Techniques to improve endurance and cardiovascular function

1
Techniques to improve endurance and
cardiovascular function
2
Review Vital signs

• Blood Pressure
• Pulse
• Respiration
• SPO2

3
Exercises

• BTE
• UE Ergometer
• Bilateral cane exercises
• Balance exercises
• Reaching for cones

4
ADL Retraining

• Review MET levels
• Start with light activities
• Monitor Pulse, BP, respiration and SPO2 during
  activities

5
Energy conservation training

• Provide written handouts
• Pacing
• Slow down. Move like you are underwater
• Avoid overhead activities
• Use adaptive equipment

6
Using O2

• Measured in liters per minute
• Make sure it is working
• Dont change it unless instructed by the doctor
• More is not necessarily better
• If pt uses it PRN, it can be used if problems
  develop
• Use it in the shower
• Use portable tank
• Fire precautions
• Dont use a heat gun or splint bath near oxygen

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What to do in an emergency?

• Patient collapses
• Story of pt who was hypotensive with me in hoyer
  lift
• CPR
• Call a code
• Call 911
• Always report any event. Dont try to conceal
• Pt becomes SOB
• Pt C/O chest pain, arm pain
• What to do for angina
• Does pt regularly take nitroglycerine?
• Do they know their routine for angina
• Typical routine for angina
• 1 pill for angina. If it does not go away
• Take another pill in 5 minutes. If it does not
  go away
• Take another pill in 5 minutes. If it does not
  go away
• Call the ambulance
• These patients are quite dangerous to treat so if
  you are not sure you know what to do in an
  emergency, dont treat them.
• You must take your job very seriously
• At all times consider what would happen if my
  patient had an MI right now. Are you prepared?

8
Lab activity

• Design an exercise program for a patient who had
  MI 1 week ago. He has been staying in the bed
  most of the time. He has just begun walking to
  the BR with PT and nurses.
• List the precautions you would consider with this
  patient.
• Go through this exercise plan with a student,
  monitoring vital signs throughout treatment
  session.
• Design an exercies program for a patient whose
  diagnosis is CAD, deconditioning, instability of
  gait. She in on the acute rehabilitation wing
  of the hospital. She can walk, but does so with
  poor balance using a rolling walker. She gets
  shortness of breath easily.
• List the precautions you would consider with this
  patient
• Go through this exercise plan with a student,
  monitoring vital signs throughout treatment
  session.
• You work in home health. Your patient has COPD
  with severe edema in legs. She has SOB with
  almost all activities including standing, walking
  or any ADL. Design an exercise program for this
  patient.
• List the precautions you would consider with this
  patient
• Go through this exercise plan with a student,
  monitoring vital signs throughout treatment
  session.