1
Recovery:
a) Has an end in sight
b) Is an ongoing process
c) Is linear in progression
d) All the above
B- Recovery is an ongoing process that can change overtime and is dependent on the client's progress and needs. The progression is not linear in progression as there can be setbacks and hurdles along the way that could be physical, mental or emotional in nature.
The 4 phases of cardiac rehab include hospitalization, post discharge period, exercise and education program, and a maintenance period.
True/False
True
A positive consequence of recovery is somatic sensitivity.
True/false
False-somatic sensitivity is a negative consequence of recovery
It is the sole responsibility of nurses to provide health education on cardiac rehabilitation.
true/false
False- it is the responsibility of the healthcare team/rehabilitation team to provide health education on cardiac rehabilitation (PT, OT, nurses, physicians, psychiatrists, etc)
Name 3 of the emotions listed in the pre-reading, that the patient and their families may experience at the time of an MI.
Some of the emotions include denial, depression, anxiety and anger before acceptance. These emotions are similar to those that are expressed upon anticipation of death.
The 4 practice recommendations for supporting and strengthening families through expected and unexpected life events as outlined by the practice guideline include:
a) Nurse-client partnership
b) Assessing needs
c) Providing information, accessing resources, and supporting families
d) Educating nurses, families and policymakers and public
E) B, C, D
F) All of the above
E - a) nurse-client partnership is not included in the recommendations. Instead, this BPG highlights the necessity of nurse-family partnership in supporting families through expected and unexpected life events.
Patients usually experience anxiety before accepting their cardiac event.
True/false
True
What is the ultimate goal of the recovery process?
Well-being → The state of being comfortable, healthy and happy - encompass all three dimensions of health
Active training raises which of the following cholesterol levels:
a) HDL levels
b) LDL levels
c) Both a and b
d) None of the above
A-Active training raises HDL levels, which is the “good” cholesterol our bodies make.
List three foundational values of recovery
Three of the following:
Recovery emerges from hope
Recovery is person-driven
Recovery occurs via many pathways
Recovery is holistic
Recovery is supported by peers and allies
Recovery is supported through relationship and social networks
Recovery is culturally-based and influenced
Recovery is involves individual, family, and community strengths and responsibility
Recovery is based on respect
Patients with an acute MI on a coronary care unit are at risk for deterioration of which of the following:
a) pulmonary ventilation
b) Peripheral muscle mass
c) Increase in total blood volume
d) Both a and b
D- While undergoing care on the coronary unit after an MI, the patient is usually restricted to be on bed rest which can result in fast deconditioning of peripheral and cardiac function. The deterioration that occurs includes decrease in pulmonary ventilation, intracardiac volume, total blood volume, vital capacity, lung volumes, muscle mass peripherally and muscle strength.
What phase of cardiac rehabilitation involves a lifelong commitment to exercising regularly?
Phase IV, maintenance phase as it involves lifelong maintenance of newly developed health habits in order to reduce the risk for future cardiac events and improve quality of life.
In recovery process, this term can be the first step because of its relation to physical health and functioning
What is healing → Refers to the physical repair of injured cells and/or tissues, which is influenced by many factors like tissue perfusion and the kind of injury.
Name a form of exercise testing in hospital that was mentioned in the pre-reading and why it is useful?
Treadmill tests which are used to increase activity and patients self-confidence in early weeks post MI.
Give examples to explain the difference between expected and unexpected life events.
Expected life events are likely to happen and include parenthood, birth, death and retirement. Unexpected life events are not expected to happen and include chronic illness, mental or physical trauma, hospitalization, move to LTC.
What were some active training exercises for recovery mentioned in the pre-reading?
The exercises are dependent on the individual's capabilities but could include swimming, treadmill exercise, cycling, upper body ergometry or vigorous walking.
In Mr. Winston’s case, what are some of his attributes of recovery?
The attributes of recovery can include:
1) Attempts to cope with the condition
-To keep stress at low levels → “He likes to be social, spending time with his friends and attending family events. He looks forward to the days he spends with his grandchildren.”
2) Develop self-control and a healthy lifestyle
-“Mr. Miller decided at that time to try and live a healthier lifestyle, as a result he lost 30 extra pounds he was carrying at that time”
-“He should quit smoking but he finds it difficult to do. He tried to quit “cold turkey” when his brother died, but that didn’t last”
3) Regaining back health and return to normal life
-“Yesterday he was ambulating in the hall and performed ADLs independently without any difficulty or chest discomfort”
What diet is considered “heart healthy” and could be a recommendation for Mr. Winston?
The Mediterranean diet which prioritizes eating plant-based foods, limits animal products and fatty foods, olive oil is the main source of fat, red meat and sweets occasionally and fish, seafood, poultry and dairy in moderation.
Explain what occurs in phase I (Inpatient) of cardiac rehabilitation?
During phase I, the patient is recovering in the hospital bed and includes assessments, patient education, physical therapy, low level exercise and discharge planning.
What is the Borg scale and what is it used for?
Borg scale is also known as the Rating of Perceived Exertion scale. It ranges from 6-10 and has descriptions from “very very hard” to “very very light”. It correlates with oxygen consumption and heart rate during exercise in unmedicated patients.