Cardiac rehabilitation is a branch of rehabilitation medicine or physical therapy dealing with optimizing physical function in patients with cardiac disease or recent cardiac surgeries.
cardiac rehab program may include exercises like cycling on a stationary bike, using a treadmill, low-impact aerobics, and swimming.
Cardiac rehab may benefit you if you have:
Cardiovascular disease
Had a recent cardiac event, such as a heart attack
Heart failure
Had a cardiac procedure, such as angioplasty or heart surgery
An arrhythmia (abnormal heart rhythm) or an implantable device (for example, pacemaker or defibrillator).
2. OBJECTIVES:
GENERALOBJECTIVE:
At the end of the class students will be able to gain adequate knowledge about Cardiac rehabilitation and will
be able to apply this in the clinical setting for better improvement in quality care.
SPECIFIC OBJECTIVES
The students will be able to
1. define Cardiac rehabilitation
2. discuss goals Cardiac rehabilitation
3. elaborate objectives of Cardiac rehabilitation
4. enumerate principles of Cardiac rehabilitation
5. enlist the steps of Cardiac rehabilitation
6. explain components of Cardiac rehabilitation
7. describe phases of Cardiac rehabilitation
3. Time
Specific
Objectives
Content
Teacher
activity
Student
activity
Evaluation
5 min
5 min
5 min
Student will be
able to define
cardiac
rehabilitation
Student will be
able to discuss
goals cardiac
rehabilitation
Introduction: Rehabilitation initially focused
primarily on patients who have had a heart attack.
It is now clear that the rehabilitation process is
equally important in patients who have undergone
surgery or angioplasty, as well as in those who
have stable coronary disease.
Definition: Cardiac rehabilitation is designed to
meet the particular needs of people who have had
a heart attack, acute coronary syndrome,
stable/unstable angina, as well as who have had a
heart surgery.
Prevent further cardiovascular events
Improve quality of life
Facilitate the patients return to a full and
active life
Discussion
Lecture
Discussion
Listening
Listening
Writing
What is cardiac
rehabilitation?
What are the
goals of cardiac
rehabilitation ?
4. 5 min
10 min
Student will be
able to elaborate
objectives of
cardiac
rehabilitation
Student will be
able to
enumerate
principles of
cardiac
rehabilitation
To help patient gain a positive image
through effective coping
To restore patients ability
To function independently
To promote life satisfaction and preserving
self-esteem
To promote self care
To prevent complications
To promote optimum wellness
Three components
Preventive
Maintenance
Restoration
Preventive: The preventive measures include skin
care, proper positioning, range of motion
exercises.
Maintenance: The maintenance of intact skills,
and functions is supported by such activities as
getting the patient out of bed to chair and
encouraging patient to be independent as much as
Lecture
method
Listening
Writing
What are
objectives of
cardiac
rehabilitation?
What are the
principles of
cardiac
rehabilitation?
5. 10 min Student will be
able to enlist
setting of
rehabilitation
possible
Restoration : The restoration includes instituting
exercise programme designed to increase range of
motion , teaching activities of daily living to a
patient
Targetgroup
Coronary heart disease
Exertional angina
Unstable angina NSTEMI or STEMI
Revascularization
Cardiomyopathy
o Outpatient setting
o Inpatient setting
o Home setting
Outpatient : Individualized with an impairment
that minimally impacts functional ability, may be
able to relieve rehabilitation in an outpatient
setting.
Home setting : More complex impairments may
require services that can be provided in the home
setting.
Lecture
method
Listening
Writing
What are the
setting of
rehabilitation?
6. 5 min Student will be
able to
explain
components of
cardiac
rehabilitation
Inpatient : Individuals with impairments that
effect multiple functional abilities may require
care of inpatient rehabilitation services.
Rehabilitation team
Core members: Patients and their families are the
core members of the team and must include goal
setting and develop the plan of care, client should
also provide information about themselves. Family
members are the primary assistants in the
rehabilitation programme.
Life style:
Diet and weight management
Smoking cessation
Physical activity and exercise
Secondary prevention
Education
Psychosocial care
Physical activity
Develop individual plan
Develop physical fitness
Regain confidence in physical activity
Self-monitoring
Lecture
cum
discussion
method
Listening
Writing
What are the
components of
cardiac
rehabilitation?
7. 10 min Student will be
able to
describe phases
of cardiac
rehabilitation
Secondaryprevention
Cholesterol management
Bp management
Blood sugar management
Cardio-protective drug therapy
Education
Treatment including medication
Recovery process
CHD risk factors
Structure of cardiac rehabilitation
Phase 1 : Inpatient
Phase 2: Immediate postdischarge
Phase 3 : 2-4 weeks postdischarge
Phase 4 : Long term
Phase 1: Inpatient rehabilitation
Initiation and delivery of phase 1 rehabilitation is
undertaken by ward staff or designated cardiac
rehabilitation professionals. Aspects consider for
phase 1 include:
Lecture
cum
discussion
method
Listening
Writing
What are the
phases of cardiac
rehabilitation ?
8. Reassurance
Information
Risk factor assessment
Education
Psychological stresses
Mobilization
Discharge information for discussion with patient,
spouse, partner or family should cover.
A written invitation to attend phase II cardiac
rehabilitation programme should be provided prior
to discharge.
Phase 2: Education topics offered should include
Modifiable and non modifiable risk factors
Food and nutrition
Exercise
Stress management
Psychological aspects
Return to work
Medication
Coronary disease management
Phase 3: This relates to the long term maintenance
of skills and behaviour change learned within
phase I and II. This phase is mainly the domain of
independent community “cardiac clubs” which act
9. as support groups. These are run by community
members or health professionals.
Phase IV
This is life time maintenance stage in which
physical activity, positive life style and
psychological changes are supported in a
minimally supervised or unsupervised setting.
It includes
Maintenance of exercise activity
Ongoing life time support
At each phase of cardiac rehabilitation the
following process is carried out
Assess the previous activity
Evaluate and monitor response to activity and
exercise
Teach the patient the ability to monitor his or her
own response to activity and exercise.
Nursing management
Mobility: The major goals of the patient nay
include absence of contracture and deformity
Performing ROM exercise to maintain or increase
the motion of a joint, ROM initiated as soon as
10. possible .
Review the nursing care plan
Monitor the patient health status
Monitor the patient for any complication.
SUMMARY :
Rehabilitation initially focused primarily on
patients who have had a heart attack. It is now
clear that the rehabilitation process is equally
important in patients who have undergone surgery
or angioplasty.
CONCLUSION:
Cardiac rehabilitation is the coordinated sum of
interventions required to ensure the best physical,
psychological and social conditions.
11. Bibliography:
1. Lewis, text book of medical and surgical
nursing, 2nd edition, Elsevier publications.
Page no:561,568,569, 630-655.
2. B Venkatesam,text book of medical
surgical nursing 1st edition; jaypee
publications , page no 254-265.