Exam 1 Flashcards
(161 cards)
1
Q
What is per diem?
A
negotiated rate of pay for services
2
Q
explain the fee-for-service payment method
A
The system under which doctors and hospitals receive a payment for each service they provide. bill 100 dollars for a session; receive 80 dollars from insurer and 20 from patient.
3
Q
payment for episode of illness
A
categorized into a DRG (diagnostic related group). set dollar amounts and annual limits
4
Q
What is ICD-10 (International Classification of Diseases) used for?
A
used to classify and code all diagnoses, symptoms and procedures
5
Q
What is capitation?
A
The set amount of payment per ICD-10 code. incentive to be more efficient with care
6
Q
What is out of pocket pay?
A
A medical bill that is not covered by insurance and must be paid by the patient. also called private pay and co-pay.
7
Q
What is individual private insurance?
A
insurance for self employed folks
8
Q
What is employment-based private insurance?
A
insurance through employer. usually offer several options at different price points. for example, school based insurance at NU
9
Q
What is workers Compensation?
A
A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment. covers employees who are injured in job duties, paid for by employer.
10
Q
What is Medicare?
A
A federal program of health insurance for persons 65 years of age and older
11
Q
What is Medicaid?
A
A federal and state assistance program that pays for health care services for people who cannot afford them; typically low income folks, elderly with disability, kids younger than 6, and school aged kids 6-10.
12
Q
What are managed care plans?
A
An umbrella term for all healthcare plans that provide healthcare in return for preset monthly payments and coordinated care through a defined network of primary care physicians and hospitals.
13
Q
What is PPO (Preferred Provider Organization)?
A
A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network.
14
Q
What is HMO (Health Maintenance Organization)?
A
A managed care organization that provides comprehensive medical services for a predetermined annual fee per enrollee.
15
Q
What is Joint Commission (JC)?
A
An independent, not-for-profit organization that evaluates and accredits healthcare organizations.
- An overview and report card is required for facility. - Reviewed every 3 years.
16
Q
What is CORF (Comprehensive Outpatient Rehabilitation Facility)?
A
voluntary quality of care regulator. Similar to JC, but applied to outpatient facilities
17
Q
What is CARF (Commission on Accreditation of Rehabilitation Facilities)
A
voluntary quality of care regulator. Similar to JC, but applied to inpatient rehab centers
18
Q
What are the 4 factors of communication?
A
receiver
sender
message
environment
19
Q
active listening
A
seeking to understand, then seek to be understood. maintain eye contact, show interest, be respectful, demonstrate understanding, and ask for confirmation
20
Q
What is therapeutic communication?
A
Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship
21
Q
What is negative bias?
A
lots of assumptions with very little fact. very common in healthcare surrounding race, gender, ageism, etc. some behaviors include avoiding or minimizing interactions, mean nicknames, ignoring patients request, etc.
22
Q
What is cultural competence?
A
A set of congruent behaviors, attitudes, and policies that blend together to form effective interactions within a cross cultural framework.
23
Q
What is HIPAA?
A
Health Insurance Portability and Accountability Act of 1996.
- Protects patients information related to healthcare. written consent is required, where they consent to who you can disclose their information to
24
Q
Protected Health Information (PHI)
A
Any information about health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a patient’s medical record or payment history.
25
What are some direct identifiers?
individual's name, SSN, driver's license numbers
26
What are indirect identifiers?
information about an individual that can be matched with other available information to identify the individual
27
What are physical safeguards?
mechanisms required to protect electronic systems, equipment, and data from threats, environmental hazards, and unauthorized intrusion. computer terminals should not be placed in public areas
28
What are technical safeguards?
Automated processes used to protect data and control access to data. every associate must keep his/her password confidential. no photographs or recordings in any type are to be taken of patients in clinics.
29
What are administrative safeguards?
Policies and procedures to release patient information/ designed to protect electronic health information outlined by the HIPAA Security Rule.
