on any physical activity without discomfort
-sx of cardiac insufficiency or the anginal syndrome may be present even at rest

Front 7

phase I of cardaic rehab

Back 7

-actue phase: early mobilization exercises - from hospital admission to hospital discharge
-low level, dynamic, ambulation, calisthenics, ADLs, closely monitored
-indications: uncomplicated- no ischemia, dysrhythmia, CHF; post MI or post surgical

Front 8

phase II of cardiac rehab

Back 8

-convalescent phase: from hospital discharge to 6 wks post MI
-pts home, but not back to work
-pt cont walking protocol and exercises that were begun in hospital
-self-pulse monitoring
-follow guidelines for activities

Front 9

phase III

Back 9

-training phase: 6 wks to ? 14 wks post MI
-scar formation
-max symptom-limited exercise test
-aerobic endurance training

Front 10

phase IV

Back 10

-maintenance phase: ? 14 wks to ? years
-venue
-recreational activities
-minimal monitoring

Front 11

phase I C/I

Back 11

1. overt CHF
2, MI extention within previous 2 days
3. vtach; >10 to 15 PVCs/ min
4. HTN: syst >160, diast >105
5. hypotension: syst <80
6. sever AoS gradient >80
7. unstable angina within 24 hrs
8. dissecting aortic aneurysm
9. uncontrolled metabolic disease
10. psychosis

Front 12

phase I goals

Back 12

-response to low level exercise withint physiologically safe limits
-tolerance to 5 MET level workloads
-begin pt edu
-reduce depression

Front 13

phase I tests

Back 13

1. holter monitor
2. nuclear scan
3. GXT

Front 14

phase II guidelines for activities

Back 14

1. walk outside in the mildest part of the day
2. hills
3. do not exceed 20 bpm above resting HR
4. eat multiple small meals during the day, avoid large meals at one sitting
5. take rest periods
6. avoid unpleasant or emotional situations
7. resume passive sexual activities

Front 15

phase II sternal precautions

Back 15

1. avoid sternal dehissance!
2. precautions for 6-8wks
3. no lifting >10lbs
4. no driving
5. no forward elevation >90 degrees, no bilateral horizontal abd, ER
6. can do unilateral activities

Front 16

cardiac rehab today

Back 16

-phase I- IV blended and compressed
-in-hospital phase 3-4 days
-emphasis on hospital discharge preparations
-self-monitoring
-home exercise program
-outpt CR for complicated pts

Front 17

monitoring strategies

Back 17

-HR
-BP
-ECG radiotelemetry
-ssx
-use of the hypothesis-oriented algorithm

Front 18

C/I to exercise continuance

Back 18

1. Disproportionate increase in HR, BP
2. Disproportionate decrease in HR, BP
3. Appearance of symptoms
-Chest pain, SOB, claudication
4. Appearance of signs
-Pallor, heart / lung sounds, ST segment changes, dysrhythmia