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17 Cards in this Set
- Front
- Back
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Cardiac Rehab Dx Requirements |
Cabg within 12 months PCI HF Heart valve repair/replacements Heart transplantation Stable Angina |
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Define intensive cardiac rehab |
Intensivecardiac rehabilitation (ICR) refers to a physician-supervised program thatfurnishes cardiac rehabilitation services more frequently and often in a morerigorous manner. |
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What must an ICR accomplish for its pts? |
One or more of the following 1)positively affected the progression of coronary heart disease 2)reduced the need for coronary bypass surgery 3)reduced the need for percutaneous coronary interventions |
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TheICR program must also demonstrate through peer-reviewed published research thatit accomplished a statistically significant reduction in what measures? |
1)low density lipoprotein 2)triglycerides 3)body mass index 4)systolic blood pressure 5)diastolic blood pressure 6) theneed for cholesterol, blood pressure, and diabetes medication |
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What is required for a Cardiac Rehab Facility? |
-Professional physician must be onsite -Facility has available cardio pulm emergency diagnostic and therapeutic life saving equipment -Program is conducted in an area set aside for exclusive use of the program while in session -Staffed by personnel that can conduct the program safely and effective and trained in BLS -Diagnostic testing - stress testing at start of program -ECG monitoring -36 sessions allowed |
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Options for a PT if not a Cardic Rehab facility |
If there is no physician supervision cannot call it cardiac rehab Can bill under Ther Ex Should still be able to read an ECG Have life saving equipment |
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4 phases of cardiac rehab |
•Phase 1- Acute Phase •Phase 2- Subacute Outpatient Phase •Phase 3 – Community Exercise Programs •Phase4 – Lifestyle modification before a cardiac event |
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Describe Phase 1 Rehab goals and outcomes |
Common for uncomplicated MI (3-5days) Start Rehab 24hrs post MI - monitor activity/ADL tolerance Counteract effects of bed rest -Maintain muscle tone -Reduce orthostatic hypotension -Maintain Joint mobility -Reduce risk of emboli Pt education |
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What are the Phase 1 exercise guidelines post uncomplicated MI |
•EarlyADLs •Supervisedambulation •Frequency -Short exercise session 2-3 times/day •Intensity-Initial MET activity in (2-3 MET range) ---Advanceto 5 METs by end of stay ---Post MI70 % max HR and or 5 METS -Until 6 weeks post MI ---RPE inlight range (8-11) ---HR ↑ of10-20 bmp above resting, depending on medications •Time –Short bouts -Gradually increase time •Type- Walking , ADLS •Strengthening – must stay under 5 METS and be cautious of Val- Salva |
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What are the Phase 1 exercise guidelines post surgical pts (Cabg, PCI) |
Can be progressed more rapidly - unless they had an MI CABG: No UE wt lifting for 6 weeks, can do LE resistance training PCI: Strengthening - 3 weeks post surgery |
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What is included in phase 1 pt education |
-Risk factor modification -Self monitoring - exertional intolerance/angina/dyspnea -Energy Conservation - pacing/activity monitoring -Sternal Precautions |
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HEP with Phase 1 cardiac rehab? |
Low risk exercises pt can do unsupervised Walking on own 102x/day--progressing up to 30 min (4-6weeks post MI) UE and LE ROM activities Recommend training family in CPR and Automatic External Defibrillator |
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Phase 2 Cardiac Rehab goals? |
Weeks 3-6 Improve function Return to Full ADLs Lifestyle Changes |
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Phase 2 exercise guidelines |
•Frequency 2-3 times week •Intensity- ---5 -9METS ---RPE-11-13 •Time 30-60 min with 5 -10 minwarm up cool down •Type TM, UBE, Cycle ) •Include strengthening ---5 weeksPost MI ---7 -8Weeks post CABG ---Light(1-3 #) hand weights or elastic bands Anyone with arrythmias or angina should be monitored with and ECG |
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Pt and family education for Phase 2 |
•Improveunderstanding of cardiac disease •Teachself-monitoring and warning signs •Teachgeneral activity guidelines, pacing, energy conservation, HEP •TeachCPR •Provideemotional support |
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Goals and outcomes for phase 3 cardiac rehab |
Improve functional exercise capacity Promote self regulation of exercise programs Life long risk factor modification |
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Exercise guidelines in Phase 3 |
Entry level criteria -Functional capacity of 5 mets -Clinically stable angina -Medically controlled arrythmias during exercise Progression to 50% to 85% of functional capacity 3-4x/wk for 45mins or more Regular medical check ups |
