foundations midterm Flashcards
7 vital signs
pain
temp
pulse/HR
O2
BP
respiration rate
walking speed
should PTs take vitals?
yes, baseline to see if they are safe to work with.
pain scale
0 none
1-2 mild
3-4 mod
5-6 mod
7-8 severe
9-10 severe
temperature
normal- 96.8-99.3
average- 98.6
fever- over 100
pulse
adult normal- 60-100
child normal- 70-130
newborn normal 100-150
respiration rate
adult normal at rest- 12-18 breaths /min
infant normal- 30-50 breaths /min
O2
normal- 95-100%
blood pressure
normal <120 and <80
elevated 120-129 and <80
hypertension1 130-139 or 80-89
HTN 2 140+ or 90+
HTN 3 180+ and/or 120+
reservoir
patient zero
method of exit
wound, respiratory tract
method of transmission
how does it travel
method of entry
how it enters
susceptible host
new host
asepsis
absence of microorganisms that produce disease
nosocomial
originated in hospital
in what order do you don ppe?
bottom up
in what order do you doff?
alphabetical order
contact precautions
gloves and gown
droplet precautions
mask, gloves, gown
airborne precautions
N-96 mask, gloves, gown, negative airflow in private room
MRSA
contact, gloves, gown
VRE
contact, gloves, gown
C. diff
contact, gloves, gown
scabies
contact, gloves, gown
zika virus
contact, mask, gown, gloves
mumps
droplet, mask, gown, gloves
meningitis
droplet, mask, gown, gloves
strep
droplet, mask, gown, gloves
measles
airborne, negative airflow room, N95 mask, gloves, gown
TB
airborne, mask, gloves, gown
chickenpox
airborne, negative airflow room, N95 mask, gloves, gown
small pox
airborne, negative airflow room, N95 mask, gloves, gown
SARS
airborne, negative airflow room, N95 mask, gloves, gown
staph
contact
COVID-19
droplet
flu
droplet
HIPAA
health insurance portability and accountability act
what does HIPAA protect?
all individual identifiable health information
most common HIPPA violation
oral conversations in hallways or elevator
informed consent
right of pt to make decisions about their care.
need to know results, recommendations, benefits, costs, risks, alternatives
tell a story
about pt
beginning, middle, end
medical necessity to show care provided
medical necessity
needed to diagnose or treats
document rationale and purpose
skilled care
show that they need PT
tips for documenting
accuracy
brevity
clarity
pt centered
legibility
how to write dates
mm/dd/yy
what can a pta do?
subjective
objective, only if retesting
interventions within POC
future plan within POC
what can a pta not do?
initial evaluation
diagnosis
prognosis
POC
discharge
define transfer
safe movement from one surface to another
dependent or total assist
pt performs 0% of work
max assist
pt performs 25-49% of work
mod assist
pt performs 50-74% of work
min assist
pt performs 75% or more of work
contact guard assist
PT is making physical contact with pt
standby/supervision
verbal or tactile cues
instructions given to pt, but no physical contact
modified independent
independent, but uses adaptive equipment or needs more time
independent
without any verbal or manual assistance
organization of transfers
inform pt
demonstration
safety precautions
use of proper equipment/assistance
before transfer
proper footwear
shortest distance
prep yourself
prep anyone assisting you
review medical chart
interview pt
mentally prepare sequence
determining appropriate transfer
evaluation
medical information available
information from pt
goals
transfer equipment
transfer board
lift
electric hoist
bed rail
over bed or trapeze bar
during transfer
one step commands
encourage maximum participation
proper body mechanics
safe and efficient transfer
while performing transfer
lock wheels
be alert to devices that may interfere
gait belt
stabilize pt’s knees, pelvis, upper thorax
remain close and guard pt properly
proper body mechanics
concise statements while guiding
bed transfers
side to side
upward
downward
which side should you roll pt onto
roll onto strong side
how to document transfers
location to location
position to position
other types of transfers
stand pivot
squat pivot
sideboard
mechanical lift
special precautions for total hip
surgical side should not be adducted, rotated or flexed over 90 degrees
do not cross ankles or pull on surgical extremity
do not allow pt to lie on surgical extremity
maintain surgical extremity in abduction
pt should sit semi-reclined
low back trauma or discomfort
avoid excessive rotation
avoid trunk bending and flexion
may have less discomfort if logroll
may be more comfortable with hips and knees partially flexed with pillow under or between knees in supine or side-lying
spinal cord injury
avoid distracting and rotational forces
do not pull on lower extremities
logroll when turning
protective positioning
