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Cardio 2 Exam 2
Inpatient Cardiac Rehab
24
Other
Not Applicable
11/11/2005

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Cards

Term
What is the typical length of stay following an uncomplicated MI or CABG?
Definition
4-5days
Term
What are some of the reasons it is difficult to develop an effective inpatient cardiac rehab program?
Definition
Pts are often anxious, and taking meds affecting cognitive function.
Term
Pts post MI or cardiac surgery should be provided with inpt CR for what major issues? (3)
Definition
1. Early assessment and mobilization. 2. ID and info regarding cardiovascular disease risk factors and self-care. 3. A comprehensive d/c planning session that includes duscussion of follow-up options for transitional care, home programming and formal outpatient CR.
Term
Inpt CR goals should be developed for what areas?(5)
Definition
1. Physical function. 2. Return to work. 3. Risk factor reduction. 4. psychological well-being. 5. family and social adjustment.
Term
What two basic tenets should d/c planning consider?
Definition
1. pt safety 2. program continutity.
Term
A pt is considered stable to begin rehab under what conditions? (4)
Definition
1. no new/recurrent chest pain in the past 8 hrs. 2. CK and/or troponin levels not rising. 3. No new signs of uncompensated failure (dyspnea @ rest w/ bibasilar rales. 4. No new significant, abnormal rhythm or ECG changes in past 8hrs.
Term
Pts my be considered for activity progression when activity responses include what 4 things?
Definition
1. Adequate HR increase. 2. Adequate SBP rise to within 10-40mmHg from rest. 3. No new rhythm or ST changes are ID'd on telemtry strip. 4. No cardiac Sx such as palpitations, dyspnea, excessive fatigue or chest pain.
Term
what are the adverse responses to inpt exercise that will lead to exercise discontinuation?(5)
Definition
1. DBP>110. 2. SBP decrease >10. 3. Significant ventricular or atrial arrhythmias. 4. Second or third degree heart block. 5. Signs/Sx of exercise intolerance.
Term
What are appropriate activity MET levels for the first 4 days postop/postMI?
Definition
Day 1 = Critical Care, 1-2METS. Day 2 = Transfer to step-down unit, 2-3 METS. Day 3=2-3METS. Day 4 = 3-4METS.
Term
What are some inpatient activities that require 1-2 MET energy expenditure? (4)
Definition
1. Bedpan. 2. Commode. 3. Urinal (in bed or standing). 4. OOB in chair.
Term
What are some inpatient activities that require 2-3 MET energy expenditure? (5)
Definition
1. Bed bath. 2. Tub bath. 3. Shower. 4. Sitting warm-ups. 5. Walking in room.
Term
How many METS are the following: Walking on a flat surface @: 2, 2.5 and 3MPH?
Definition
2mph=2-2.5METS. 2.5mph=2.5-2.9METS. 3mph=3-3.3METS
Term
Upper body exercises while standing spend how many METs for the following: Arms and Trunk?
Definition
Arms = 2.6-3.1 Trunk = 2-2.2
Term
How many METs is expended by descending and ascending one flight of stairs?
Definition
Down = 2.5. Up = 4.0
Term
What would you expect the HR response to be w/ 1-2MET activities?
Definition
5-15 beats from RHR
Term
What would you expect the HR response to be for 2-3MET activities?
Definition
10-20beats from RHR
Term
What is the expected HR response to 4MET activities?
Definition
10-25 beats from RHR
Term
What three activities will you allow your Day 1 post-op/post-MI pt to do while in the CCU?
Definition
1-2 MET activities; Bed rest until stable, then OOB in chair and bedside commode.
Term
What activities will you allow your Day 2 inpt to do?
Definition
Routine CCU activities w/ emphasis on self-care. Sitting warm-ups. Walking in the room. (2-3METS)
Term
What activities can your Day 3 Inpt do?
Definition
OOB as tolerated, Standing warm-ups, Walking 5-10mins in hall 2-3times/day. (2-3METS)
Term
What activities will your Day 4 Inpt be doing?
Definition
Shower w/ seat, Standing warm-ups, walking 5-10 mins in hall 3-4 times; up one flight of stairs; treadmill walking. (3-4METS)
Term
What do you want the patient to know in the event of a sudden heart problem? (Their emergency plan)(4)
Definition
1. Recall and compare Sx of their presentation to common signs and Sx (recognize their Sx!). 2. Describe the sequence of steps should similar/suspicious Sx occur. 3. Don't waste time waiting and wondering. 4. Choose a form of emergency ID.
Term
What is the plan of action if the pt experiences signs/Sx of another heart attack if nitro is prescribed? (5)
Definition
1. Stop what they're doing. 2. Quickly sit or lie down. 3. If Sx don't lessen in 1-2mins place 1 nitro under tongue & expect relief in 3-5min. 4. If no relief or worsens, take another nitro. 5. Wait another 5 mins, and if still no relief take another.
Term
What is the plan of action if the pt experiences signs/Sx of another heart attack if nitro is prescribed? (4Do's, 3 Don'ts.)
Definition
1. Stop what doing. 2. Sit or lie. 3. If Sx don't less in 1-2min, summon help by shouting to have someone call 911. 4. Request transport to nearest ER. 5. Do NOT try to get to physician = waste of time! 6. Do NOT drive self to hospital. 7. Do NOT worry about false alarms.
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