30
List the cycle of transmission?
- source of infecting organism
- susceptible host
- method of transmission
- infection in new host
30
what is a nosocomial infection?
An infection acquired during hospitalization. also knows as HAIS (health care-associated infections).
- 10 percent of patients acquire one of these infections and there are 20,000 plus deaths annually. It occurs in 1 out of 24 patients and is the 4th leading cause of death.
31
3 ways of infection can transmit to others
contact, droplet, airborne
32
What is contact transmission?
can be direct or indirect through physical contact with either an infected host (direct) or contact with a person that an infected host has made contact with previously (indirect).
- gowns and gloves are necessary. examples include clostridium difficile (in feces) and herpes zoster (shingles - skin). MRSA is also an example of this
33
What is droplet transmission?
Involved contact of the conjunctivae or mucous membranes of the nose or mouth with large particle droplets. generated by coughing, sneezing, or suctioning. streptococcal pneumonias are an example. similar to airborne, but droplets involves larger droplets (phlegm)
34
What is airborne transmission?
occurs through contact with contaminated respiratory droplets spread by a cough or sneeze. droplet nuclei. requires a mask. measles, varicella, and tuberculosis are examples.
35
How do you prevent transmission?
hand washing, CDC guidelines, disinfecting, and checkong patients medical record or posted signs/doorways
36
Occupational Safety and Health Administration (OSHA)
agency of the US department of labor.
37
What is OSHA blood-borne pathogens standard?
Guidelines designed to protect employees against occupational exposure to blood-borne pathogens.
38
What is Needlestick Safety and Prevention Act
Revision to Bloodborne Pathogens standard that requires employers to minimize employees' exposure to blood through sharps injuries.
39
What are blood borne pathogens (BBPs)?
pathogenic microorganisms, including hepatitis B virus and human immunodeficiency virus, that if present in blood, can cause disease in humans
40
Explain PPE (personal protective equipment)
A barrier between a person and pathogens; includes gloves, gowns, masks, goggles, and face shields
41
What is Ergonomics?
The study of workplace equipment design or how to arrange and design devices, machines, or workspace so that people and things interact safely and most efficiently. prevents work related strains and sprains to back and shoulders from frequent lifting and reaching
42
T or F? Hand soap is more effective than alcohol-based hand rub
False, alcohol-based hand rub is better
43
5 elements of patient management
(EEDPI) Examination, Evaluation, Diagnosis, Prognosis, Intervention
44
What occurs during a patient examination?
Begins with a review of the patient's relevant and medical history and the taking of a subjective history. followed by a systems review or screen
45
Explain Heart Rate
Number of beats per minute. makes up 1/2 of the cardiac output equation (_____ X stroke volume = cardiac output).
45
What is a cardiopulmonary screen?
Assesses heart rate, blood pressure, respiratory rate, oxygen saturation, temperature, and edema. assessment of vital signs is critical for the examination of all our patients and is the best practice as recognized by the APTA
46
What are the vital signs?
heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation (SpO2), and temperature
47
What is a peripheral artery?
Where a heart rate is palpated. examples: radial artery, brachial artery, carotid artery, or femoral artery.
48
Tachycardic Heart Rate numbers
Greater than 100bpm
49
Bradycardic Heart Rate numbers
Less than 60bpm
50
What is tachypnea?
more than 20 breaths per minute
51
What is bradypnea?
less than 12 breaths per minute
52
What is apnea?
Absence of breathing
53
Systole
contraction phase of ventricle (pumping)
54
spygmomanometer
instrument for measuring blood pressure; also referred to as blood pressure cuff.
54
Diastole
relaxation phase of ventricle (filling)
55
Types of blood pressure cuffs include
mercury, aneroid, electronic (oscillometric).
56
Korotkoff sounds
series of sounds that correspond to changes in blood flow through an artery as pressure is released
57
Pre-hypertention numbers
120-139/80-89
58
Stage 1 hypertension numbers
140-159/90-99
59
Stage 2 hypertension numbers
>160/>100
60
What is Oxyhemoglobin saturation (SpO2)?
