Exam 1 Flashcards
Importance of correct body mechanics
safety, energy conservation, anatomically efficient movement, physiologically efficient movement, injury prevention
Common causes of back problems
improper body mechanics, poor posture, microtrauma to back structures, poor flexibility and trauma
deep lift squat
full squat, hips below knees, head up, feet straddle the object and vertical trunk with lumbar lordosis and anterior pelvic tilt
Power lift
half squat where hips remain above the knees
feet are parallel to each other behind the object
trunk is more vertical with lumbar lordosis and anterior pelvic tilt
Straight Leg Lift
Knees extended or only slightly flexed
trunk is vertical OR horizontal
lumbar lordosis and anterior pelvic tilt
One leg stance lift (golfer’s lift)
used for light objects that can be lifted with one UE
LEs are positioned in a stride with weight shifted over the front LE
weight bearing LE is partially flexed at the knee while back LE is lifted into extension to counterbalance the flexion of the trunk
Half-Kneeling Lift/Tri-pod lift
kneel on one knee
object grasped by UEs
opposite lower extremity assists with raising the body as the person continues to stand
Traditional Lift
Lower extremities are in a full squat position, stride position on each side of the object, UE flexor muscles begin to lift followed by lower extremity extensors
normal lumbar lordosis is maintained
Stoop Lift
Used when an object can be reached without full squatting
hips and knees partially flexed
normal lumber lordosis
Face sheet/Pt information contains
patient’s name, diagnosis, home address and telephone #, next of kin/parent or guardian and their insurance info
Physicians Order section contains…
Medications, diagnostic tests, procedures, diet, consultations needed, activity level, resuscitation status
Physician’s Admission Note contains
History, Physical examination, physician assessment, and plan
Physician Daily/progress Notes contain
physical findings, assessment and plan
SOAP
Consult Service Notes contain
other physician services notes such as cardiology, neurology, infectious disease etc, or other healthcare professionals like PT, OT, SLP or social work
Our SOAP notes go here and eval reports go here
Should PT be performed right after dialysis
no, patients are completely exhausted
Pertinent information that will assist PT in hospital setting includes
weight bearing status, fall risk, droplets for PPE, level on incontinence and competence, current medications and wounds, can they drink water?
acute care definition
short term medical treatment, usually in a hospital setting for patients experiencing an acute illness or injury and/or recovering from surgery
standard COVID minimum that is used with ALL patients
hand hygiene, risk assessment of PPE, respiratory hygiene, cough etiquette
contact plus precautions
gown, gloves, hand washing with soap and water, advanced cleaning (caviwipes)
How many patient identifies should occur prior to any treatment initiation or direct care
2
ex. Patient name and date of birth
DO NOT USE ROOM NUMBERS.. they switch all the time
Air fluidized support bed
indicated for skin protection
pressurized air flow to suspend pt
attempt to firm bed prior to bed mobility and/or transfers-typically auto-firm
what is a KREG BED used for
verticalization therapy
the minutes and degrees can be recorded
how often should a patient change position
every 2 hours to prevent contractures, relieve pressure on the skin and aid circulatory systems
Fowlers Position
supine, hip/knee flexion, HOB elevated
Trendelenburgs Position
supine, head dependent position
Diagonally laying with head below legs
Sequential Compression Devices (SCD)
intermittent compression system with inflatable sleeves that aim to reduce edema
When wouldn’t you use SCDs
if a patient is suspected of deep vein thrombosis (DVT) or pulmonary embolism risk
Pressure Relief Ankle Foot Orthosis (PRAFO)
boot worn on the calf and foot to prevent skin breakdown
- heel suspension
- most commonly heel decubitus ulcers
- allows for neutral hip, knee and ankle alignment
Pulse Oximeter
a photoelectrical device that measures oxygen saturation of the blood (SpO2)
DON’T WANT IT BELOW 90%
Rapid Response Team
intervenes before a patient experiences respiratory or cardiac arrest.
Code Blue
hospital code used to indicate a Pt requires immediate resuscitation, typically cardiac arrest and usually CPR is in progress
IV
administration of fluids into a vein through the use of a steel needle or plastic catheter
Arterial monitoring line (A-line)
catheter inserted into an artery and attached to an electronic monitoring system to directly measure arterial blood pressure and can be used for blood draws
Peripheral Inserted Central Catheter (PICC)
long catheter introduced through a vein in arm, follows through subclavian vein into the SVC or RA to administer fluids, meds, blood draws or measure Central Venous Pressure
Central Venous Pressure
reflects the amount of blood returning to the heart and the ability of the heart to pump the blood into the arterial system AKA right atrial pressure
Mean Arterial Pressure (MAP)
determined by the cardiac output and systemic vascular resistance
Typically desired MAP
> 60
Swanz-Ganz Catheter (PA Line)
IV catheter usually inserted into basilic or subclavian vein and terminating in the pulmonary artery used for cardiac function monitoring (IN THE NECK)
- check to see if pt. is on bedrest
- check with RN to ensure line locked
- ipsilateral shoulder flexion limited to 90 degrees
Triple Lumen
central line located in jugular, subclavian or femoral veins with three external ports, assists with IV med administration, blood tests and CVP monitoring
Foley Catheter
INDWELLING.. inside the bladder, inserted through urethra into the bladder to remove urine with drains through plastic tubing into a collection bag
External Catheters
males have a condom catheter drainage bag
females have a wall suction with canister, no drainage back and can be removed for mobility
Nasogastric Tube (NG tube)
plastic tube inserted through a nostril that terminates in stomach and assists with removing fluid or gas, evaluating GI activity, administering meds and feeding of Pt.
