Basic Exercise and Assessment Flashcards
2 basic types of exercise
active and passive
What is AAROM exercise
movement that combines voluntary contraction of muscles with an external force to increase joint ROM
indications for PROM
unable to perform active ex
avoid active ex with unhealed fracture
counteract neg effects of immobilization
evaluate ROM/flexibility
provide sensory stimulation/awareness
reduce cardiopulmonary stress
benefits of PROM
maintains existing ROM
minimize muscle shortening/other complications
maintain circulation
maintain sensory awareness
promote cartilage nutrition
reduce/inhibit pain
limits of PROM
can’t prevent atrophy
can’t maintain muscle tone, strength, or contractile endurance
can’t reduce adipose tissue
what are the scores for the GG scale if the activity occurred
6=independent
5=set up
4=supervision/touching
3=partial assistance
2=substantial assistance
1=dependent
what are the scores of the GG scale if activity did not occur
07=refused
09=non applicable
10=not attempted due to environmental limitations
88=not attempted due to medical condition safety
what are the goals of proper pt positioning
safety
comfortablet
access
prevent ulcers/pressure injuries
prevent loss of ROM
prevent nerve impingement
use position changes to assist in breathing, vascular flow, etc
difference between short and long term positioning
long term = prevent injury/better breathing position
short = allow treatment
rules for times pts are in certain position
change position every 2 hours (may need sooner if fragile, poor circulation, etc)
short term = reposition every 15 min
general guidelines for pt positioning
explain to pt
maintain neutral spine
always give pt a way to call for help if needed
areas of greatest pressure when laying supine
occipital tuberosity
SPs of vertebrae
inferior angle of scap
olecranon process
PSIS
sacrum
posterior calcaneus
areas of greatest pressure when laying prone
forehead or lateral ear
tip of acromion
anterior humeral head
sternum
ASIS
patella
tibial crest
dorsum of foot
areas of greatest pressure sidelying
lateral ear
lateral ribs
lateral acromion
lateral humeral head
medial/lateral epicondyles of humerus
greater trochanter
medial/lateral condyles of femur
medial/lateral malleolus
areas of greatest pressure in sitting
ischial tuberosities
posterior thighs
sacrum
SPs of vertebrae
medial epicondyles and olecranons (if resting arm on hard surface)
what is the skin blanching test
when pressed healthy skin will bleach and quickly return to pin
if it doesn’t blanche it indicates compromised tissue
don’t position pt in compromised area
hard to do in pts with increased pigment
what contractors occur most
flexion
factors to take into account for long term positioning in sitting
reposition every 10-15 min
may require lumbar roll
hip at 90, knee at 90, and neutral ankle
avoid sacral sitting
support arms
what is an ekg
electrocardiogram
records summed electrical activity of heart
what do the p wave, QRS complex, and the t wave represent
p = atrial depolarization
QRS = ventricular depolarization
T wave = ventricle repolarization
how does the electrical activity travel through the heart
SA node generates impulse
goes to AV node (delays)
impulse goes to apex via the bundle branches or bundle of His (ventricular excitation)
signal travels through purkinji fibers (end signals complete ventricular excitation)
how to look at rhythm on EKG
ventricular = look at R-R intervals
atrial = look at P-P intervals
are distances relatively equal
what is regular irregular vs irregularly regular in reference to rhythm of EKG
regularly irregular = pattern to the irregularity
irregularly irregular = no pattern
how do you determine rate on a EKG
count each large square (5 small squares)
try to start on a solid line and count from there
counting order = 300,150,100,75,60,50
if in-between would just be “between 100 and 75 bpm)
what is A-fib
atrial fibrillation
continuous rapid firing of multiple atrial foci
no single impulse depolarizes. the atria completely
common causes of Afib
MI
CABG surgery
valvular disease
CHF
HTN
chronic alchoholism
what is premature ventricular contraction
PVC
early QRS complex
wide/bizzare QRS
No P wave
deflection of ST segment and T wave is opposite of the QRS
compensatory cause
what is ventricular tachycardia
continuous run of PVC (150-250 bpm and each QRS is wide)
common causes of ventricular tachycardia
acute MI or ischemia
electrolyte imbalance
medication toxicity
idiopathic
illicit drugs
clinical signs/symptoms of ventricular tachycardia
hypotension (low BP)
syncope
ventricular tachycardia can deteriorate into what
ventricular fibrillation (cardiac arrest)
common profiles of lab screening
electrolyte
metabolic
kidney
liver
cardiac markers
lipid panel
complete blood count
reference value for WBCs
5.0-10.0 x 10^9/L
WBCs trending up indicates what
leukocytosis
> 11.0 x10^9/L
causes WBC would trend up and clinical presentation and therapy implications
causes: infection, leukemia, obesity, inflammation, stress pain
presentation: weak fatigue, fever, dizzy
time therapy around early morning low level and late afternoon peak
what does it mean if WBCs trend down
<4.0 x 10^9/L
leukopenia and neutropenia
causes of WBCs trending down
causes: viral or bacterial infection/radiation
