class 4: non systems 1 Flashcards
can a PTA modify the plan of care
no
who can do this - add a hamstring exercise to a program that say LE strengthening
PT and PTA
who can supervise a PTA student
PT and PTA
who can supervise a PT student
PT
what does CMS to
determines how much will be reimbursed by medicare for pt care
what does CARF do
accredits free standing rehab programs and facilties
what does the joint commision do
accredits hospitals, SNF, home health agencies, PPO, HMO, and mental health intuitions
what is the role of OSHA
determining the safety of the work enviroment
what is used for droplet precautions - PPE
mask when working within 3 feet from the pt
what is used for airborne precautions - PPE
N-95 mask
gown and gloves for severe contamination
what kind of precautions do you use for PNA
droplet precautions
what is the PPE for contact
gown and gloves
contact hand hygiene
wash before entering or leaving room
contact - can they leave their room
yes but try to min
droplet example
mumps
PNA
flu
mengitis
hand - airborne
wash before and after
droplet - hand
wash before and after
how far shoulder a pt monitor be
18-20 inches
degree wise where should the pt’s monitor be
10-deg below eye level
C1-C2 breathing muscles
SCM
upper traps
cervical extensors
C3 - C4 breathing muscles
partial diaphragam
scalenes
levator scapulea
C5-C8 breathing muscles
diaphragram, pec major and minor , serratus anterior, rhomids
, lats
how long should a pregnant women stay in a supine position
a pregnant women should not exceed 5 mins of supine positioning any time after the first trimester
this is to avoid vena cava conpression of the uterus
what is hematocrit
a blood test that measures the percentage of red blood cells in a person’s blood
how many chest compression should be performed per min
100-120/min
what is the depth to which chest compression should be performing
2 inch/ 5 cm
what is the normal amount of anteversion in adults
8-15 degrees
how manny brunnston stages are there
6
7 - technically beacsue this just mean every thing is back to normal
6 - no more spacity
when do we give breaths in CPR
after 30 compressions
each breath lasting over 1 secs allowing the chest to rise
what is a hickman catheter
cephalic or internal jugular vien
long term drug admin: this is used for providing antibiotics, nutritional solutions, and blood samples
what is a swan ganz catheter
balloon flotation device that is inserted through the internal jugular vein into the pulmonary artery
monitors pulmonary arterial pressure and heart function
what is a central venous catheter
indwelling venous catheter with a manometer
measures blood pressure directly from right atrium and superior vena cava
right ventricle function
circulating blood volume
what is the arterial line used for
inserted into art and attached to onto a monitoring system
used to monitor arterial blood gases and BP
what is the order for doffing PPE
gloves
goggles
gown
mask
(ABC order)
what is the purpose of the the pulmonary artery
carries deoxy blood to the lungs from the right ventricle
what is the function of Chest drainage tubes
may be used to remove air,
blood, purulent matter from the patient’s chest or pleural cavity
where are chest drainage tubes inserted
inserted through an incision
in the chest and may be connected to a mechanical or gravity-based suction system
what do you do if Chest tubes is disloged
If dislodged, have the patient exhale, place gauze
or a gloved hand over the area and call nursing staff
Catheters precautions
hang below level of bladder, do not empty bag if output is being monitored, empty or alert staff if overfilled
IV lines things sot know
arm should not be held above head for extended
periods, alert staff if fluid is low due to air bubbles
Arterial line if disloged
if dislodged, apply firm pressure and alert nursing immediately
Femoral line thing to avoid
avoid repetitive hip flexion and hip flexion >45 degrees
wheel chair measurements - seat height
how - Heel to popliteal fold + 2 inches
average - 19.5 to 20.5
inches
what is pleural effusion
where fluid build up in the pleural space
wheel chair measurements - seat depth
how - Posterior buttock along lateral thigh to popliteal fold - 2 inches
average - 16 inches
