NUR 267 Chapter 38 Content Objectives Spring 2017 Answer all questions listed below. Submit via turnitin through BB. 1. Explain the role of the interdisciplinary team in cardiac rehabilitation. Collaboration with members of the interdisciplinary health team members is necessary when caring for patients who are preparing or currently participating in cardiac rehabilitation. Cardiac rehabilitation is the process of actively assisting the patient with cardiac disease in achieving and maintaining a vital and productive life while still remaining within the limit of the heart’s ability to respond to increases in activity and stress. Interdisciplinary health goals for cardiac rehabilitation include, increasing activity tolerance. The expected outcomes for a patient trying to increase their activity tolerance is that the patient will increase activity without chest pain and the need for supplemental oxygen as a result of the collaborative cardiac rehab program. The nurse collaborates with the physical therapist to initiate the cardiac rehabilitation program and the patient is expected to continue the program after discharge from the acute care setting. During the initial phase it is the nurse’s responsibility to promote rest and ensure limited mobility. The patient may require the nurse’s assistance to perform some ADLs. The patient is expected to progress at their own pace to be able to ambulate themselves within their room and to the bathroom. The nurse is responsible for monitoring the patients vital signs as well as level of fatigue during increases in level of activity. The nurse is responsible for monitoring for intolerance of activity, manifested by: a decrease greater than 20 mm Hg in systolic blood pressure, a change in 20 beats per minute in heart rate, or reports of dyspnea or chest pain. The nurse should collaborate with the health care provider if this situation presents itself and the nurse should not advance the patient to the next level of activity. Physical therapy should be involved in helping the patient regain activity tolerance as well as case management who can help plan for the patients continued care after discharge. Patients with ACS should always be referred to a phase to cardiac rehabilitation program by case management. 2. Develop a teaching plan for patients at risk for CAD regarding cardiovascular risk modification programs and lifestyle changes.
There are many modifiable and nonmodifiable risk factors for CAD. Nonmodifiable risk factors are personal characteristics that cannot be altered or controlled. While a patient should be made aware of these risk factors, a teaching plan should be centered on risk factors that the patient can modify themselves. Modifiable risk factors are lifestyle choices that the patient can change to lessen their risk of developing CAD. The patient should be taught that they may not be able to change the risk factors on their own and may require medical intervention to help them. These risk factors include, elevated
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