Lecture 20 - Mobility and Discharge Flashcards
What are some methods of mobilization
Describe the de Morton Mobility Index
What are 5 categories of benefits of mobilization
What are 3 types of respiratory benefits from mobilization
What are 3 types of cardiovascular benefits from mobilization
What are 5 types of musculoskeletal benefits from mobilization
What are 4 types of neurological benefits from mobilization
What are 4 types of psychosocial benefits from mobilization
What are 3 key points about mobilizations
What are 5 key considerations before mobilization of a patient
What does a chart review consist of (mobilization)
What are 3 types of current status reported (mobilization)
What are 2 key principles of cardiovascular reserve (mobilization)
What are 3 key factors for respiratory reserve (mobilization)
What are 5 other factors to consider (mobilization)
What are 3 MSK considerations (Mobilization)
To figure out mobilization parameters, should a screening and assessment be done? If so, what assessment is done, and what does it determine?
What are the mobilization parameters
What are some important treatment considerations
When communicating with a patient during mobilization what 2 things need to be done
What are some important treatment responses to mobilization (5)
What are inappropriate treatment responses to mobilization (8)
What are 4 special considerations when dealing with patients for mobilizations
What are 3 risk factors of mobilization
What are the signs/symptoms of DVT
What are 3 tests to determine if an individual has DVT
What are the main treatments for DVT
What are 4 considerations for mobilization of an individual with DVT
What are 3 important considerations for patients with bariatric care needs in terms of mobilizations
What are 4 important considerations for patients who are confused/disoriented in terms of mobilizations
What are 5 important considerations for patients who have language barriers in terms of mobilizations
What are 3 important considerations for discharge planning
What are some discharge/transfer destinations
What are some criterion examples in order to be discharged to home
What are some considerations for discharge
What are some examples of Pt’s role in discharge
- Yes, may be concerned with higher systolic but will monitor should be fine. RPE (rate of perceived exertion), vital were all good, pain meds are optimal in this time frame
- 4+1, reserve capacity (HR and rhythm, BP, SPO2, PaO2/FiO2, resp rate), ROM, IPPA, NPRS
- Bed edge sitting, sit to stand, walk (not too much because patient doesn’t want to push) -> could see how he is feeling after medication kicks in
- 2-wheel walker (less exertion and he seems stable) because more stable POD#1 but could use crutches to help with his home environment (may not even need a gait aid by the time he leaves home)
- F: 3 times a day I: Test to see how fatigable he is and base off that (RPE, HR) T: Depends on distance (could use rest breaks too to take breaks in laps) T: Depends on mobilization we deem appropriate for the patient
-Could be when he goes to the bathroom or any activity that nursing does
-PTA could take them for a couple of walks also - Ability to do stairs, ability to stand independently for showering or have a stool, his ability to use his right foot without pain or to be able to walk to commute via transit, social support (home assessment -> helps plan what equipment we need)
- Showering safely, stairs, driving
- May need a bar for the shower, may need to ensure railing, may need to either modify vehicle (expensive), strengthen leg, or start taking transit/carpool system, social support system
- Railing for bathroom and stairs
Outpatient clinic or homecare physio (requires specific criteria)
- Get consent from both the son and mother if the son is the primary caregiver. Explain the procedures thoroughly when the best time of day is. IF she is still competent you need to get consent from Rosa, if not then you will have to talk to a substitute decision maker.
- Explain to Rosa the importance of her weight bearing restrictions in terms of her surgery. Maybe get nursing and PTA to check in more frequently to remind her of her weight bearing restrictions. Need to educate loss and see why she isnt following orders or if she doesn’t understand. Talk to them about you just want to help and want her to get better. Could also use family as supportive members. Can use signs as visual reminders. Maybe change gait aid to standard walker (no crutches). She may have to get surgery again and will be at higher risk of falling and reinjure. Surgical revision (potential subluxation)
- Could be unpredictable she may or may not want you around. Want to work around her mood and may have to revisit the situation at a later time or talk about something else to get her in a better mood
- Long-term care or home depending on patient needs (could use in-home nurse but very expensive) -> convalescent care option (temporary nursing home option)
- Sit both of them down with a social worker and weigh out the options that best fit them and their needs. We want safety and whats best for the patient and also the family. Explain to the son her state and the amount of attention she would need from her home environment. Offer different facilities.
