Cardiac Rehabilitation Nursing Overview

Cardiac Rehabilitation Nursing

• Cardiac rehabilitation is a complex intervention for heart disease patients.
• It includes health education, advice on reducing cardiovascular risk, physical activity, and stress management.
• Cardiac rehab has three key components: exercise counseling and training, education for heart-healthy living, and counseling to reduce stress.
• Components and organization 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 typically last three months with sessions two or three times a week (usually 36 sessions over a 12-week period).
• Dieticians provide practical workshops on healthy eating habits, label reading, and cooking demonstrations for patients.
• General dietary recommendations include reduced saturated fat, cholesterol, increased polyunsaturated and monounsaturated fats, an adequate calorie distribution between carbohydrates, protein, and fats and increased fiber intake.
• Recent dietary recommendations emphasize moderation and plant-based foods.
• Weight management is a significant component requiring assessment of waist circumference according to WHO standards.
• Central obesity risk is dependent on ≥88cm in women, ≥102cm in men, and ≥80cm for women and ≥94cm for men in Turkish populations.
• BMI greater than 25 kg/m2 may necessitate personalized short and long-term targets based on risk factors.
• High blood pressure is common in cardiac rehabilitation patients.
• Reducing systolic blood pressure by 10 mmHg or diastolic blood pressure by 5-6 mmHg significantly reduces cardiovascular mortality by 20-40% and stroke risk by 42%, respectively.
• Blood pressure management education includes an awareness of the importance of blood pressure control, medications, side effects, therapeutic lifestyle change measures, and blood pressure devices for use by patients.
• Patients referred for cardiac rehabilitation often have diabetes and multiple risk factors, including smoking, hypertension, hypercholesterolemia, overweight, and obesity.
• The goal of diabetes management is to maintain glycosylated hemoglobin (HbA1c) concentration of less than 7%.
• Patients with heart disease may have psychological and social problems affecting morbidity and mortality.
• Depression, anxiety, and denial occur in up to 20% of patients post-myocardial infarction.
• Cardiac rehabilitation follow-up includes screening for psychological, social, and familial issues to help patients adjust to their new health situations and support their return to daily life.

Pulmonary Rehabilitation Nursing

• Pulmonary rehabilitation (PR) is a multidisciplinary approach to improve the physical and emotional well-being of patients with chronic respiratory diseases, involving supervised exercise, education, support, and behavioral interventions, improving quality of life.
• Indications for pulmonary rehabilitation 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), Pulmonary Fibrosis.
• Pulmonary rehabilitation programs have several components including exercise training, inspiratory muscle training, psychosocial counseling, nutritional evaluation and counseling, and education on prescribed drug use.
• Nursing assessment in pulmonary rehabilitation includes: a health history and clinical assessment, monitoring vital signs, assessment of physical function including mobility, muscle strength, and endurance, and psychoogical assessments of anxiety, depression, and coping strategies.
• Key nursing interventions include breathing techniques, exercise programs, patient education, psychosocial support, and nutritional support.
• Barriers to pulmonary rehabilitation can include physical limitations, psychological factors (anxiety, depression, lack of motivation), socioeconomic factors (limited access to healthcare, financial constraints), and cultural factors (lack of understanding or mistrust of healthcare interventions).
• Older adults (COPD, ILD, Pulmonary Fibrosis) rehabilitation needs modifications like lower intensity, more focus on functional independence, and addressing comorbidities.
• Patients with Obesity Hypoventilation Syndrome need support in weight management and sleep hygiene alongside addressing breathing difficulties and the role of CPAP/BiPAP in respiratory support.
• National guidelines recommend a six-week program with two sessions per week, including supervised exercise and education and home training.
• Goal-oriented therapy includes having patients define specific goals and use a structured approach to encourage patient self-responsibility and independence.
• The pulmonary rehabilitation program includes activities such as relaxation techniques, disease education, dietary advice, benefits advice, energy conservation training, medication advice, chest clearance, and breathing control techniques.
• Advance care planning in pulmonary rehabilitation (PR), including establishing the burden of treatment, therapy options, preferred place of death, navigating complex decisions, and patient-centered end-of-life care.

Neurological Rehabilitation Nursing-1

• Neurological rehabilitation is a therapy process to improve function and overall well-being in people with neurological conditions.
• The goal of all neurorehabilitation programs is to restore health, independence, and functionality.
• Assessment tools like the Barthel Index measure functional ability and dependency in activities of daily living (ADLs).
• Phases of rehabilitation may include: Long-Term Acute Care Hospitals, Acute Rehab, Subacute Rehabilitation, Long-Term Care Facilities, and Home with services. Long-Term Acute Care may be the first stage after inpatient hospital stays, requiring intensive clinician supervision and management, commonly including vent management, tracheostomy care, and wound infection care.
• Neurological conditions benefitting from this include traumatic brain injuries, spinal cord injuries, strokes (hemorrhagic and ischemic), structural/neuromuscular disorders (e.g., Bell's palsy, cervical spondylosis), tumors, peripheral neuropathy, muscular dystrophy, myasthenia gravis, Guillain-Barré syndrome, and functional disorders like headache, seizure disorder, dizziness, and neuralgia, and infectious diseases (brain infections like polio, meningitis, brain abscesses, and encephalitis), and neurodegenerative diseases like multiple sclerosis, Alzheimer's, amyotrophic lateral sclerosis (ALS), Parkinson's disease, and Huntington's disease
• Aims of neurological rehabilitation include preventing complications, teaching adaptive strategies, and facilitating function in a normal environment.
• Approaches to neurological rehabilitation may include gait re-education, exoskeletons, transfer rehabilitation, mobility rehabilitation, and contracture management; assistive mobility devices (e.g., wheelchairs, walkers) are often recommended.
• Targeted exercise programs like Functional Movement Training focus on exercises mirroring daily life to improve overall functionality.
• Tailored workouts are customized programs addressing specific neurological challenges.
• Adaptive equipment integration involves tools to aid in rehabilitation process.
• Assistive technologies like augmented reality tools, smart wearables, and robot-assisted therapy enhance independence and engagement in therapy.

Oncological Rehabilitation Nursing 1&2

• Oncology rehabilitation is a specialized approach to managing and improving the impairments and functional limitations resulting from cancer and its treatments in patients.
• The goal of oncology rehab is to enhance physical, emotional, and psychological well-being.
• Rehabilitation encompasses preventative (prehabilitation), restorative, supportive, and palliative phases to optimize quality of life for cancer patients.
• Settings for oncology rehabilitation include inpatient rehabilitation facilities, skilled nursing facilities, home health care agencies, long-term care hospitals, and outpatient settings (therapy centers).
• Assessment tools used to evaluate patients incorporate cancer therapy-related quality of life questionnaires, health-related quality of life questionnaires, activities of daily living, fatigue, functional mobility, exercise behavior, cognitive function, communication, sexual function, and return-to-work evaluations.
• This holistic model aims to address a wide range of patient needs, including pain, fatigue, functional limitations, emotional and mental well-being, body image issues, and enhanced survivorship support.
• Rehabilitation programs address a holistic approach to patient care, including cancer diagnosis and treatment, and ongoing support for each patient.

This quiz covers the essentials of cardiac rehabilitation nursing, including key components such as exercise counseling, health education, and stress management for heart disease patients. Explore the structure and duration of typical programs, as well as dietary recommendations provided by dieticians to support heart-healthy living.