Your Current Target Heart Rate Should Be Between: -

Transcription

1 SPECIAL CARD - 1 TARGET HEART RATE (THR) Exercise for several minutes, stop, and immediately take pulse for 10 seconds at wrist. See beats table to get beats per minute and check against what your current THR should be. Check pulse periodically to maintain THR for the entire workout. Your Current Target Heart Rate Should Be Between: - SPECIAL CARD - 2 RATED PERCEIVED EXERTION (RPE) 0-10 Use the following chart to determine your RPE: how much effort you are having to give in order to keep up with the particular workload of your exercise. 0 = none; rest 6 = 1 = very light 7 = very hard 2 = light 8 = 3 = moderate 9 = 4 = somewhat hard 10 = maximum possible 5 = hard NOTE: for best results, your RPE should be 2, 3, or 4 during exercise; if RPE is 1 or 2, push yourself a little harder; if RPE is greater than 4, slow down. Page 1 of 8

2 SPECIAL CARD - 3 RATED PERCEIVED EXERTION (RPE) 6-20 Use the following chart to determine your RPE: how much effort you are having to give in order to keep up with the particular workload of your exercise. 6 = 15 = hard 7 = very very light 17 = very hard 9 = very light 18 = 11 = fairly light 19 = very very hard 13 = somewhat hard 20 = NOTE: for best results, your RPE should be during exercise; if RPE is 6-10, push yourself a little harder; if RPE is greater than 14, slow down. SPECIAL CARD - 4 MEDICATION CARD Medication name: Dosage: Time(s): Side effects: What if I forget to take it? Reason for medication: Page 2 of 8

3 SPECIAL CARD - 5 NITROLGLYCERINE PROTOCOL for ANGINA 1. Sit down and place 1 nitroglycerine tablet under your tongue and wait 3-5 minutes. If angina is unrelieved: 2. Place another nitroglycerine tablet under your tongue and wait 3-5 minutes. If angina is still unrelieved: 3. Take a third nitroglycerine tablet and CALL 911. DO NOT drive yourself. DO NOT have another person drive you to the hospital. You may be having a heart attack, and you should be in the care of Medics who will safely bring you to the hospital. ENERGY CONSERVATION - 1 Grooming: Shaving Sit in chair to use electric shaver. Support arm using other hand, or rest elbow on vanity. Page 3 of 8

4 ENERGY CONSERVATION - 2 Grooming: Styling Hair Sit in front of mirror and alternate hands to minimize fatigue. Consider using a blow dryer that has built-in curling brush. ENERGY CONSERVATION - 3 Bathing: Drying Off Put on terry robe immediately after stepping out of shower or bath. Sit down and pat to dry off. Page 4 of 8

5 ENERGY CONSERVATION - 4 Mobility: Chair With Wheeled Base To cover short distances indoors, sit in center of seat for stability. make sure chair has stable base with 5 wheels. Works best on non-carpeted areas such as the kitchen. May grasp stable furniture to assist movements. CAUTION: Brace chair against wall when getting in and out. ENERGY CONSERVATION - 5 Kitchen Clean Up Place towel on work surface and washable non-skid mat on floor to minimize need to wipe counter or mop floor. Page 5 of 8

6 ENERGY CONSERVATION - 6 Home Management: Pots / Pans Leave frequently used pots on stove or counter instead of putting away and taking out each time. ENERGY CONSERVATION - 7 Making Bed Try sitting when tucking sheets. Place bed in area where you can reach all corners without straining. Use lightweight bedding. Down comforter or cotton coverlet can serve as cover. Page 6 of 8

7 ENERGY CONSERVATION - 8 Reading Rest arm against trunk and place book on bed surface. May also use arm resting on bed surface or slant board to prop book on bed. ENERGY CONSERVATION - 9 Gardening Activities Carry lightweight equipment in pockets to avoid trips back and forth. Rest frequently when carrying out demanding tasks such as pruning. Alternate heavy work with light tasks that can be done while sitting. Page 7 of 8

8 ENERGY CONSERVATION - 10 Transporting Items Use a lightweight shopping or tea cart for moving household items or bulky laundry from one room to another. Page 8 of 8

