Acute Care and Post Op Management

Question 1

What are 5 strategies to prevent falls?

Answer 1

• Proper footwear
• Medication review
• Adequate room lighting
• Frequent toileting
• Routine mobilization

Question 2

What are signs and symptoms of DVT

Answer 2

• Redness, swelling, heat, +ve Homan’s sign, leg pain, tenderness, dilated veins, ankle edema

Question 3

What are 4 prevention strategies for DVT?

Answer 3

• Early mobilization
• Ankle pumps
• Anti coagulants
• Graduated compression stockings

Question 4

What are the benefits of early mobilization? (Improves and prevents)

Answer 4

Improves: breathing, chest mobility, secretion clearance, mood, conditioning and activity tolerance, independence, GI function
Prevents: aspiration, thrombus formation, atrophy, contractures, pressure sores, neuropathy

Question 5

What should be included in a patient interview in the acute care setting?

Answer 5

• Functional level before admission
• Previous use of aids
• Recreation and exercise prior
• Need for adaptive equipment on regular basis
• Additional medical problems limiting use of assistive devices or participation in therapy
• Hx of falls
• Hx of chronic pain
• Support system
• D/C location
• Goals

Question 6

What are 5 components of observation?

Answer 6

• General appearance
• Signs of respiratory distress
• Position of extremities
• Incision site for signs of infection
• Environment (lines, tubes, etc.)

Question 7

What are 4 general physiotherapy goals in acute care?

Answer 7

• Decrease pain and/or muscle guarding
• Prevent circulatory and pulmonary complications
• Prevent ROM and strength deficits
• Improve functional mobility (while protecting involved structures)

Question 8

What are signs and symptoms that would prompt you to alert the surgeon or nurse? (7)

Answer 8

• Extreme pain and swelling
• Unwillingness to bear weight
• Infection
• Chest pain
• Calf pain
• Excessive bruising
• Excessive laxity of post op joint

Question 9

What are signs to terminate the exercise session? (7)

Answer 9

• Excessive fatigue
• Marked dyspnea
• Dizziness, light headedness or ataxia
• Excessive pain
• Patient requests to stop
• Moderately severe or increasing angina
• Cyanosis or pallor

Question 10

What are goals during the maximum protection phase post THA? How long does this phase last?

Answer 10

4-6 weeks
Prevent complications
Prevent muscle atrophy
Regain active mobility and control
Achieve independent functional mobility

Question 11

What are the goals during the maximum protection phase post TKA? How long does this phase last?

Answer 11

1-4 weeks
Control post op swelling
Minimize pain
ROM 0-90
3/5 - 4/5 quads
Ambulate with or without aid
Establish HEP

Question 12

What are the goals of fracture management? (6)

Answer 12

• Bony union without further bone or soft tissue damage
• Restoration of maximal function
• Regain lost ROM
• Minimize muscle atrophy
• Minimize impairments associated with limited skeletal weight bearing (ex. OP)
• Prevent complications

Question 13

What are signs of increased ICP?

Answer 13

LOC, changes in motor function, headache, pupillary changes