be aware of syncope
burns
avoid shear force over burn and graft site
elevate body to avoid shear forces
hemiplegia
avoid pulling involved extremities
many pts experience discomfort when lie on involved shoulder
COG
center of gravity
BOS
base of support
VGL
vertical gravity line
lumbar lordosis
natural curve at wasit line
valsalva maneuver
increase inter thoracic pressure
hold breath while bearing down
plumb line
ear
shoulder
hip (greater trochanter)
knee
ankle (lateral malleolus)
ideal sitting posture
arms parallel
top of screen at eye level
soles flat
rules of lifting
load close
maintain blance
shorten lever arm to decrease torque
no twisting
larger and stringer muscles
push, pull, roll, slide object
deep squat
wide BOS, low COG
hips below knees
power lift
1/2 squat
hips above knees
straight leg
knees slightly flexed
golfer’s
balance support with opposite UE
pushing and pulling
crouching or semi squat position
reaching and carrying
COG close to yours
positioning for prevention
soft-tissue injury
joint contracture
nerve injury
infection
pt comfort
precautions for positioning
avoid folds and wrinkles in fabric
observe skin color
protect bony prominences
extremities within support surface
lacking normal circulation or sensation
surgeries or injuries
3 reasons to drape
modesty
temperature control
protect skin or clothing
3 to always drape
chest
perineum
buttocks
bony prominences supine
occipital tuberosity
spine of scapula
inferior angle of scapula
vertebral spinous processes
sacrum
medial epicondyle of humerus
olecranon process
posterior calcaneus
greater trochanter
head of fibula
lateral malleolus
bony prominences prone
forehead
lateral ear
tip of acromion
sternum
anterior superior iliac spine
anterior head of humerus
clavicle
patella
ridge of tibia
dorsum of foot
bony prominences side-lying
lateral ear
lateral ribs
lateral acromion
lateral head of humerus
epicondyles of humerus
greater trochanter
lateral condyles of femur
malleolus of tibia and fibula
fifth metatarsal
bony prominences sitting
ischial tuberosities
scapular and vertebral spinous processes
sacrum
medial epicondyle of humerus
olecranon process
greater trochanter
popliteal fossa
posterior calcaneus
initial evaluation
history
systems review
tests and measures
diagnosis
prognosis
treatment plan
daily notes
date
what provided and billed
signature and designation
compare to last time
progress note
reassessment of status
plans for continuation or change
change goals if needed
discharge
summary
status of goal
objective measures
recommendation of continued care
8 minute rule
first unit must be over 8 minutes
every unit after adds 14 minutes
APTA top 10
limit abbreviations
date and sign
legibly
functional progress
at visit if possible
identify note type
all related communication
missed or canceled visits
skill and medical necessity
discharge planning throughout
disability
physical/mental impairment that limits major life activity
physical/mental impairment
1 or more body systems affected
reasonable accomodation
making modifications to enable disabled to easily perform job
undue burden
accommodation that causes employer/owner significant difficulty or expense
qualified individual with a disability
person who can perform essential functions with or without benefits of reasonable accommodations
covered entity
employer, employment agency, labor organization, state/local government
slope and rise ratio
1 inch up and 1 foot over
max rise
30 inches up
clearance width for hallway
36 inches
wheelchair clearance width
48 inches for ambulating person to pass
60 inches for two wheelchairs to pass each other
landing dimensions
5 feet in length by width of ramp
90 degree turn landing
5 feet by 5 feet
leaving the house considered 90 degree turn
180 degree turn landing
5 feet by twice ramp width
handr
on rise greater than 6 inches
34-38 inches in height
edge protection
minimum of 2 inch curb
door width
32 inches because can use door frame to pull through
windows
36 inches form ground
sliding or cranking opening
guide to practice first developed
1992
common mistakes when documenting the examination
fail to state affected body part
fail to state measurable information
fail to state type being measured
fail to measure unaffected side
incomplete data
importance of evaluation
reflection of judgement
summary of deficits
it is viewed by other providers
viewed by 3rd party payers
during assessment
how impairments relate to functional deficits
justify decisions
discuss progress
discuss inconsistencies
prognosis
predicts improvement and time needed
4 things to take into account in prognosis
severity
living environment
goals
prior level of function
when did PT start?
WW1
