Istanbul Gelisim University Faculty of Health Sciences - Rehab Week 7 PDF

Name of Department : NURSING Course Code and Name : HEY413E REHABILITATION NURSING Course Week : WEEK 7 Course Day and Time : Tuesday (12:00 to 13:50) Course Credit/ACTS Information : 2 Examination Type and Gradings : Mcqs Instructor’s Name & Sur...

Name of Department : NURSING Course Code and Name : HEY413E REHABILITATION NURSING Course Week : WEEK 7 Course Day and Time : Tuesday (12:00 to 13:50) Course Credit/ACTS Information : 2 Examination Type and Gradings : Mcqs Instructor’s Name & Surname : Dr. Hina Zahoor E-mail & Phone: : [email protected] Instructor’s Room : 305 Office Hours : 9.00 to 5.00 GBS Link : https://gbs.gelisim.edu.tr/ders-detay-5-160-6267-1 ALMS Link : https://lms.gelisim.edu.tr/almsp/u/Home/Index AVESIS Link : https://persis.gelisim.edu.tr/Default.aspx. | WEEKLY LEARNING OUTCOMES | Discuss the advantages for patients undergoing cardiac rehabilitation. Explain the specific objectives aimed to be achieved through rehabilitation. Cover which patient populations or conditions are suitable for this type of program. Discuss situations or conditions where cardiac rehabilitation may not be appropriate. Explain the different stages or steps involved in a comprehensive rehabilitation program.  | NOTE | Attendance Attendance is mandatory for all scheduled lectures.  | NOTE | Be Responsible Come to class on time.  | NOTE | Be disciplined Avoid talking to friends in the class.  | NOTE | Show discipline Mobiles are not allowed in the class.  | ABOUT THE LAST LESSON | Psychosocial adaptation Stress Crisis Self concept Elisabeth Kübler-Ross’ 5 stages of grief Factors that affect an individual's psychosocial responses to diseases Aims of psychological support in rehabilitation nursing  | ABOUT THE TODAY LESSON | Cardiac Rehabilitation Nursing part 1  | DAILY FLOW | 12.00-12.50 / 1st Hour Benefıts Of Cardıac Rehabılıtatıon Goals of Cardiac Rehabilitatio The indications for cardiac rehabilitation 13.00-13.50/ 2nd Hour Contraindications Phases of Cardiac Rehabilitation  | Cardiac Rehabilitation Nursing | Cardiovascular diseases are one of the most important health problems today and are among the leading causes of mortality and morbidity all over the world. According to the American cardiovascular and pulmonary rehabilitation association, ischemic heart disease will continue to be the number one cause of mortality and insufficiency in 2020.  | Cardiac Rehabilitation Nursing | CARDIAC REHABILITATION Cardiac rehabilitation is defined as to support those with known cardiovascular disease to achieve and maintain optimal health.  | Cardiac Rehabilitation Nursing | Cardiac Rehab A progressive program with a goal of helping patients restore and maintain optimal health while helping to reduce the risk of future heart problems.  | Cardiac Rehabilitation Nursing | Cardiac rehab is a medically supervised program designed to improve patient’s cardiovascular health if a patient has experienced heart attack heart failure angioplasty heart surgery  | Cardiac Rehabilitation Nursing | If a client has a heart attack or other heart problem, cardiac rehabilitation (rehab) is an important part of recovery. Cardiac rehab can help prevent another progression of disability, perhaps more serious, heart attack, can help patient build heart- healthy habits, improves physical function and improves quality of life.  | Cardiac Rehabilitation Nursing | Cardiac rehabilitation is an accepted form of management for people with cardiac disease. Rehabilitation was offered mainly to people recovering from a myocardial infraction (MI), but now encompasses a wide range of cardiac problems.  | Cardiac Rehabilitation Nursing | Cardiac rehabilitation is a complex intervention offered to patients diagnosed with heart disease, which includes components of health education, advice on cardiovascular risk reduction, physical activity and stress management.  | Cardiac Rehabilitation Nursing | In recent years, a better understanding of the natural history of many cardiac pathologies and the fact that, despite tremendous advances, heart disease remains the number one killer have led to a renewed interest in cardiac rehabilitation.  | Cardiac Rehabilitation Nursing | BENEFITS OF CARDIAC REHABILITATION Strengthening heart and body after a heart attack. Relieving symptoms of heart problems, such as chest pain. Building healthier habits, including getting more physical activity, quitting smoking, and eating a heart-healthy diet.  | Cardiac Rehabilitation Nursing | BENEFITS OF CARDIAC REHABILITATION Approximately half of the mortality reduction achieved by exercise-based cardiac rehabilitation(28%) can be attributed to reductions in major risk factors, particularly smoking. Reduction in inflammation ischemic preconditioning, improved endothelium function and a more favorable fibrinolytic balance. An increase of tolerated metabolic equivalents by 33% and of maximal oxygen consumption by 16%. This improvement in exercise performance is associated with beneficial effects on the quality of life and cardiovascular events. | Cardiac Rehabilitation Nursing | Goals of Cardiac Rehabilitation  | Cardiac Rehabilitation Nursing | The main goal of cardiac rehabilitation is to promote secondary prevention and to enhance quality of life among cardiac patients  | Cardiac Rehabilitation Nursing | To achieve the goals of cardiac rehabilitation a multidisciplinary team approach is required. The multidisciplinary team members include: Cardiologist/Physician and co-coordinator to lead cardiac rehabilitation Clinical Nurse Specialist Physiotherapist Clinical nutritionist/Dietitian Occupational Therapist Pharmacist Psychologist Smoking cessation counsellor/nurse  | Cardiac Rehabilitation Nursing | *Cardiac rehabilitation in particular; 1. Prevents progression of disease / disability, 2. Improves physical function, 3. Improves quality of life.  | Cardiac Rehabilitation Nursing | Cardiac rehabilitation is an accepted form of management for people with cardiac disease. Initially, rehabilitation was offered mainly to people recovering from a myocardial infraction (MI), but now encompasses a wide range of cardiac problems  | Cardiac Rehabilitation Nursing | The indications for cardiac rehabilitation are: Acute myocardial infarction, Stable angina pectoris, Coronary artery bypass graft surgery, Heart valve repair or replacement, Percutaneous transluminal coronary angioplasty Heart transplantation or heart-lung transplantation, Peripheral artery disease (PAD)  | Cardiac Rehabilitation Nursing | Phases of Cardiac Rehabilitation | Cardiac Rehabilitation Nursing |  | Cardiac Rehabilitation Nursing | PHASE I : 1-2 WEEKS Phase I myocardial infarction, angioplasty, coronary artery by pass surgery after hospitalization or begins after the patient's recovery period. Medical evaluation of the patient Trainings on rehabilitation Determine the exercise program related to the transition to daily life If necessary, psychological support is provided and appropriate diet program is determined.  | Cardiac Rehabilitation Nursing | PHASE II: 2-12 WEEKS Phase II begins 2-12 weeks after the patient is discharged and the patient is evaluated individually and taken to the appropriate exercise program in the hospital.  | Cardiac Rehabilitation Nursing | PHASE III: 3-9 MONTHS Phase III, Diet of the patient throughout his/her life. Planning of the exercises. The purpose of the exercises : To regulate blood pressure, Having proper breathing exchanges, Heart rate reduction  | Cardiac Rehabilitation Nursing | PHASE IV : Lifetime PHASE IV, is a continuation of phase III but without support. In this phase, the patients continue to apply what they have learned during the preceding phases. | REVISION | Preventive Care: These services focus on preventing diseases or conditions before they occur. Examples include vaccinations, screenings (like mammograms or blood pressure checks), counseling on healthy lifestyle choices (diet, exercise) health education programs. Curative Health Services: Curative services are focused on treating diseases or medical conditions to cure or manage them. such as Surgeries medications chemotherapy Rehabilitative Health Services: These services aim to restore or improve a person's functional abilities after an illness or injury. Physical therapy occupational therapy speech therapy other forms of rehabilitation that help individuals regain skills or adapt to new circumstances. Medical rehabilitation refers to the process of restoring or improving physical, mental, or cognitive functions that have been lost or impaired due to illness, injury, or surgery. Social rehabilitation: a set of activities aimed at