Term
| What is the typical length of stay following an uncomplicated MI or CABG? |
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Definition
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Term
| What are some of the reasons it is difficult to develop an effective inpatient cardiac rehab program? |
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Definition
| Pts are often anxious, and taking meds affecting cognitive function. |
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Term
| Pts post MI or cardiac surgery should be provided with inpt CR for what major issues? (3) |
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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. |
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Term
| Inpt CR goals should be developed for what areas?(5) |
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Definition
| 1. Physical function. 2. Return to work. 3. Risk factor reduction. 4. psychological well-being. 5. family and social adjustment. |
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Term
| What two basic tenets should d/c planning consider? |
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Definition
| 1. pt safety 2. program continutity. |
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Term
| A pt is considered stable to begin rehab under what conditions? (4) |
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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. |
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Term
| Pts my be considered for activity progression when activity responses include what 4 things? |
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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. |
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Term
| what are the adverse responses to inpt exercise that will lead to exercise discontinuation?(5) |
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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. |
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Term
| What are appropriate activity MET levels for the first 4 days postop/postMI? |
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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. |
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Term
| What are some inpatient activities that require 1-2 MET energy expenditure? (4) |
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Definition
| 1. Bedpan. 2. Commode. 3. Urinal (in bed or standing). 4. OOB in chair. |
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Term
| What are some inpatient activities that require 2-3 MET energy expenditure? (5) |
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Definition
| 1. Bed bath. 2. Tub bath. 3. Shower. 4. Sitting warm-ups. 5. Walking in room. |
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Term
| How many METS are the following: Walking on a flat surface @: 2, 2.5 and 3MPH? |
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Definition
| 2mph=2-2.5METS. 2.5mph=2.5-2.9METS. 3mph=3-3.3METS |
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Term
| Upper body exercises while standing spend how many METs for the following: Arms and Trunk? |
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Definition
| Arms = 2.6-3.1 Trunk = 2-2.2 |
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Term
| How many METs is expended by descending and ascending one flight of stairs? |
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Definition
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Term
| What would you expect the HR response to be w/ 1-2MET activities? |
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Definition
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Term
| What would you expect the HR response to be for 2-3MET activities? |
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Definition
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Term
| What is the expected HR response to 4MET activities? |
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Definition
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Term
| What three activities will you allow your Day 1 post-op/post-MI pt to do while in the CCU? |
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Definition
| 1-2 MET activities; Bed rest until stable, then OOB in chair and bedside commode. |
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Term
| What activities will you allow your Day 2 inpt to do? |
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Definition
| Routine CCU activities w/ emphasis on self-care. Sitting warm-ups. Walking in the room. (2-3METS) |
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Term
| What activities can your Day 3 Inpt do? |
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Definition
| OOB as tolerated, Standing warm-ups, Walking 5-10mins in hall 2-3times/day. (2-3METS) |
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Term
| What activities will your Day 4 Inpt be doing? |
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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) |
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Term
| What do you want the patient to know in the event of a sudden heart problem? (Their emergency plan)(4) |
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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. |
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Term
| What is the plan of action if the pt experiences signs/Sx of another heart attack if nitro is prescribed? (5) |
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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. |
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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.) |
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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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