Ventilators
use positive pressure to move or propel gas or air into the patients lungs
intubation (oropharyngeal or nasopharyngeal)
ensure with RN to ensure physical therapy is appropriate prior to the session
nasal cannula
delivery of low to moderate oxygen concentrations via nostrils
oronasal mask
mask with small vent holes to expel exhaled air covering the pt’s nose/mouth, moderate to high air concentrations, usually short term
tracheostomy mask
placed over the trach tube, usually high concentrations of air are administered
oxygen tanks and portable holders
often needed for mobility purposes, store tanks before and after use (fire hazard)
Chest tube/drain
remove air, blood, purulent matter or undesirable material from the pts chest or pleural cavity
ostomy
surgically produced opening in the abdomen to eliminate feces collected in a plastic bag
rectal catheter
inserted into the rectum sometimes as far as the prox. colon, used to help collect or draw out gas/feces
Dialysis
acute or end stage renal failure blood pumped out of the body, cleansed and returned to body from dialyzer machine DON'T TAKE BP ON THE UE due to fistula CVVH and AVVH close vital monitoring typical PT is bedside activity
WBAT=
weight bearing as tolerated
100% permitted and encouraged
PWB=
partial weight bearing
25-50% permitted
TDWB=
touch down weight bearing
up to 25% permitted
TTWB=
Toe Touch weight bearing
*promotes bad gait
NWB=
non weight bearing so no weight is permitted
Total Hip Arthroplasty Precautions (posterior lateral approach)
no hip flexion past 90
no hip adduction
no internal rotation
Total Hip Arthroplasty Precautions (anterior approach)
no excessive hip extension, no external rotation
minimal to no muscle cutting
surgeon protocols may vary
Spinal Precautions
avoid BLT (typically 6-8 weeks post surgery) no bending, lifting or twisting
teach the log roll
Coronary Artery Bypass Graft (CABG) precautions
no pushing
no pulling
no lifting more than 5-10 lbs
avoid shoulder flexion.abduction greater than 90 and scapular adduction
Ischemic Stroke (cerebral vascular accident)
loss of perfusion to area of the brain
could be from embolus (solid, liquid or gas block) or thrombus (atherosclerotic plaque occlusion)
hemorrhagic stroke
abnormal bleeding in the brain due to a rupture in blood supply
Transient ischemic attack (TIA)
atherosclerotic thrombus link, temporary occlusion that resolves quickly
Pt presentation post stroke
Unilateral UE or LE weakness on opposite side
Poor trunk control
Increased or Decreased tone
visual deficits/neglect
sensory and cognitive deficits (impulsive and agitated)
bandage recommended for foot and ankle
3-4”
bandage recommended for hand or wrist
1-2”
bandage recommended for elbow
2,3,4”
bandage recommended for knee
3-4”
bandage recommended for thigh
6”
bandage recommended for upper arm
3-4”
how much should a bandage cover
one inch above and below the wound dressing
____ material is not used for dressing or bandaging
polyester
function of dressing
prevent wound contamination, prevent infections to other sites, prevent further injury, absorb drainage, apply pressure to avoid hemorrhage, assist wound healing
Bandaging functions
keep dressing in place, maintain a barrier between dressing and the environment, provide external pressure to control swelling, provide support or stability, hold splints or other objects in place, assist the dressing in accomplishing its functions
common location of pressure sores
malleoli, heel, elbow epicondyles, ischial tuberosities, sacrum
minimum assistance
requires touching, contact guard, or guided assistance. Pt performs 75-99% of the work
Moderate Assistance
one caregiver
patient performs 50-74% of the work
one caregiver
Maximum Assistance
patient performs 25-49% of the work
one caregiver
Total Assistance
Patient performs less than 25% of the task.
One or more caregivers
if more than one person is required the patient automatically moves to total assist level in FIM scoring (1)
FIM 7
complete independence
FIM 1
total assistance
CARE partial/mod assistance
less than half
CARE substantial/max assistance
more than half
NEVERS in mobility
do not use the patient’s clothing
never pull on the pt’s neck or extremities when moving the patient
never allow the pt to pull on your neck
contraindications to ROM exercise
movement disrupts to healing such as after an acute injury with an unhealed or unprotected fracture, unprotected recent surgical site or if the patients symptoms intensify with exercise
