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NMR II > Aging II > Flashcards

Aging II Flashcards

1
Q

What does acute care hospital consist of?

A
  • Emergency department
  • Critical care
  • Complex medical conditions
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2
Q

When a patient has medicare how long are they expected to need medically necessary hospital care in order to be admitted?

A

2 or more nights

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3
Q

What is the number one cause of acute care hospitalization?

A

Congestive heart failure

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4
Q

What does the acute care physical therapist do?

A
  • Perform thorough chart review
  • Tries to establish patient’s prior level of function was
  • Assess strength & balance
  • Assess functional mobility
  • Monitor vitals & tolerance to activity
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5
Q

What is the goal of acute care physical therapy?

A
  • Assess patients mobility and provide recommendations for discharge planning
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6
Q

Describe the type & number of patients an acute physical therapist will see? And the setting?

A
  • Patients tend to be very ill, post-surgical, complex
  • PT tend to see a high volume of patients
  • Setting is fast paced & unpredictable
  • Treatment session tend to be short
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7
Q

T/F: As an acute care physical therapist you will have to make justification for medical necessity of DME for insurance reimbursement

A

True- EX may be walkers, canes, wheelchairs, hospital beds, transfer boards, crutches

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8
Q

What is the average length of stay in acute care physical therapy?

A

2-3 days

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9
Q

What should be considered in discharge planning?

A
  • Determine appropriate D/C location
  • Identify needs for smooth transition
  • Begin process of meeting pre/post DC needs
  • Consider all disciplines
  • Provide realistic options to pt
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10
Q

What documentation for inpatients acute rehab is required daily?

A
  • Pre-admission screen & post admission evaluation
  • Comprehensive plan w/ multiple services
  • MD overseeing care
  • Progress notes
  • Team conferences
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11
Q

What is the criteria for admission to inpatient acute rehabilitation facility?

A
  • Active ongoing therapy from multiple discipline (one must be PT or OT)
  • Intensive rehab (over 3 hours/day, 5 days/week)
  • Reasonable expectation of significant benefit & measurable improvement
  • Physical supervision
  • Intensive, coordinated interdisciplinary approach
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12
Q

Name some conditions commonly treated in acute inpatient rehab

A
  • Stroke
  • SCI
  • Amputation
  • Major multiple trauma
  • Brain injury
  • Neurological disorders
  • Arthritis medical conditions
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13
Q

When can knee or hip joint replacement be treated in acute inpatient rehab?

A
  • If bilateral
  • Pt BMI greater than 50
  • Patient was 85 or older
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14
Q

What is subacute rehabilitation?

A

Short - term program of care which typically include 1-3 hours rehab per day for at least 5 days per week

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15
Q

How does someone qualify for sub acute care rehab?

A

Patients must have a definitive rehab goal & identified needs for skilled care

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16
Q

What is home health care?

A

Agency provides services within patients home

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17
Q

What is the eligibility criteria for home health care?

A
  • Under physicians care
  • Require 1 or more services
  • unable to regularly leave home (homebound)
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18
Q

What does it mean for a patient to be homebound?

A

Challenging and taxing to leave the home, may require assistance or assist devices

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19
Q

On average what is durations and frequency of a home health care session?

A
  • 30 to 60 min
  • Average 1-3x per week
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20
Q

What assessment is conducted on start of care, discharge of services or resumption of home health care?

A

Outcome and Assessment Inform Set (OASIS)

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21
Q

What are adult day services?

A
  • Adjunct facilities to Rehab centers
  • “day hospitals”
  • Provide respite care for family caregivers
22
Q

Describe independent living

A
  • Handicap accessible
  • Dinner may be included
  • Does not require 24 hour supervision
23
Q

Describe assisted living

A
  • Meals included
  • Medication management
  • Prefer environment 24 hr supervision
  • Can have needs safely met
24
Q

What are some possible reasons that someone may go to assisted living?

A
  • Possible visual/hearing impairments
  • May require some ADL assistance
  • Independent transfer, walk, w/c
25
Q

Why may someone go to an enhanced care memory unit?

