Intro and Exam of Acute Care (pt 1)- Class 4

Question 1

as a PT in the acute care setting we must

Answer 1

consider the pathology of the dz

impact of the meds

Question 2

impact of the meds

Answer 2

while utilizing the benefits but not impeding the physiologic monitoring and pt support equipment

Question 3

pt support equipment

Answer 3

tubes and lines

Question 4

it will be common for a PT to make clinical judgement calls that

Answer 4

impact d/c planning

after only 1 pt interaction

Question 5

exam

Answer 5

history

systems review

tests and measures

d/c planning process

Question 6

history

Answer 6

systemic gathering of data

from past and present

related to why the pt is seeking the services of PT

Question 7

when do pts in the hospital request therapy services

Answer 7

rarely

but other HCPs or institutional guidelines recommend it

Question 8

why do other HCPs or institutional guidelines recommend it

Answer 8

therapy services are beneficial in the ongoing care of the pt

Question 9

the data from the pts history allows

Answer 9

the clinician to hypothesize about

impairments and fxnal limitations

that are commonly related to a medical condition

Question 10

common data generated from a pt history

Answer 10

general demographics

social history

living environment

Question 11

what is the pts current living situation

Answer 11

the hospital

this can be overwhelming to the pt, family and caregivers and also the PT

Question 12

what must we familiarize ourselves with

Answer 12

monitors

equipment

supplies

alarms

Question 13

what could not understanding this equipment do

Answer 13

undermine the therapist-pt relationship

Question 14

the PT must understand what about d/c

Answer 14

the options for the pt

where will the pt be going and what does that environment look like?

Question 15

what about the d/c environment must we consider

Answer 15

stairs

bathrooms

potential space and access requirements for home hospital equipment

general health status

social health status

family history

medical/surgical history

current condition/chief complaint

Question 16

family history

Answer 16

health status of the caregiver

early recognition of any issues assists in appropriate d/c management

Question 17

what else must we consider –> history

Answer 17

is is safe for the pt to participate in PT

what is the story

are there current therapeutic interventions being provided by other HCPs?

Question 18

WB, activity or positional restrictions –> history

Answer 18

fxnal status

medications

other clinical tests

Question 19

fxnal status

Answer 19

determining the pt’s prior level of fxning may change your expectations for the episode of care

Question 20

meds –> PT must consider

Answer 20

impact of meds on the pt’s hemodynamic profiles

–> at rest and with activity

potential connection b/w meds side effects, mental status and NM complaints

Question 21

other clinical tests can be found

Answer 21

pt’s chart

usually contains extensive amounts of data

Question 22

what does the data on the medical chart provide

Answer 22

info that may help in determining the pt presentation and clinical responses observed during the exam or interventions

Question 23

lab values can guide

Answer 23

interventions appropriateness

intensity

duration

look for on daily basis

Question 24

systems review

Answer 24

brief examination of the other systems

Question 25

other systems include

Answer 25

CV/pulmonary integ MS NM communication, affect, cognition, language and learning style

Question 26

CV/pulmonary should include

Answer 26

BP, HR and RR b/c vital signs give us a lot of info

Question 27

the hospitalized pt will likely be monitored

Answer 27

extensively vital signs will be available to the therapist from nursing documentation and telemetry monitors

Question 28

resources for vital signs are not

Answer 28

a substitute for not doing them ourselves

Question 29

we should always...--> vital signs

Answer 29

check what their values are on your own before and after

Question 30

fragile skin can be caused by

Answer 30

bed rest poor nutrition some meds (corticosteroids)

Question 31

how can integ lesions be avoided

Answer 31

frequent position and postural changes esp out of bed activities

Question 32

what must we consider as PTs --> integ

Answer 32

pts fxnal status body type pathologies

Question 33

what are we using these considerations for --> integ

Answer 33

to make suggestions for beds, chairs, mattresses, cushions or assistive devices

Question 34

what do we asses with MS

Answer 34

gross muscle tole ROM fxnal strength

Question 35

what are common --> MS

Answer 35

contractures esp in bed bound mechanically ventilated or critically ill pt

Question 36

what must we consider --> MS

Answer 36

extremities and head and neck

Question 37

when on mechanical ventilation, how may the pt be positioned --> MS

Answer 37

facing the vent may develop limitations in cervical ROM

Question 38

NM

Answer 38

important area for the acute care pt

Question 39

when might initial signs of NM dyfxn become apparent

Answer 39

when pt attempts to move

Question 40

PTs are often --> NM

Answer 40

first to mobilize a pt may be first to observe these signs

Question 41

what should we asses --> NM

Answer 41

movement patterns sensation proprioception

Question 42

what should we asses for --> communication etc. etc.

Answer 42

consciousness and arousal

Question 43

what can arousal and alertness be impaired d/t

Answer 43

sedatives anxiolytics narcotics other meds

Question 44

what can alter or influence communication

Answer 44

artificial airways

Question 45

tests and measures

Answer 45

different deck!

Question 46

d/c planning process --> goal in acute care setting is to

Answer 46

transition the pt to the next level of care while minimizing fxnal limitations and disabilities

Question 47

what must therapists do --> d/c planning

Answer 47

appropriate d/c recommendations

Question 48

appropriate d/c recommendations

Answer 48

decisions on assistive devices appropriate levels of continued inpatient rehab whether or not pt is safe to go home

Question 49

who will our recommendations be sought by

Answer 49

pt family medical, surgical, nursing, social work and case management teams

Question 50

what are typical questions a PT must answer about d/c

Answer 50

when is the pt safe to go home is inpatient rehab required how much therapy can the pt tolerate per day if the pt is going home, what adaptive equipment must be ordered is home PT necessary or are outpatient services appropriate