9 CHART COPY Routine For: SPECIAL CARD - 1 TARGET HEART RATE (THR) Exercise for several minutes, stop, and immediately take pulse for 10 seconds at wrist. See beats table to get beats per minute and check against what your current THR should be. Check pulse periodically to maintain THR for the entire workout. Your Current Target Heart Rate Should Be Between: - SPECIAL CARD - 2 RATED PERCEIVED EXERTION (RPE) 0-10 Use the following chart to determine your RPE: how much effort you are having to give in order to keep up with the particular workload of your exercise. 0 = none; rest 6 = 1 = very light 7 = very hard 2 = light 8 = 3 = moderate 9 = 4 = somewhat hard 10 = maximum possible 5 = hard NOTE: for best results, your RPE should be 2, 3, or 4 during exercise; if RPE is 1 or 2, push yourself a little harder; if RPE is greater than 4, slow down. SPECIAL CARD - 3 RATED PERCEIVED EXERTION (RPE) 6-20 Use the following chart to determine your RPE: how much effort you are having to give in order to keep up with the particular workload of your exercise. 6 = 15 = hard 7 = very very light 17 = very hard 9 = very light 18 = 11 = fairly light 19 = very very hard 13 = somewhat hard 20 = NOTE: for best results, your RPE should be during exercise; if RPE is 6-10, push yourself a little harder; if RPE is greater than 14, slow down. SPECIAL CARD - 4 MEDICATION CARD Medication name: Dosage: Time(s): Side effects: What if I forget to take it? Reason for medication: SPECIAL CARD - 5 NITROLGLYCERINE PROTOCOL for ANGINA 1. Sit down and place 1 nitroglycerine tablet under your tongue and wait 3-5 minutes. If angina is unrelieved: 2. Place another nitroglycerine tablet under your tongue and wait 3-5 minutes. If angina is still unrelieved: 3. Take a third nitroglycerine tablet and CALL 911. DO NOT drive yourself. DO NOT have another person drive you to the hospital. You may be having a heart attack, and you should be in the care of Medics who will safely bring you to the hospital. ENERGY CONSERVATION - 1 Grooming: Shaving Sit in chair to use electric shaver. Support arm using other hand, or rest elbow on vanity. ENERGY CONSERVATION - 2 Grooming: Styling Hair ENERGY CONSERVATION - 3 Bathing: Drying Off ENERGY CONSERVATION - 4 Mobility: Chair With Wheeled Base Sit in front of mirror and alternate hands to minimize fatigue. Consider using a blow dryer that has built-in curling brush. Put on terry robe immediately after stepping out of shower or bath. Sit down and pat to dry off. To cover short distances indoors, sit in center of seat for stability. make sure chair has stable base with 5 wheels. Works best on non-carpeted areas such as the kitchen. May grasp stable furniture to assist movements. CAUTION: Brace chair against wall when getting in and out. ENERGY CONSERVATION - 5 Kitchen Clean Up ENERGY CONSERVATION - 6 Home Management: Pots / Pans ENERGY CONSERVATION - 7 Making Bed Place towel on work surface and washable non-skid mat on floor to minimize need to wipe counter or mop floor. Leave frequently used pots on stove or counter instead of putting away and taking out each time. Try sitting when tucking sheets. Place bed in area where you can reach all corners without straining. Use lightweight bedding. Down comforter or cotton coverlet can serve as cover. Page 1 of 2

10 CHART COPY Routine For: ENERGY CONSERVATION - 8 Reading ENERGY CONSERVATION - 9 Gardening Activities ENERGY CONSERVATION - 10 Transporting Items Rest arm against trunk and place book on bed surface. May also use arm resting on bed surface or slant board to prop book on bed. Carry lightweight equipment in pockets to avoid trips back and forth. Rest frequently when carrying out demanding tasks such as pruning. Alternate heavy work with light tasks that can be done while sitting. Use a lightweight shopping or tea cart for moving household items or bulky laundry from one room to another. COMMENTS: Patient Name/Number: Clinician Name/Signature: Date: Page 2 of 2