Englewood Values Flashcards
INR
Greater than 4.0
What type of blood transfusion to watch out for…
Non autologous
Tests a person might have to undergo to be cleared from the suspended list
EKG, cardiac enzymes, vascular studies, or X-Ray to rule out a fracture
If the results are negative PT can continue.
If the results are positive new orders with clearance is required.
Pulse oximetry
Less than 90 with or without O2 that is not resolved by deep breathing.
When a CT scan comes back as positive for a bleed for someone with suspected CVA
Therapy has to be held until there is another scan confirming that the bleed is stable.
Vitals for clearance after CVA or TIA
If either is suspected or has actually occurred
Systolic greater than 200
Diastolic greater than 100
What to look for with CVA or TIA aside from blood pressure
Are they neurologically stable or unstable
What type of heart event and what is the time frame
Ventricular tachycardia in last 8 hours
Positive for DVT
If they test positive for DVT in any vessel theroay will be held until the patient is cleared to resume functional activities by the MD, NP, PA
What type of minor surgical procedures might call for a hold on PT
PEG or PICC line placement or removal. Pacemaker placement. Colonoscopy. Endoscopy. AV shunt placement.
Dependent or weaned from….
Ventilation
What to do what a patient is given tpa
Patient has had a CT scan. Negative for bleed and received tpa may not receive therapy for a minimum of 24 hours and a second CT confirms the patient is negative for hemorrhagic conversion.
Potassium levels!
Less than 3.3 or greater than 5.5
For patients in chronic renal failure or receiving hemodialysis the potassium range is 3.3 to 6.0
Vitals for PT after orthopedic surgery
Systolic less than 80
Diastolic less than 50
And who are symptomatic
Atrial Pressure…
Less than 60
Platelet count contraindication.
If it is below 20,000 the patients physician will be contacted for clearance prior to therapy
A patient’s PT/OT may be modified and based on patient reaction held for a limited period of time doe any of the following
4 reasons
Resting heart rate of greater than 120 bpm
Resting respiratory rate of greater than 45 bpm
Resting systolic blood pressure of less than 90 or
180
Resting diastolic blood pressure less 50 or greater than 100.
Pacemaker leads pulled. Time from to start up therapy.
One hour
Femoral lines
If a patient has a femoral line the physician who places the line must clear the patient to participate in therapy and OOB activity.
The seven reasons why a patient will be discharged until new orders are written
- CAC
- Respiratory Arrest
- Major surgical procedure
- Patient transfers from one level of care to a more intensive level of care
- Patient refuses to participate in program, or refuses 3 consecutive visits
- MI
- Patient has a VAC dressing change in the operating room.
Steps to take when a diagnosis of CVA is suspected
They will be seen after the initial CT scan if that scan is negative for a bleed. If a MRI was also ordered therapy can continue as long as the CT was negative.
Hemoglobin
Less than 6.9
Blood glucose value that is high enough to seek action.
If it is over 300 the therapist will speak with the nurse and as necessary obtain a recent glucose level. If it is still more than 300 the therapy will be delayed until the level is under 300