A measure of the percentage of hemoglobin in the blood that is bound to oxygen
61
What is Hemoglobin?
A protein in red blood cells that carries oxygen from the lungs to the rest of the body
62
What does "Hypoxic" mean?
deficient in oxygen. oftentimes the elderly and people with anemia are hypoxic.
63
What does afebrile mean?
Not feverish, normal temperature
64
hypothermia vs hyperthermia
hypothermia means below the normal temperature (cold)
Hyperthermia means above the normal temperature (hot)
65
What is the rate of perceived exertion (RPE)?
Subjective scale that describes how hard a person feels that they are working during an activity.
- scale between 6-20 (cooresponds with heartrate)
66
Why is it important to have proper body mechanics?
Conserves energy, reduces stress and strain on body structures, reduces risk of personal injury, promotes safe and efficient movements, promotes and maintains proper body control and balance, and promotes effective and efficient respiratory and cardiopulmonary function
67
What is the vertical line of gravity (VLG)?
An imaginary line that bisects the body in the sagittal plane beginning at the head and continuing through the center of gravity. it must fall between feet for balance and stability
68
What is a fulcrum?
The fixed point around which a lever pivots
69
What is the Valsalva maneuver?
When a patient holds their breath while performing physical activity which causes air to trap in the thorax, increasing intrathoracic pressure.
- It also decreases venous flood into the right side of the heart, decreases cardiac output, increases peripheral blood pressure, and can potentially cause a cerebral vessel rupture.
70
What part of the back is most vulnerable when lifting objects?
Lumbar spine
71
Lifting Precautions
Avoid simultaneous trunk flexion (bending) and rotation (twisting). use footstool to reach for objects above head, be aware of personal abilities and limits, and obtain human or mechanical assistance to move large objects
72
Where is a person's COG in standing?
2nd sacral segment in the center of the pelvis
73
single act of lifting a heavy object, lifting improperly, repetitive lifting, and cumulative episodes of microtrauma are all...
means of injury
74
Straight leg lift
persons knees are slightly bent or straight. lower extremities are either parallel to each other or straddling the object being picked up. arms parallel, and grab opposite sides of object. trunk is either vertical or horizontal and lumbar spine remains in lordosis. an example of this is picking up a chair.
75
Half-kneeling lift
kneel one knee, which should be positioned behind and on the side of the object. the other leg is on the ground, foot flat, with knee and hip flexed to 90 degrees. grasp object and lift with arms. then, the object should be placed on the thigh of the flexed leg. object is moved close to the body and the person can then rise to a standing position. maintain lordosis of the lumbar spine.
76
Golfer's lift
this lift is used to lift light objects. the person should face the object and shift their weight to their forward leg. partially flex the hip and knee on weight-bearing leg, and extend the non-weight bearing leg. lift object as if removing a gold ball from a cup. place other hand on an object like a table for more stability
77
when sitting at a desk, the top of the computer screen should be _____ above eyes.
15 degrees
78
Arms and legs should be at this angle when sitting at a desk
90-100 degrees
79
High risk areas when sitting include...
ischial tuberosities, scapular and vertebral spinous processes, olecranon processes, medial epicondyles of humerus, back of knees, heels and feet.
80
numbness, tingling, and localized edema indicate...
excessive/prolonged pressure
81
What is deep venous thrombosis (DVT)?
A blood clot that forms in a deep vein, usually in the legs but can also occur in the arms, pelvis, or abdomen
82
What is pulmonary embolism (PE)?
A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow.
83
Explain a Heart attack? what is another name for it?
