Acute Inpatient Flashcards

1
Q

What is Acute Care?

A

Hospital setting

Goal: D/C patient as soon as the patient deemed healthy and stable, w/ appropriate D/C instructions

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2
Q

LTAC

A

Long Term Acute Care
certified hospitals, patient stay longer than 25 days, with more than one serious condition

high need for medical services

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3
Q

SNF

A

Skilled Nursing Facility
after 3 days of hospital stay; therapy services > MD, 24 hour nursing, meds, custodial care

NOT a nursing home

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4
Q

Inpatient Rehab

A

3 hours of therapy/day, 24 hour nursing (requires 2 out of the 3 therapy services)

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5
Q

Long Term Care

A

therapy 1-3 days per week for 30-60 mins, nursing services

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6
Q

Subacute Rehab

A

more intensive skilled than SNF, therapy 1-2 hours/day

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7
Q

What is our role as a PT?

A

advocate for our patient
what brought them here and what can we do to help them meet the longer goals
which level of care is best…

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8
Q

Acute Care PT

A

advanced skills and knowledge to thoroughly examine and appropriately intervene with patients in medically compromised situations across the lifespan

high degree of triage skill, integration of complex info from many HCP, and effective interdisciplinary communication are necessary for practice

demonstare awareness and recognition of changes in medical stability w/ onset of activity

skill and resolve focus on body functions and impairments while max the func capabilities of the individual in order to facilitate the best pt outcome

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9
Q

Environments

A
General Medical/Sx
Orthopedics
Oncology
Neurology
ICU
Step Down Unit
Pediatrics
Trauma
Cardiology
Pulmonary
Vascular
Transplant
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10
Q

3 acute care considerations:

A

Infection Control
Universal Precautions
Isolation Precautions

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11
Q

3 levels of Isolation Precautions

A

Contact - gloves and a gown barrier, skin
Droplet - transmitted through sputum, cough, sneeze, could be on surface
Airborne - most concerning, mask w/ one way movement involved, particles that are transferred in the air

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12
Q

Role of PT in Acute

A

consultative
member of multidisciplinary patient care team
patient, family/caregiver education
clinical judgements that impacts discharge planning

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13
Q

Common components of inpatient chart

A
demographic info
physician orders
H&P
progress notes
operative reports
consult reports
nursing notes
meds sheets
lab values
other diagnostic tests
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14
Q

Precautions

A

confirm physician orders
know surgical procedure
know WB status
know your physician

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15
Q

Total Hip Precautions

A
Risk for dislocation of new px jt
Positions to avoid to decrease risk
- Hip flexion >90
- Hip Abd > neutral (do not cross midline)
- Hip IR
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16
Q

Spine Precautions

A

Positions and movements to avoid to prevent loosening of hardware or fusion

  • No spine flexion
  • No rotation
  • No lifting greater than 5-10 lbs (depends)
17
Q

WB Restrictions

A
NBW
TTWB
PWB
WBAT
FWB
18
Q

Sternal Precautions

A

No lifting more than 5-10 lbs
Avoid WB through UE
Avoid reaching posteriorly
No shoulder flexion >90 (depends)

19
Q
Assist levels (very subjective)
Functional Independence Measure (FIM)
A

Independence
Mod Independence, pt requires use of device, but no physical A
Min A, pt can perform 75% of more of task
(CGA, pt can do 90% of work, w/ PT hand on them)
Mod A, 50-74% of task
Max A, 25-49% of task
Total A,

20
Q

Fundamental S&S to look for a patient in distress

A
20 mmHg change in SBP
10 mmHg change in DBP
100 HR
Increased RR
Decreased O2 sats
92-100% is normal
Complaints of dizziness, nausea, speech slur
Change in level of awareness/direction
21
Q

AGAIN… what are the 6 elements of Patient Management

A
Examination
Evaluation
Diagnosis
Prognosis (Plane of Care)
Intervention
Outcomes
22
Q

3 major categories for Examination:

A

History (HPI)
Review of systems
Specific tests & measures

23
Q

What is in the Examination: History?

A

Chart Review
Medical Team
Subjective Interview
Family/Caregiver

24
Q

History includes:

A
General Demographics
Social History
Living Environment
General Health Status
Social/Health Habits
Family Hx
Medical/Sx Hx
CC/cc
Functional status & Activity Level
Meds
Clinical tests
25
Q

What is in the Examination: Systems Review?

A
Cardio
Pulm
Integ
MS
Cognitive
NM
*Determines PT
26
Q

What is in the Examination: Tests & Measures?

A
Specific tests...
Aerobic capacity
Cranial/Peripheral nerve integrity
Cognition
Assist/adapt devices
Functional mobility
Balance
Motor control
Muscle performance
Pain
Vitals
Strength
ROM
Cognition (x4)
Balance
Function
27
Q

Common lines in Inpatient Setting

A
PIC IV
Urinary Catheter
Cardiac Monitors
Surgical Drains
Gastric suction
Arterial Lines
Ventilator