Basic Exercise and Assessment

Question 1

2 basic types of exercise

Answer 1

active and passive

Question 2

What is AAROM exercise

Answer 2

movement that combines voluntary contraction of muscles with an external force to increase joint ROM

Question 3

indications for PROM

Answer 3

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

Question 4

benefits of PROM

Answer 4

maintains existing ROM
minimize muscle shortening/other complications
maintain circulation
maintain sensory awareness
promote cartilage nutrition
reduce/inhibit pain

Question 5

limits of PROM

Answer 5

can’t prevent atrophy
can’t maintain muscle tone, strength, or contractile endurance
can’t reduce adipose tissue

Question 6

what are the scores for the GG scale if the activity occurred

Answer 6

6=independent
5=set up
4=supervision/touching
3=partial assistance
2=substantial assistance
1=dependent

Question 7

what are the scores of the GG scale if activity did not occur

Answer 7

07=refused
09=non applicable
10=not attempted due to environmental limitations
88=not attempted due to medical condition safety

Question 8

what are the goals of proper pt positioning

Answer 8

safety
comfortablet
access
prevent ulcers/pressure injuries
prevent loss of ROM
prevent nerve impingement
use position changes to assist in breathing, vascular flow, etc

Question 9

difference between short and long term positioning

Answer 9

long term = prevent injury/better breathing position

short = allow treatment

Question 10

rules for times pts are in certain position

Answer 10

change position every 2 hours (may need sooner if fragile, poor circulation, etc)

short term = reposition every 15 min

Question 11

general guidelines for pt positioning

Answer 11

explain to pt
maintain neutral spine
always give pt a way to call for help if needed

Question 12

areas of greatest pressure when laying supine

Answer 12

occipital tuberosity
SPs of vertebrae
inferior angle of scap
olecranon process
PSIS
sacrum
posterior calcaneus

Question 13

areas of greatest pressure when laying prone

Answer 13

forehead or lateral ear
tip of acromion
anterior humeral head
sternum
ASIS
patella
tibial crest
dorsum of foot

Question 14

areas of greatest pressure sidelying

Answer 14

lateral ear
lateral ribs
lateral acromion
lateral humeral head
medial/lateral epicondyles of humerus
greater trochanter
medial/lateral condyles of femur
medial/lateral malleolus

Question 15

areas of greatest pressure in sitting

Answer 15

ischial tuberosities
posterior thighs
sacrum
SPs of vertebrae
medial epicondyles and olecranons (if resting arm on hard surface)

Question 16

what is the skin blanching test

Answer 16

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

Question 17

what contractors occur most

Answer 17

flexion

Question 18

factors to take into account for long term positioning in sitting

Answer 18

reposition every 10-15 min
may require lumbar roll
hip at 90, knee at 90, and neutral ankle
avoid sacral sitting
support arms

Question 19

what is an ekg

Answer 19

electrocardiogram

records summed electrical activity of heart

Question 20

what do the p wave, QRS complex, and the t wave represent

Answer 20

p = atrial depolarization

QRS = ventricular depolarization

T wave = ventricle repolarization

Question 21

how does the electrical activity travel through the heart

Answer 21

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)

Question 22

how to look at rhythm on EKG

Answer 22

ventricular = look at R-R intervals

atrial = look at P-P intervals

are distances relatively equal

Question 23

what is regular irregular vs irregularly regular in reference to rhythm of EKG

Answer 23

regularly irregular = pattern to the irregularity

irregularly irregular = no pattern

Question 24

how do you determine rate on a EKG

Answer 24

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)

Question 25

what is A-fib

Answer 25

atrial fibrillation

continuous rapid firing of multiple atrial foci

no single impulse depolarizes. the atria completely

Question 26

common causes of Afib

Answer 26

MI
CABG surgery
valvular disease
CHF
HTN
chronic alchoholism

Question 27

what is premature ventricular contraction

Answer 27

PVC

early QRS complex
wide/bizzare QRS
No P wave
deflection of ST segment and T wave is opposite of the QRS
compensatory cause

Question 28

what is ventricular tachycardia

Answer 28

continuous run of PVC (150-250 bpm and each QRS is wide)

Question 29

common causes of ventricular tachycardia

Answer 29

acute MI or ischemia
electrolyte imbalance
medication toxicity
idiopathic
illicit drugs

Question 30

clinical signs/symptoms of ventricular tachycardia

Answer 30

hypotension (low BP)
syncope

Question 31

ventricular tachycardia can deteriorate into what

Answer 31

ventricular fibrillation (cardiac arrest)

Question 32

common profiles of lab screening

Answer 32

electrolyte
metabolic
kidney
liver
cardiac markers
lipid panel
complete blood count

Question 33

reference value for WBCs

Answer 33

5.0-10.0 x 10^9/L

Question 34

WBCs trending up indicates what

Answer 34

leukocytosis

> 11.0 x10^9/L

Question 35

causes WBC would trend up and clinical presentation and therapy implications

Answer 35

causes: infection, leukemia, obesity, inflammation, stress pain

presentation: weak fatigue, fever, dizzy

time therapy around early morning low level and late afternoon peak

Question 36

what does it mean if WBCs trend down

Answer 36

<4.0 x 10^9/L

leukopenia and neutropenia

Question 37

causes of WBCs trending down

Answer 37

causes: viral or bacterial infection/radiation