Intro and Exam of Acute Care (pt 2)- Class 4 Flashcards
what are chosen tests and measures determined by
info gathered during the history and systems review
common tests and measures (1)
aerobic capacity and endurance
anthropometric characteristics
arousal. attention and cognition
assistive and adaptive devices
circulation
CN and peripheral nerve integrity
environmental, home and work barriers
common tests and measure (2)
gait, locomotion and balance
integ integrity
motor fxn
muscle performance
orthotic, protective and supportive devices and prosthetic requirements
pain
aerobic capacity and endurance may be examined through
assessment of vital sign responses in
bed mobility
trasnfers
ambulation
toileting
bathing
structured tests of aerobic capacity and endurance
6 minute walk test
6 minute walk test
we keep tack of distance (in steps)
good for prediction of pt outcomes
what is it difficult to do for the 6 minute walk test
find space for it
count steps
when should we record vital signs
prior to therapy
determine the physiologic responses as the therapy session proceeds
anthropometric characteristics
measurements of body dimensions
albumin is a
blood plasma protein
what does anthropometric characteristics include
results of lab testing
including serum albumin
prealbumin
serum album and prealbumin are measurements of
nutritional status
what are prealbumin and serum albumin decreased w/
acute/chronic infections and inflammation
cirrhosis/liver dz
nephrotic syndrome
Chrohns
burns
malnutrition
thyroid dz
liver dz –> dz/dyfxn may result in changes in
mental status
behavior
MS pain
those w/ liver dz are at an increased risk of
infection
what occurs w/ liver dz
fluid shifts and changes in vascular status
change in blood ammonia and urea levels
fluid shifts and changes in vascular status
heart will try and compensate –> must monitor vital signs
change in blood ammonia and urea levels
impair peripheral nerve fxn –> causing numbness and tingling
edema can be d/t –> anthropometric characteristics
CHF
nutritional deficits
liver +/or renal dysfxn
fluid overload
inactivity
what is edema most likely going to be from
inactivity
how should edema be assesed
girth or volumetric measurements
obesity is associated w/ –>anthropometric characteristics
DM
coronary heart dz
hypothyroidism
other metabolic dz processes
on its own, obesity can
limit pts mobility
leading to abnormalities in the integ and CV systems
Cachexia can occur with
long standing dz
impaired nutrition status
associated w/ poor outcomes
nutritional dysfxn can lead to
muscle wasting
reduced respiratory and peripheral muscle strength and endurance
increased rate of infection
increased mortality
reduced pulmonary fxn
arousal, attention and cognition information
can impact interventions chosen
if pt is unable to safely perform ADLS or iADLs –>arousal, attention and cognition
d/c plan may be influenced
cognition
act of process of knowing
what does cognition include
awareness
memory
judgement
how is cognition assessed
mental status exam
arousal
a state of responsiveness to stimulation or action of physiologic readiness for activity
how can we assess orientation
asking the pt their name, current location, month/day/year and reason for admission
how can we challenge short term memory
asking pt to repeat our name
mental status fxn may
fluctuate throughout hospitalization
why might mental status fluctuate
meds
sleep deprivation
depression
etc.
we must asses –> assistive adaptive devices
pt’s safety
we must determine –> assistive adaptive devices
if the use of the device “enables” or “disables” task completion
circulation
HR, BP
palpation
description of edema and pulses
CN and peripheral nerve integrity
abnormalities identified in the systems review will lead to specific testing
environmental, home and work barriers
refers to the physical impediments that keep pts from fxning optimally in their surroundings
when is environmental, home and work barriers gathered
history
once environmental, home and work barriers are determined, the PT will provide
pt/family education on modification to the d/c environment that will enhance pt safety and mobility
gait assessment includes
observational gait analysis as well as specific tests
gait tests
timed get up and go
6 min walk test
timed get up and go = TGUG –> normal
less than 10 s
timed get up and go = TGUG –> moderate risk
in b/w 10-30 s
at risk of falling
may need to use other tests
timed get up and go = TGUG –> high risk of falling
over 30 s
balance tests
ber balance
rhomberg
fxnal reach
fxnal reach
6 inches of more is normal/safe
berg balance
<45 is a risk for falling
tinetti test
2 parts
balance and gait test
tinetti –> low risk of falls
score of 25-28
tinetti –> medium risk of falls
score of 19-24
tinetti –> high risk for falls
score of less than 19
gait and balance test results will give the PT
objective info
regarding fall risk and for prescription of assistive devices
critical for d/c plan
integ integrity
exam of sensation
incisions
bony prominences
pressure points
indwelling lines
motor fxn includes
tests of dexterity and coordination
rapid alternating movements
accuracy of movements
fxnal tests may include
buttoning a shirt
tying shoes
muscle performance
MMT
what should muscle performance include
fxnal tests
seated transfers, stair climbing, self-care activities, physical performance tests, time activity tests
orthotic, protective and supportive devices and prosthetic requirements
equipment used to support or protect weak or ineffective joints or muscles and serve to enhance performance
orthotic devices include
braces
casts
shoe inserts
splints
protective devices
braces
cushions
helmets
supportive devices
compression garments
abdominal binders
neck collars
serial casts
slings
prosthetic requirements
biomechanical elements necessitated by the loss of a body part
prosthesis
artificial device used to replace a missing part of the body
when is a prosthesis usually prescribed
in the future
after hospital stay
what might we need to evaluate
previously prescribed prosthetic