wheel chair measurements - seta width
how - Widest aspect of buttocks or thighs + 1.5 to 2 inches
average - 18 inches
wheel chair measurements - back height
how - Chair seat to axilla - 4 inches (consider any seat cushions and add thickness to final value)
average - 16 inches
wheel chair measurements - armrest height
how - Seat of chair to olecranon + 1 inch (consider cushions)
average - 9 inches
how do we turn right on a wheel chair
Push the left wheel forward while pulling back on the right wheel
how do we perform a Wheelie on a WC
Patient places hands back on
hand rims, then push them forward
abruptly and forcefully
Ascending curb WC
Lift the front casters onto the curb by
performing a small wheelie
Push forward on the push rims to lift the rear wheels onto the curb
Descending curb WC
Perform a wheelie and descend with rear wheels off the curb followed by castor wheels
OR
Descend backwards: Allow the rear wheels to slowly roll off the curb, followed by the castor wheels
Standard Crutches (Axillary Crutches) - sizing
- Axilla space of approx. 2”
- Crutch is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
- Elbow flexion approx. 20-25 degrees when grasping handpiece
Forearm Crutches (Lofstrand Crutches) - sizing
- Top of forearm cuff is just distal to elbow, approx. 1-1.5” below olecranon process
- Crutch is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
- Elbow flexion approx. 20-25 degrees
Cane - sizing
- Always goes on the opposite side
- Cane is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
- Elbow flexion approx. 20-25 degrees
- Ascending = Good foot goes up first, followed by bad foot and cane
- Descending = Bad foot and cane first, followed by good foot
- Longitudinal Arch (Scaphoid pad) used for what
Pes Planus
UCBL (University of California Berkeley Lab) does what
̶Controls hindfoot valgus
̶Reduces subtalar motion.
Three-point counterforces – control
calcaneal eversion, forefoot abduction
abd obestity WC
move rear axel anteriorly 2 inches
obesity in the waist and hips WC
move rear axel 2 inches posteriorly
bilateral amp WC
move rear axel post 2 inches
what is addison’s disease
a rare disorder that occurs when the adrenal glands don’t produce enough of certain hormones.
what are the signs and sym of addison’s disease
fatigue
hyperpigmentation
N/V
muscle pain
low BP
low blood sugar
what is Posterior leaf spring used for
weak DF
Posterior leaf spring - function
It recoils during swing phase to
produce dorsiflexion
Plantarflexion stop/ resistance AFO is used for
PF tightness
Plastic hinged AFO with a posterior stop
posterior approach hip replacement - what movement do we avoid
FADIR
anterior approach hip replacement - what movement do we avoid
FABER
what is Pes Equinus
Pes Equinus is a condition in which the upward bending motion of the ankle joint (dorsiflexion) is limited
Child CPR - ventilation to compression ratio
30:2 one recuser
15:2 two recusers
adult CPR - how many breaths per 6 secs
1 bretah
Child CPR - bpm for compression
100-120
Child CPR - how many breaths per 2-3 sec
1 bretah
Child CPR - compresssion depth
2 inch in child
1.5 inch in infant
Child CPR - compression hands
1 hand in small child
2 finger in infant center of chest
adult CPR - location of compression
2 hands on lower sernum
CPR - chets compression interuptions
min chest compression interupption to < 10 secs
what do we do when we have an AED and have child or infant with an unwitnessed collapse
give CPR from 2 min
then get AED
2 recuser - get the AEED while the other gives compressions
Child CPR - chest compression location
1/3 AP chest diameter
ergonomics - when sitting what should knee flexion be
90-deg
ergonomics - when sitting what angle should the elb be on armrests
90-deg
ergonomics - how far should the computer mointor bee from the patients face
20 inches
ergonomics - where should the top of the computer monitor be
just below eye level
10-deg below horizontal
ergonomics - where should wrist rest be placed
front edge of teh key board
ergonomics - mouse characteristics
contours to the hand
ergonomics - space underneath the desk
30 inches wide
19 inches deep
27 inch is height
2-3 inched between the top of the thigh and the desk
ergonomics - ankle angle
90
