Cardiac Rehabilitation Nursing Overview

Cardiac Rehabilitation Nursing

Cardiac rehabilitation is a complex intervention for patients with heart disease.
Components include health education, advice on cardiovascular risk reduction, physical activity, and stress management.
Cardiac rehabilitation has three equally important parts: exercise counseling and training, education for a heart-healthy lifestyle, 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 span three months, with sessions two to three times a week (usually 36 sessions over a 12-week period).
Dieticians lead workshops teaching healthy eating habits, including label reading and cooking demonstrations.
General dietary advice for cardiac patients includes a reduced intake of saturated fats (<7% of total calories) and cholesterol (<200 mg/d), increased intake of polyunsaturated and monounsaturated fats, appropriate calorie distribution (about 50-60% carbohydrates, 15% protein, 25-35% fat), and increased fiber intake (about 20-30 g/d).
Recent studies recommend a plant-based diet for patients with heart disease.
Weight management: If waist circumference is 88 cm or more for women and 102 cm or more for men, there is central obesity.
In Turkish society, the generally accepted thresholds for women are > 80 cm and for men are > 94 cm.
If the body mass index (BMI) is >25 kg/m2, individual short and long-term weight targets are set considering other risk factors.
Blood pressure management: High blood pressure is common in 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% and Coronary heart disease events by 15%.
Blood pressure management programs include education on blood pressure control, medications and their side effects, therapeutic lifestyle changes, and blood pressure devices.
Diabetes management: About 26% of patients in cardiac rehab have diabetes. These patients often have multiple risk factors like smoking, hypertension, hypercholesterolemia, or obesity.
Therapeutic education is important for diabetes control.
The goal for diabetes is to maintain glycosylated hemoglobin (HbA1c) at <7%.

Pulmonary Rehabilitation Nursing

Pulmonary rehabilitation (PR) is a multidisciplinary approach improving physical and emotional well-being for patients with chronic respiratory diseases.
PR uses supervised exercise, education, support, and behavioral interventions to improve daily functioning and quality of life.
Indications for PR : COPD, Interstitial Lung Disease (ILD), Cystic Fibrosis, Pulmonary Hypertension, Severe Asthma, Post-lung transplant, Post-surgical recovery (e.g., pneumonectomy), and Pulmonary Fibrosis.
Benefits of PR include improved exercise capacity, reduced breathlessness, reduced hospitalizations, improved survival, improved health-related quality of life, and improved psychological wellbeing.
PR involves components like exercise training, inspiratory muscle training, psychosocial counseling, nutritional evaluation, and education on prescribed drugs.
Nursing assessment in PR includes: thorough health history and clinical assessment, monitoring vital signs (oxygen saturation, heart rate, blood pressure), and assessment of physical function (mobility, strength, endurance), and psychological assessment (anxiety, depression, coping strategies).
Key nursing interventions in PR involve breathing techniques (e.g., diaphragmatic, pursed-lip), support and monitoring during exercise (walking, cycling), patient education about medication adherence, oxygen therapy, environmental triggers, psychosocial support, and nutritional support.
Barriers to PR include physical limitations (exercise tolerance, dyspnea, fatigue), psychological factors (anxiety, depression), socioeconomic factors (access to healthcare, financial constraints), and cultural factors (lack of understanding, mistrust).
PR in special populations (older adults, patients with obesity hypoventilation syndrome) requires modifications for lower intensity and functional independence, assessment of comorbidities (e.g., osteoporosis, cardiovascular disease) and managing polypharmacy and medication side effects.

Neurological Rehabilitation Nursing-1

Neurological rehabilitation is therapy to improve function and well-being for patients with neurological conditions.
The goal of neurorehabilitation is restoring health, independence, and functionality.
Phases of neurorehabilitation include: Acute Rehab , Subacute Rehabilitation in Skilled Nursing Facilities, Long-Term Care Facility or Nursing Home, and Home with services.
Conditions that benefit include traumatic brain injuries, spinal cord injuries, strokes (ischemic and hemorrhagic), subdural hematoma, transient ischemic attacks, structural/neuromuscular disorders, functional disorders, brain infections, neurodegenerative diseases (multiple sclerosis, Alzheimer's disease, ALS, Parkinson's disease, Huntington's disease).
Aims of neurorehabilitation include preventing complications, secondary complications associated with conditions, and facilitating function in a normal environment.
Approaches to neurorehabilitation include: Bobath, Carr and Shepherd, gait re-education, transfer rehabilitation, mobility rehabilitation, and contracture management.

Neurological Rehabilitation Nursing-2

Targeted exercise programs for neurological recovery include functional movement training, tailored workouts, and adaptive equipment integration.
Functional movement training mirrors real-world movements.
Tailored workouts are customized for individuals' needs.
Adaptive equipment includes things like wheelchairs, walkers, and assistive devices.
Assistive technologies like augmented reality tools, smart wearables, and robotic-assisted therapy enhance independence and participation in the rehabilitation program.

Oncological Rehabilitation Nursing 1&2

Oncology rehabilitation manages and improves impairments/functional limitations caused by cancer or cancer treatment side effects.
It aims to reduce cancer-related morbidity and healthcare costs.
Rehabilitation happens in various settings: inpatient, outpatient, and at home.
The rehabilitation process typically involves stages: prehabilitation, restorative, supportive, and palliative care.
The process includes assessment, developing a plan, implementing the plan, monitoring it, and discharge planning with follow-up care.
Assessment tools include different questionnaires for quality of life, daily living, and functional mobility.
Advantages of oncology rehabilitation include improved physical function, pain management, enhanced quality of life, improved energy and endurance, emotional and mental support, improved body image and self-confidence, and enhanced survivorship, and a nurturing community.