A

Require additional care due to memory deficits

26
Q

Describe Long Term Care

A
  • SNF or floor of acute care hospital
  • Assistance needed 24/7
  • Therapy services available if necessary
  • Manage chronic conditions
27
Q

Describe wellness centers

A
  • Community or medical facility based
  • Focus on general fitness, prevention, health & wellbeing
  • General or disease - specific
28
Q

What is the goal of wellness centers?

A
  • Enhance function & fitness
  • Decrease risk of disease or adverse event
29
Q

How is care often delivered in wellness centers?

A
  • Group settings
  • Fitness instructors/personal trainer
30
Q

Describe hospice care

A
  • Compassionate care for people with life-limiting illness or injury
  • Considers patients needs and wishes
31
Q

Where can hospice care be provided?

A
  • Home
  • Long term care
  • Hospice center
32
Q

What is an advanced directives?

A
  • Documents that are completed by a patient prior to onset of an illness that dictate how the patient want their end of life care to be carried out
  • Durable power attorney and a living will are two types of advanced directives
33
Q

What is a living will?

A

Legal document in which a patient dictates their preference for health care treatment, which become especially important, if the patient becomes terminally ill and can no longer express their wishes

34
Q

What is a DNR?

A
  • Do not resuscitate
  • Medical order written by doctors that documents a patients wishes to not be resuscitated with CPR if they stop breathing or heart stops beating
35
Q

What is the definition of hospice?

A
  • Form of palliative care for terminally ill patients who have a limited life expectancy that focuses on the management of their pain & other symptoms as well as the acceptance of their own death
  • Goal is to allow patient to remain in their home as they near death, though there are inpatient facilities that provide these services as well
36
Q

What is palliative care?

A

An approach to a patients care that aims to relieve their pain and suffering as well as address and psychological, social, & spiritual problems with the goal of improving the patients quality of life

37
Q

What are 7 essential care transition interventions?

A
  • Manage medications
  • Transitions planning
  • Patient & Family engagement and education
  • Information transfer
  • Follow up care
  • Health provider engagement
  • Shared accountability
38
Q

Medicare is a federal health insurance program given to people 65 years or older who meet what criteria?

A
  • Qualify for social security benefits

or

  • currently reside in US an are either (A US citizen or a permanent US resident who has lived continuous in US last 5 years)
39
Q

Medicare is a federal health insurance program given to people under 65 years who meet what criteria?

A
  • Have a disability (usually 2 year wit period)
  • End stage renal disease
40
Q

Does a patient pay a copay with medicare or medicaid?

A

Medicare

41
Q

What is medicaid?

A

Federal - State health insurance program for low-income & needy people

42
Q

What is a fall?

A

Even where an individual unexpectedly comes to rest on the ground or another lower level without known loss of consciousness

43
Q

Falls forward or backward often result in what fractures?

A

Wrist fractures due to reaching to prevent falls

44
Q

Falls to the side often result in what fracture?

A

Hip

45
Q

Falls on buttocks result in what fracture?

A

None usually

46
Q

Name some risk factors for falls

A
  • History
  • Age
  • Living Alone
  • Meds
  • Medical condition
  • Muscle weakness
  • Gait & balance problems
  • Fear of falling
  • Nutritional deficiencies
  • Impaired cognition
  • Visual impairments
  • Environment hazards
  • Footwear/clothing
  • Inappropriate walking aids or assistance devices
47
Q

What does a multi factor falls risk assessment include?

A
  • Focused history
  • Physical exams
  • Functional exam
  • SOM
  • Environment assessment
48
Q

What is the recommended amount of moderate or vigorous intensity exercise?

A
  • Moderate: Aerobic exercise greater than or = 30 min, greater than or = 5 days/week (150 min total)
  • Vigorous: 20-60 min greater or = 3days/week for at least 10 min durations
49
Q

What is the recommended amount of balance exercises?

A

Greater than or = 2x/week for patients with balance problems or history of falling

50
Q

What is the recommended amount of strength training?

A

Major muscle groups greater than or = 2x/week at range of 8-12 reps

NMR II (14 decks)

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