Cardiac Rehabilitation Nursing

Cardiac Rehabilitation Nursing

• Cardiac rehabilitation is a complex intervention for patients diagnosed with heart disease.
• It includes health education, advice on cardiovascular risk reduction, physical activity, and stress management.
• Cardiac rehab has three equally important parts: exercise counseling and training, education for heart-healthy living, and counseling to reduce stress.
• Components of cardiac rehabilitation include; patient assessment, exercise training, physical activity counseling, tobacco cessation, nutritional counseling, weight management, aggressive coronary risk-factor management, and psychosocial counseling.
• Cardiac rehabilitation programs generally span three months, with sessions two or three times a week (typically 36 sessions over a 12-week period).
• Practical workshops teach patients healthy eating habits, including; label reading and cooking demonstrations.
• General dietary recommendations include a reduced intake of saturated fats (<7% of total calories) and cholesterol (<200 mg/d), an increased intake of polyunsaturated and monounsaturated fats, and adequate repartition of calorie sources. Increased fiber intake (20-30 g/d).
• Recent nutrition studies recommend plant-based food for patients with heart disease.
• According to the World Health Organization (WHO), if the waist circumference is 88 cm or more in women and 102 cm or more in men, there is central obesity.
• Europe in Turkish society accepts >80 cm for women and >94 cm for men.
• If the body mass index (BMI) exceeds 25 kg/m2, individualized short and long-term targets are set, considering other risk factors.
• High blood pressure is prevalent among cardiac rehabilitation patients.
• Reducing systolic blood pressure by 10 mmHg can decrease cardiovascular mortality by 20-40%.
• Reducing diastolic blood pressure by 5-6 mmHg can reduce stroke risk by 42%.
• Coronary heart disease events decrease by 15%, with blood pressure control during cardiac rehabilitation.
• Patients undergoing cardiac rehabilitation understand the importance of blood pressure control, associated medications and their side effects, therapeutic lifestyle changes, and blood pressure devices.

Pulmonary Rehabilitation (PR)

• Pulmonary rehabilitation (PR) is a multidisciplinary approach to improve the physical and emotional well-being of patients with chronic respiratory diseases.
• It includes supervised exercise, education, support, and behavioral intervention improving how people with chronic lung disease function in daily life, and enhancing quality of life.
• Indications for PR include; Chronic Obstructive Pulmonary Disease (COPD), Interstitial Lung Disease (ILD), Cystic Fibrosis, Pulmonary Hypertension, Severe Asthma, Post-lung transplant, Post-surgical recovery (e.g., pneumonectomy), and Pulmonary Fibrosis.
• Benefits from attending a PR program include improved exercise capacity, reduced breathlessness, improved survival, reduced hospitalizations, reduced anxiety and depression, improved health-related quality of life and improved psychological well-being.
• PR programs may generally improve quality of life, including reducing breathlessness, improving exercise tolerance, promoting well-being, and decreasing the number of hospitalizations. However, clearly there is no significant evidence that enhances survival.
• Goals of pulmonary rehabilitation include improving exercise capacity, enhancing quality of life, decreasing symptoms (e.g., dyspnea), preventing hospital readmissions, and enhancing emotional well-being and self-management.
• Components of a PR program include; exercise training, inspiratory muscle training, psychosocial counseling, nutritional evaluation, and education on prescribed drugs' proper use.
• Nursing assessment in PR includes; thorough health history and clinical assessment, monitoring of vital signs (oxygen saturation, heart rate, blood pressure), assessment of physical function, and psychological assessment.
• Key nursing interventions for pulmonary rehabilitation include breathing techniques (diaphragmatic breathing, pursed-lip breathing), exercise programs (low-impact aerobic exercises), patient education (medication adherence, oxygen therapy, energy conservation, avoidance of environmental triggers), psychosocial support (emotional support for chronic illness, coping strategies), and nutritional support (adequate nutrition).
• Potential barriers to effective PR include physical limitations, psychological factors, socioeconomic factors, and cultural factors.

Neurological Rehabilitation Nursing-1

• Neurological rehabilitation is the process of engaging in therapy to improve function and well-being.
• It is a program designed to help patients with neurological conditions to recover or improve functionality in their environment.
• The goal of neurorehabilitation programs is to restore health, independence, and functionality for patients with neurological conditions.
• The Barthel Index is used to measure functional ability and dependency in activities of daily living (ADLs).
• The Barthel Index assesses recovery progress and evaluates intervention effectiveness.
• ADLs include Feeding, Bathing, Grooming, Dressing, Bowel control, Bladder control, Toilet use, Chair/Bed transfers, Mobility (walking or wheelchair use), and Stair climbing.
• Different phases of neurological rehabilitation exist, such as; Long-Term Acute Care Hospital (LTACH), Acute Rehab, Subacute Rehabilitation in Skilled Nursing Facilities and Home with services.
• Conditions that could potentially benefit from neurological rehabilitation include traumatic brain injuries, spinal cord injuries, hemorrhagic strokes, ischemic strokes, subdural hematoma, transient ischemic attacks(TIAs), neurological disorders, brain infections, and neurodegenerative diseases.
• Aims of neurological rehabilitation focus on preventing complications, facilitating normal function in a normal environment, and teaching adaptive strategies.
• Approaches to neurological rehabilitation include adaptive strategies, functional movement training, tailored workouts, adaptive equipment integration, robotic-assisted therapy, gait re-education, transfer rehabilitation, and mobility rehabilitation.

Oncological Rehabilitation Nursing 1&2

• Oncology rehabilitation is a specialized program focusing on managing and improving impairments and functional limitations for cancer patients.
• Four phases of oncology rehabilitation are preventative rehabilitation (encompassing care prior to treatment), restorative rehabilitation (focus on restoring function), supportive rehabilitation (maximizing function with cancer progression), and palliative rehabilitation (comfort and function during terminal illness).
• Setting for oncology rehabilitation is varied, including inpatient, outpatient and home settings.
• Oncology rehabilitation offers many benefits, including improved function, pain management, quality of life, boosted energy and endurance, emotional and mental support, improved body image and self-confidence, enhanced survivorship, and nurturing a community.
• Common assessments/tools include patient outcomes, activities of daily living, mobility, fatigue, cognition, communication, sexual function, and/or return to work measures.