When a blood cot occurs and cuts off the oxygen supply to the heart
Myocardial infraction
84
What is a stroke?
inadequate supply of blood/oxygen to the brain
85
What are some stroke symptoms?
calf pain, redness, swelling, dyspnea, tachypnea, sweating, chest pain
86
What is dyspnea?
difficulty breathing
87
What are some predisposing factors for DVT (blood clot lower leg)
immobility (bed rest, airplane), venous pooling (edema), dehydration, diabetes mellitus, medications, malnutrition, aging (decreased cardiac output)
88
How to prevent DVT (blood clot lower leg)
89
What is orthostatic hypotension?
A type of low blood pressure that occurs when a person stands up from a sitting or lying down position
90
Types of restraints
belts, straps, body garments, bed sheets, bed rails, drugs
91
Most stable assistive device
parallel bars
92
Least stable assistive device
cane
93
Where is popliteal?
Behind the knee
94
What is a plumb line?
A string with a weight used to provide a vertical reference line.
95
What is hallux valgus?
An abnormal enlargement of the joint at the base of the great toe (bunion)
96
What is code red?
Fire
97
What is code orange?
Hazardous material spill
98
What is code blue?
Heart or respiratory emergency
99
What is code grey?
Combative person
100
What is code silver?
Person with weapon or hostage situation
101
What is advanced directive?
instructions given by individuals specifying what actions should be taken for their health in the event that they are no longer able to make decisions due to illness or incapacity, and appoints a person to make such decisions on their behalf
102
What is health care proxy
Appoint an agent to make health care decisions if the primary individual is incapable of executing such decisions
103
What is living will?
provides specific directives about the course of treatment that is to be followed by health care providers and caregivers
104
What are the 5 wishes
Who i want to make care decisions for me when i cant, the kind of medical treatment i want or don't want, how comfortable i want to be, how i want people to treat me, what i want my loved ones to know
105
What is DNR?
Do Not Resuscitate. Does not want CPR or AED measures if in cardiac arrest
106
What is DNI?
Do Not Intubate
107
What is cardiac arrest?
lost of consciousness, loss of pulse, not breathing. initiate CPR if their AD assists you to do so.
108
What is a seizure?
loss of consciousness, muscle rigidity, vomiting. do not put anything in patients mouth and do not force them into any position.
109
What is hypoglycemia?
Low blood sugar
110
What is hyperglycemia?
High blood sugar
111
What are some structural impairments?
physiological problems that PT attempts to address. such as posture, pain, swelling, inflammation, ROM, flexibility, strength, etc.
112
What are some functional limitations?
problems with ADLs (activities in daily living). getting out of bed, brushing teeth, making lunch, running errands, doing chores.
113
Diagnosis
organize the patient data into clusters, categories, and syndromes. this patient presents consistent with...
114
Prognosis
predicted level of function the patient will attain in a certain time frame.
115
SOAP notes acronym
subjective, objective, assessment, plan
116
What is the subjective part of soap notes for?
what, where, when, and how of the injury. HPI, meds, complaints, allergies, pain scale
117
What is the objective part of soap notes for?
- physical findings, typically measurable and repeatable
- everything observed, palpated, or tested
118
What is the assessment part of soap notes for?
the PTs diagnosis based off the S and O portions within a clinical summary
119
What is the plan part of soap notes for?
- treatment for that day
- plan for further assessment or reassessment
- patient and family education + home instructions
- referral if necessary
- plans for discharge
120
Percentage of patients that comply with home exercise program (HEP
40%
121
What is a modality?
form of stress applied to the body for the purpose of eliciting an involuntary physiological response
122
What is a therapeutic Modality?
A device or application that delivers a physical agent to the body for therapeutic purposes
123
What is an acute injury?
strains, sprains, or fractures. too much force in too short of a time. also known as a macrotrauma.
124
What is a chronic injury?
stress fractures or continuing inflammatory conditions (microtrauma).
125
What is a primary injury?
tissue destruction directly resulting from the traumatic force
126
What is a secondary injury?
Cell death caused by a blockage of the oxygen supply to the injured area (ischemia) or caused by enzymatic damage and mitochondrial failure
127
What is an acute inflammatory response?
