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Discharge: 40 hours
o Reviewed discharge GXT with 12 patients.
o Summarized exercise progression throughout cardiac rehab and
explained discharge exercise prescription to 18 patients.
o Utilized the Karvonen method to determine a target heart rate range for 30
patients.
Patient education/tailored risk factor reduction: 65 hours
o Instructed one cardiac patient education session per week without
supervision for 16 weeks during my summer internship. Education topics
included:
o Nutrition
o Saturated vs unsaturated fats
o Omega 3s and 6s
o Complex carbohydrates and whole grains
o Sodium reduction
o Blood glucose management
o DASH diet
o Weight management
o Physical activity and exercise
o Home exercise programs
o Daily step recommendations
o Blood pressure management
o Lipid management
o Diabetes management (include metabolic syndrome)
o Psychosocial (depression, anxiety, anger)
o Instructed patient education once a week for 12 weeks at Watertown.
Each education session was taught in a group setting of no more than
eight patients. Education sessions typically lasted 15-20 minutes with a
question and answer session at the end. Topics covered at Watertown
included:
o Rate your plate
o Understanding stress
o Relaxation
o Blood pressure management
o Cholesterol management
o How to reduce your cardiovascular risk factors
o Heart healthy diets
o Whole grains
o Lean proteins
o Portion control
o Eating a variety of fruits and vegetables
o Healthy weight management
o Physical activity recommendations
o Home exercise
o MET levels
o FITT principle
o Anaerobic vs aerobic exercise
o MyPlate
o DASH diet
Diagnostic stress testing: 100 hours
Exercise stress test: 60 hours
o Conducted two GXTs with minimal supervision. The protocol used for both GXTs
was the Bruce protocol.
o Other protocols that were conducted during my stress test experiences were:
Modified Bruce, Naughton, Ebbeling, USAFSAM, and Balke-Ware.
Echo: 10 hours
Nuclear: 6 hours
Pharmacological: 10 hours
Catherizations/Surgeries: 14 hours
o Observed one TAVR and CABGx4 procedure at Gundersen Health Systems.
o Observed seven cardiac catherizations and two peripheral catherizations.
Pulmonary Rehab: 120 hours
Inpatient: 25 hours
Supervision: 15 hours
Patient education: 10 hours
o Inpatient education includes overview and purpose of medications, discharge
instructions, and guidelines for home exercise.
Outpatient: 95 hours
Functional assessment (6 MWT, etc): 15 hours
o Conducted two 6 MWTs with minimal supervision and ten 6 MWTs without
supervision during my summer internship experience at Gundersen.
o Conducted four 6 MWTs with minimal supervision and five 6 MWTs without
supervision during my fall internship at Watertown.
o During 6 MWTs the following parameters need to be assessed: oxygen
saturation, heart rate, RPE, RPD, claudication (if necessary), and an immediate
post exercise blood pressure.
Exercise: 40 hours
Aerobic: 20 hours
o Intervals for severe COPD patients.
o Limiting upper body exercises that exacerbate their COPD symptoms.
Resistance: 10 hours
o Total body resistance band training.
Functional: 10 hours
o Range of motion exercises to improve upper body flexibility.
o Inspiratory muscle and diaphragmatic training.
Breath control: 5 hours
o Techniques taught include diaphragmatic and pursed lip breathing.