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Three phases of Cardiac Rehabilitation
1 - acute illness to discharge from hospital, promote rest and limited mobility, monitor HR and BP with activities
- 2 – begins after discharge and continues
- through convalesence at home
3 – long term conditioning
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Restoration of a person to an optimal state of functioning in six areas…
Physiological
Psychological
Mental
Spiritual
Economic
Vocational
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Many patients recover from physical illness but may never attain the
psychological wellness because of misconceptions regarding the illness or life changes needed.
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CAD is a chronic
illness, not cured or will disappear
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Physical Exercise Increases
Increases CO
- Increases blood flow through the coronary
- arteries
Increase muscle mass and flexibility
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Physical Exercise Decreases
Decreases blood lipids
Decreases BP
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Physical Activity levels are measured through
MET (metabolic equivalents units)
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1 MET is the amount of
oxygen needed by the body at rest (3.5 ml of Oxygen per kilogram per minute)
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By discharge goal for patient able - tolerate at least
3 MET
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<3 MET =
eating, washing hands, driving a car
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3 -6 MET =
showering, using a bedpan, dancing etc
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6-8 MET =
walking up stairs /mowing lawn with mower
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>9 MET =
heavy labor, shoving heavy snow
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Physical Exercise Patient teaching…
Avoid overexertion
“listen to what the body is saying”
Avoid exercising outdoors in extreme temperatures.
Avoid extreme hot or cold showers after exercise
Know what type of exercise is appropriate
“isotonic vs isometric”
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Isometric (static) Exercises
Should be limited
Increase HR and BP rapidly
Lifting, carrying and pushing heavy objects
Involve straining muscles against other muscles
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Isotonic Exercises (dynamic)
Walking, jogging, bike riding
Put a safe steady load on the heart
Improve circulation to many organs
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Sexual Activity after an MI
- Before counseling, the nurse needs to know the patient’s…
- - physiological status
- - psychological effects of having an MI
Sexual dysfunction after MI is common and that dysfunction usually disappears after several attempts
Medication to correct erectile dysfunction available but caution use when taking nitrates
Chest pain during intercourse can occur
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Sexual Activity Can generally be resumed about
1 week after an uncomplicated MI
The energy expended during sexual activity is similar to walking briskly up two flights of stairs
Inability to perform sexually after MI is common and the dysfunction usually disappears after several attempts
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