A quick response from the immune system to injury or illness (0-14 days)
128
What is a subacute inflammatory phase?
symptoms begin to decrease (14-31 days). Also known as the repair, healing stage.
129
What is the chronic inflammatory phase?
A reaction that persists for longer than one month
130
Signs of inflammation include
heat, redness, swelling, pain, and loss of functio
131
What is edema?
A buildup of excess fluid in interstitial spaces resulting from the imbalance between the pressures inside and outside of the cell membrane
132
What is a muscle spasm?
Involuntary contraction of a muscle
133
What is denervation atrophy?
shrinkage of paralyzed muscle when nerve remains disconnected
134
Components of intervention include
manual therapy, therapeutic exercise, patient education, and therapeutic modalities.
135
What is adjunct therapy?
additional to or supportive of a different primary treatment
136
What is sensory testing?
- Always performed before we apply any modality.
there are three types:
- light touch
- sharp/dull
- temperature
137
What is cryotherapy?
cold application with temps ranging from 32 to 65 degrees. when applied to an acute injury, it decreases the cells metabolism and decreases the need for oxygen so you won't create a secondary hypoxic injury.
138
What does the acronym RICE stand for?
Rest, Ice, Compression, Elevation
139
What does compression do for swelling?
equalizes pressure gradient, slows down hemorrhage
140
What are the effects of cryotherapy?
Decreases blood flow, Inflammation, and pain
141
Cryotherapy contraindications include...
rheumatoid conditions, raynauds disease, uticaria, cold intolerance, anesthetized skin, circulatory insufficiency, cardiac or respiratory involvement
142
What is reynaud's disease?
a vascular reaction to cold application or stress that results in a white, red, or blue discoloration of the extremities
143
Explain frostbite
freezing of the fluid in the extracellular area. below 32 degrees. 1st sign is the fading of redness relpaced with a waxy white sheen. can warmup body part by immersion into water at 100 degrees F then go to doctors
144
Benefits of thermotherapy
decreases pain, vasodilation, reduce muscle spasm, increase ROM
145
What is thermotherapy?
heat therapy between 104-113 degrees. anywhere higher will cause tissue damage
146
Heat indicators include
- Subacute or chronic inflammatory conditions
- reduction of subacute or chronic pain
- subacute or chronic muscle spasm
- decreased ROM
- tendonitis
- spasm
- joint contractures
- hematoma resolution
147
CRYOTHERAPY RESPONSES (KNOW THIS)
CBAN
- Cold
- Burning
- Aching
- Numbness
148
Heat contraindications
- acute injury
- peripheral vascular disease
- impaired circulation
- anesthetized areas
- sleeping/unconscious
- malignancy
149
Superficial heat agents include
hydrocollator packs, WWP, paraffin, laster (need 6 layers)
150
Deep heat agents include...
diathermy, ultrasound, laser
151
What is molting?
When heat makes the skin red and then white splotches are in the area, and then the white spots turn beat red
152
hydrocollator packs
silica filled packs (sand) stored in hot water of 160-170 degrees in between uses. reheat for 30-45 mins. put 6 layers in between patient and hot pack.
153
What is a paraffin bath?
the immersion of a body part in melted paraffin to increase circulation and flexibility as well as to decrease pain and muscle spasms. 118-126 degrees. 15-20 minutes. 7:1 ratio. has a low specific heat index and can provide 6 times the amount of heat as water. it feels cooler and is more tolerable than water at the same temp
154
warm whirlpool
Combines heated water and massaging action. 15-20 mins. 90-100 degrees. indications: decreased ROM, subacute or chronic inflammatory conditions
155
Systolic BP shouldn’t change more than _____ mmHg
20
156
Diastolic BP shouldn’t change more than ____ mmHg
10
157
What is over pronation called?
Pes planus
158
What is over supination called?
Pes cavus
