Acute Care Worksheet (precautions, WB, Positions) Flashcards
Independent (I)
Define, staff effort, pt effort
-pt requires no assistance or supervision from PT or device and is safe and secure to ambulate and/or complete tasks
-0% staff efforts
-100% pt effort
Modified independence (Mod I)
Define, staff effort, pt effort
-pt completes task using assisted devices (walker, cane grab bar etc.) and/or requires extra time to complete a tasks
-0% staff effort
-100% pt effort
Supervision (S)
Define, staff effort, pt effort
-no physical contact from PT or assistant; assistant stands next to pt and gives verbal cues
-0% staff effort
-100% pt effort
Standby assist (SBA)
Define, staff effort, pt effort
-have to be in pt’s bubble ready to catch pt if needed, but don’t put hands on pt
-5 to 10% staff effort
-90 to 95% pt effort
Contact guarding (CGA)
Define, staff effort, pt effort
-pt requires light physical contact from PT or assistant (ex. Hand placed on pt’s back to steady pt w/o physical support)
<5% staff effort
>95% pt effort
Minimum assistance (Min A)
Define, staff effort, pt effort
-pt requires 25% or less physical support or assistance to safely complete task/transfer/ambulation
25% staff effort
At least 75% pt effort
Moderate assistance (Mod A)
Define, staff effort, pt effort
-pt requires 50% assistance from PT or assistant to safely complete task/transfer/ambulation
50% staff effort
26-74% pt effort
Maximal assistance (Max A)
Define, staff effort, pt effort
-pt requires 75% assistance or support from staff member to safely complete task/transfer/ambulation
75% staff effort
25% pt effort
Dependent (D)
Total assistance (Total A)
Define, staff effort, pt effort
-pt requires 100% assistance or support from staff members to complete task/transfer/ambulation
100% staff effort
0% pt effort
WB-ing level: FWB
Full BW through extremity
WB-ing level: WBAT
Weight bearing as tolerated - as much BW as pt can tolerate through extremity usually limited by pain or ability
WB-ing level: PWB
Partial weight bearing - 50% of BW through extremity
WB-ing level: TTWB
Toe touch weight bearing - only toes allowed to touch ground; primarily use limb for balance ~25% BW
WB-ing level: heel touch weight bearing
Only heel allowed to touch ground; primarily use heel for balance, ~25% of BW
WB-ing level: NWB
-no weight at all is allowed through the extremity and do not allow extremity to touch support surface
TKA precautions
-if there is WB restriction it would be WBAT initially moving towards FWB
-precautions given by Dr/surgeon
General THA WB
precautions
-if there is a WB restriction it would be WBAT initially moving toward FW
Anterior approach THA precautions
-minimally invasive approach
-NO ext past neutral, ER and ADD
Posterior approach THA precautions
NO IR, flexion >90 degrees, ADD past midline
ORIF (open reduction internal fixation) precautions
-precautions set by surgeon
-typically NWB or PWB
-ask nurse or dr if precautions are not stated
What is a CABG surgery?
Coronary Artery Bypass Graft
Traditional sternal precautions (maintained for 4-6 wks)
-do not reach B arms over head (flex)
-do not reach B arms out to the side (ABD past 90)
-do not reach arms behind back
-do not lift more than 5-8 lbs
-do not push w/ arms
-beneficial to hold pillow w/ arms during functional tasks of rolling, supine to sit, and sit to stand
-beneficial to hold pillow during cough or sneeze
Cervical spinal restrictions
-if in place; no lifting >10 lbs, aspen collar in place all the time, ROM restrictions per surgeon, no flexion >90 degrees
Lumbar spinal precautions
-primarily after spinal laminectomy, decompression surgery
-if precautions in place; NO twisting, forward bending, >90 degrees, minimize SB
-use log roll when moving from supine to sit or sit to supine
Complications of being in supine
Flexion contractures of hips, knees, or foot PF
Purpose for prone
Relieve pressure to posterior bony prominences, reduce joint contractures, and provide relief to spine
Purpose of side lying
Assists w/ relieving pressure from bony prominences but majority of BW is on downside hip and shoulder
What is Fowler’s position? Purpose?
-pt sitting upright in bed w/ legs resting on bed
-used to facilitate abdominal drainage, relieve difficulty w/ breathing, tension on abdominal sutures, facilitate eating, reading, socializing, and relaxes large muscles of back
High, semi and low Fowler positions
High: 75-90 degrees
Semi: 40-45 degrees
Low: 30 degrees