rehabilitation and improving the functional capability of people and their inclusion in the society to give the individual a new job and profession COMMON GOALS OF REHABILITATION Preventive Care: These services focus on preventing diseases or conditions before they occur. Examples include vaccinations, screenings (like mammograms or blood pressure checks), counseling on healthy lifestyle choices (diet, exercise) health education programs. Curative Health Services: Curative services are focused on treating diseases or medical conditions to cure or manage them. such as Surgeries medications chemotherapy Rehabilitative Health Services: These services aim to restore or improve a person's functional abilities after an illness or injury. Physical therapy occupational therapy speech therapy other forms of rehabilitation that help individuals regain skills or adapt to new circumstances. Medical rehabilitation refers to the process of restoring or improving physical, mental, or cognitive functions that have been lost or impaired due to illness, injury, or surgery. Social rehabilitation: a set of activities aimed at rehabilitation and improving the functional capability of people and their inclusion in the society to give the individual a new job and profession COMMON GOALS OF REHABILITATION  Interdisciplinary model Collaborator, Holistic Patient centered Maintaining of care 1.Collaborative Team Structure Team Composition: Form a team of diverse professionals, including: Physicians Physical Therapists Occupational Therapists Speech-Language Pathologists Psychologists Social Workers Nutritionists Roles and Responsibilities: Clearly define the roles of each team member to ensure all aspects of the patient's rehabilitation are addressed.  Benefits of working in an effective interdisciplinary team to increase the continuity of care, to cooperate in achieving the target, to solve problem with a common understanding among professionals to know the value of team members to increase patient, family and healthcare professional satisfaction. Application areas determined by the Association of Rehabilitation Nurses Independent rehabilitation centers Hospitals Long-term subacute care centers Long-term care centers Comprehensive outpatient rehabilitation centers Special application areas Home care Clinical and daily rehabilitation programs Community and state services Schools and universities HOME REHABILITATION Patients who cannot leave the home despite the need for professional rehabilitation services, can receive rehabilitation therapies in their own homes. The most common home therapies; Physiotherapy Occupational therapy Speech therapy  | Goals of Rehabilitation | Depending on the nature and stage of a patient’s condition, the goals of rehabilitation might be; to prevent secondary disability improve the body’s function return patients to their former functioning state assist patients adapt to a new state of functioning  | Objectives of Rehabilitation Nursing| There are 4 objectives of rehabilitation nursing: To restore affected abilities to the highest possible level of function. To prevent further disability/ handicap. To protect the person abilities. To assist the person  | PROFESSIONAL NURSE’S ROLES| Caregiver Role The main goal of a nurse in this role is to deliver understanding about what is important and to provide support. The nurse acceptance the individual as a whole and gives care. Caring is a central focus of nursing and health care services. Caregiver role is an essential feature of the professional nurse.  | PROFESSIONAL NURSE’S ROLES| Decision Maker Role A nurse is directly involved in the decisionmaking process for the treatment of patients. It is important that they are able to think critically when assessing patient signs and identifying potential problems so that they can make the appropriate recommendations and actions. The nurse does not make the decision-making role alone on behalf of the patient, but includes the individual and the family in the care plan and treatment decision.  | PROFESSIONAL NURSE’S ROLES| Patient Advocate Role Advocacy involves promoting what is best for the patient, ensuring that the patient’s needs are met, and protecting the patient’s rights. Nurses engaged in this form of advocacy can create healthy environments through community education, and involvement in professional organizations. A patient advocate is an advocate of patient’s rights.  | PROFESSIONAL NURSE’S ROLES| Manager Role The manager role of the nurse includes primarily managing patient care. In addition to this; coordination of other health care workers in patient care, management of training activities, communication management  | PROFESSIONAL NURSE’S ROLES| Rehabilitative Role The nurse aims providing the lost function of the patient as much as possible, supporting the daily life activities, providing psychological support.  | PROFESSIONAL NURSE’S ROLES| Educator Role Nurses constantly educates patients, families, communities, colleagues and other health professionals. Education includes topics such as health protection and development, acquiring correct health behaviors, developing and maintaining individual care.  | PROFESSIONAL NURSE’S ROLES| Career Developer Role In the formation of this role; Increased training opportunities for nurses Professionalization of nursing The expansion of working fields has been influential. For example; do master's degree, do a PhD, participate in courses such as certificate programs  | PROFESSIONAL NURSE’S ROLES| Researcher Role The nurse searches for new information to improve care and service quality, new information provides better care and service. This care and service is based on scientific basics with research. Researches also contribute to the development of the profession by increasing the content of scientific knowledge of the nursing. The nurse carries out this role by conducting research.  | PROFESSIONAL NURSE’S ROLES| Counselor Role Nurse as a councilor focuses on helping the patient to develop new attitudes, feelings, and behaviors about quality of life. It is the responsibility of the physician to determine the medical diagnosis and medical treatment. Nurses take responsibility for the administration of the treatment specified by the physician and fulfill medical requirements.  | PROFESSIONAL NURSE’S ROLES| Therapeutic Role It is the responsibility of the physician to determine the medical diagnosis and medical treatment. Nurses take responsibility for the administration of the treatment specified by the physician and fulfill medical requirements. | CHRONIC CONDITION AND DISABILITY| Chronic diseases; slowly progressive 6 months or more long-term caused by multiple risk factors usually complicated and affect the quality of life of the person. | CHRONIC CONDITION AND DISABILITY| Causes of death in Turkey 1.Circulatory system diseases (Ischemic heart disease) 2. Benign and malignant tumors (Lung, Stomach, lymphoid CA ……) 3. Respiratory System Diseases 4. Endocrine, nutrition and metabolic diseases 5. Other …  | CHRONIC CONDITION AND DISABILITY| FEATURES OF CHRONIC DISEASES Complex and multiple cause Gradual and sudden onset with acute stage Occurring across the life cycle Compromising Quality of Life through physical limitations and disability Long-term and persistent Gradual deterioration of health | CHRONIC CONDITION AND DISABILITY| Risk factors | CHRONIC CONDITION AND DISABILITY| CHRONIC DISEASES Cardiovascular disease (CVD) Cancer Chronic respiratory disease DM Chronic renal disease Arthritis and musculoskeletal disease Mental health problems and disorders | CHRONIC CONDITION AND DISABILITY| What is Disability? The World Health Organization (WHO 1976) draws on a three–fold distinction between impairment, disability and handicap: Impairment is any loss or abnormality of psychological, physiological or anatomical structure or function. Disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. Handicap is a disadvantage, for a given individual, resulting from impairment or a disability, which prevents the fulfilment of a role that is considered normal (depending on age, sex and social and cultural factors) for that individual | CHRONIC CONDITION AND DISABILITY| Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).  | CHRONIC CONDITION AND DISABILITY| Causes and Risk Factors of Disability 1. Malnutrition: is a major cause of disability as well as a contributory factor in other disease, that increase susceptibility to disabling conditions. Common micro-nutrient deficiencies that affect disability include: Vitamin A deficiency – blindness Vitamin B complex deficiency – beriberi, pellagra, anaemia Vitamin D deficiency – rickets (soft and deformed bones) Iodine deficiency –learning difficulties, intellectual disabilities goitre Iron deficiency – anaemia, which impedes learning and activity Calcium deficiency – osteoporosis (fragile bones)  | CHRONIC CONDITION AND DISABILITY| Causes and Risk Factors of Disability 3. Occupational Hazards: for ex. low standards of safety and hazardous working conditions, Wheat harvesting and amputations, paddy sowing and muscular diseases, coconut picking and spinal cord injuries. | CHRONIC CONDITION AND DISABILITY| Causes and Risk Factors of Disability People with disabilities have in general poorer health, lower education achievements, fewer economic opportunities than people without disabilities. They have less access to health care services and therefore experience unmet health care needs. Several attempts are being made in order to meet the needs of people with disabilities. The healthcare sector, a key sector for the care and treatment of people with disabilities, contributes a lot to the integration of people with disabilities into the society | CHRONIC CONDITION AND DISABILITY| | CHRONIC CONDITION AND DISABILITY| | CHRONIC CONDITION AND DISABILITY|  | CHRONIC CONDITION AND DISABILITY| Our Social Perspective On Disability - We have to accept that disabled person is a complete human being. - We have to respect the citizenship rights. - We must respect their differences. - We must respect their life. - We must respect their personal dignity. -We must represented them - We must be in cooperation in the struggle against the rights of disabled. - We must ensure equality of opportunity | CHRONIC CONDITION AND DISABILITY| 97.3% of the population in long-term care institutions consists of elderly individuals. The health of the aging population is the highest public health priority, and the CDC is committed to helping older adults live longer, higher quality, productive and independent lives. | CHRONIC CONDITION AND DISABILITY| Over a billion people are estimated to live with some form of disability. This corresponds to about 15% of the world's population. Between 110 million (2.2%) and 190 million (3.8%) people 15 years and older have significant difficulties in functioning. Furthermore, the rates of disability are increasing in part due to ageing populations and an increase in chronic health conditions. | CHRONIC CONDITION AND DISABILITY| 1. Monitoring of current physical health; Self-reports on physical health may indicate new disease or indicate areas for improvement. 2. Increasing physical activity in the elderly; In order to benefit from the positive effects of physical activity on health, opportunities for physical activity should be more accessible to the elderly | CHRONIC CONDITION AND DISABILITY| 3. Increasing preventive services; Preventive vaccination can be used for early treatment and prevention of diseases with the use of screening programs for early diagnosis of diseases. Influenza and pneumococcal immunization | CHRONIC CONDITION AND DISABILITY| 4. Developing healthy behaviors in the elderly; Simple measures such as physical activity, improving diet, fighting obesity and give up smoking can improve elderly health, but these measures require good communication between the elderly and the service provider and good access to social resources. | CHRONIC CONDITION AND DISABILITY| 5. Implement fall prevention programs; Preventing fractures associated with severe falls, such as hip fractures; it helps to reduce death and disability and to incline quality of life. 6. Eliminating mental distress associated with risky and unhealthy behavior that affects healing or causes new physical or mental problems  | CHRONIC CONDITION AND DISABILITY| 7. Improving oral health to prevent infection and tooth loss 8. Preparing the health care workforce for the aging community. In this direction, providing geriatrics education at all levels of health care, conducting new studies on the subject, increasing employment in the field of geriatrics  | Rehabilitation for chronic conditions | 1. Goals of Rehabilitation for Chronic Conditions Improve Physical Function: Enhance mobility, strength, endurance, and overall physical functioning to perform daily activities. Pain Management: Use therapies such as physiotherapy, occupational therapy, and cognitive-behavioral therapy (CBT) to alleviate chronic pain and improve coping mechanisms. Enhance Quality of Life: Focus on the psychological and social well- being of the patient, helping them adapt to lifestyle changes brought about by their condition. Promote Independence: Equip patients with the skills and strategies to perform activities of daily living independently, reducing the need for long- term care.  | Rehabilitation for chronic conditions | 2. Types of Rehabilitation Interventions Physical Therapy (PT): Focuses on exercises to improve strength, flexibility, balance, and coordination, tailored to each patient’s abilities and condition. Occupational Therapy (OT): Helps patients regain skills for everyday activities, such as dressing, cooking, and using adaptive devices to maintain independence. Speech and Language Therapy: For conditions affecting speech, swallowing, and communication, such as after a stroke or in Parkinson’s disease. Psychological Support: Addresses mental health challenges, including anxiety, depression, and adjustment difficulties that are common in chronic conditions. Nutritional Counseling: Develops dietary plans that address specific needs, such as controlling blood sugar levels in diabetes or managing weight for heart disease.  | Rehabilitation for chronic conditions | Key Focus Areas for Different Conditions Cardiovascular Rehabilitation: Emphasizes exercise training, education on heart-healthy living, and counseling to reduce heart disease risk factors and improve heart health. Pulmonary Rehabilitation: Aims to improve the lung function and overall well-being of those with COPD or other chronic respiratory conditions through exercise, breathing techniques, and education. Neurological Rehabilitation: Tailored for individuals recovering from strokes, traumatic brain injuries, or living with conditions like Parkinson's disease or multiple sclerosis, focusing on improving motor function, communication, and cognitive skills. Musculoskeletal Rehabilitation: For conditions like osteoarthritis and chronic back pain, this focuses on pain relief, strengthening muscles, and improving joint function.  | Rehabilitation for chronic conditions | Cardiovascular Rehabilitation Cardiac rehab has three equally important parts: Exercise counseling and training: Exercise gets your heart pumping and your entire cardiovascular system working. You’ll learn how to get your body moving in ways that promote heart health. Education for heart-healthy living: A key element of cardiac rehab is educating yourself: How can you manage your risk factors and take care of yourself? Quit smoking? Make heart-healthy nutrition choices? Counseling to reduce stress: Stress hurts your heart. This part of cardiac rehab helps you identify and tackle everyday sources of stress.  | Rehabilitation for chronic conditions | Pulmonary rehabilitation What happens in pulmonary rehabilitation? Pulmonary rehabilitation focuses on exercise and education. But your team will tailor it based on your goals and an assessment of your health. Possible aspects of pulmonary rehabilitation include: Exercise. Education. Breathing retraining. Chest physiotherapy and airway clearance. Mental health support. Nutrition. Some of these might be in one-on-one sessions and others might be in a group session.  | Rehabilitation for chronic conditions | Pulmonary rehabilitation Benefits of pulmonary rehab can include: Symptom improvement. Fewer hospital visits. Fewer exacerbations. Improved quality of life. Improved ability to walk, exercise or perform daily tasks. Improved mental health. Less tiredness.  | Rehabilitation for chronic conditions | Neurological rehabilitation Symptoms Any patient with a neurological condition may be referred for rehabilitation through a prescription or order provided by a doctor. Symptoms that may prompt the need for neurological rehabilitation include: Muscle weakness and abnormal muscle tone Pain Difficulty walking Difficulty with daily activities such as eating, dressing, bathing, toileting Difficulty swallowing Difficulty speaking Impairments in thinking, memory and problem solving Impairments in vision or eye-hand coordination  | Rehabilitation for chronic conditions | Musculoskeletal Rehabilitation Musculoskeletal Rehabilitation should start early to reduce the effects of inactivity. An ideal rehabilitation program focuses on therapeutic exercises while monitoring changes in the symptoms of the patient. Musculoskeletal Rehabilitation is done in 3 phases. Acute phase The focus during this phase is on reducing pain and inflammation and promoting tissue healing. Recovery phase This phase aims to restore normal range of motion, improve muscle control and work on core strength. Maintenance phase Neuromuscular control is improved during this phase by increasing power and endurance. By the end of this phase, the person should be pain free, have full range of motion and normal muscle strength and balance.  | Rehabilitation for chronic conditions | Recent Rehabilitation Technology Trends 1. Immersive Technologies 2. Telehealth 3. Rehabilitation Wearables 4. Rehabilitation Robotics 5. Artificial Intelligence in Rehabilitation  | Cardiac Rehabilitation Nursing | Cardiovascular diseases are one of the most important health problems today and are among the leading causes of mortality and morbidity all over the world. According to the American cardiovascular and pulmonary rehabilitation association, ischemic heart disease will continue to be the number one cause of mortality and insufficiency in 2020.  | Cardiac Rehabilitation Nursing | Cardiac rehab is a medically supervised program designed to improve patient’s cardiovascular health if a patient has experienced heart attack heart failure angioplasty heart surgery  | Cardiac Rehabilitation Nursing | Cardiac rehabilitation is a complex intervention offered to patients diagnosed with heart disease, which includes components of health education, advice on cardiovascular risk reduction, physical activity and stress management.  | Cardiac Rehabilitation Nursing | BENEFITS OF CARDIAC REHABILITATION Strengthening heart and body after a heart attack. Relieving symptoms of heart problems, such as chest pain. Building healthier habits, including getting more physical activity, quitting smoking, and eating a heart-healthy diet. | Cardiac Rehabilitation Nursing | Goals of Cardiac Rehabilitation  | Cardiac Rehabilitation Nursing | The indications for cardiac rehabilitation are: Acute myocardial infarction, Stable angina pectoris, Coronary artery bypass graft surgery, Heart valve repair or replacement, Percutaneous transluminal coronary angioplasty Heart transplantation or heart-lung transplantation, Peripheral artery disease (PAD)  | Cardiac Rehabilitation Nursing | Phases of Cardiac Rehabilitation | Cardiac Rehabilitation Nursing |  | Cardiac Rehabilitation Nursing | PHASE II: 2-12 WEEKS Phase II begins 2-12 weeks after the patient is discharged and the patient is evaluated individually and taken to the appropriate exercise program in the hospital.  | Cardiac Rehabilitation Nursing | PHASE III: 3-9 MONTHS Phase III, Diet of the patient throughout his/her life. Planning of the exercises. The purpose of the exercises : To regulate blood pressure, Having proper breathing exchanges, Heart rate reduction  | Cardiac Rehabilitation Nursing | PHASE IV : Lifetime PHASE IV, is a continuation of phase III but without support. In this phase, the patients continue to apply what they have learned during the preceding phases.  | WHAT TO TAKE HOME? | Benefıts Of Cardıac Rehabılıtatıon Goals of Cardiac Rehabilitatio The indications for cardiac rehabilitation Contraindications Phases of Cardiac Rehabilitation | QUESTIONS AND SUGGESTIONS | ANY QUESTION ?  | RECOMMENDED DAILY STUDIES | McPherson, K, Gibson, BE & Leplege, A 2015, Rethinking Rehabilitation: Theory and Practice, CRC Press, NW, Florida. Hoeman, SP 2008, Rehabilitation Nursing: Prevention, Intervention and Outcomes, 4th edn, Mosby, St Louis, United States  | REFERENCES | Mauk K. L. Current Approaches to Rehabltaton Nursng Practce (L. Ozdemr, H. Sutçu Cicek, Translated). Ankara: Nobel Academc Publshng, 2014. Ay F. A. (2013). Basic Concepts And Skills In Health Practices. Nobel Medical Bookstore, Istanbul. Asti T. A., Karadag A. (2016). Nursing Fundamentals Nursing Science and Art. Academy Press And Publishing, Istanbul. Mampuya WM. (2012). Cardiac rehabilitation past, present and future: an overview. Cardiovasc Diagn Ther. 2012 Mar; 2(1): 38–49.  | ABOUT THE NEXT WEEK | Cardiac Rehabilitation Nursing part 2  ………….. – ………………………… Since course presentations are private, using the texts and images contained herein on social media or else without permission from the course instructor is against the regulations Law No. 6698.