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TRI 4 - PCM 2 > Midterm exam > Flashcards

Midterm exam Flashcards

1
Q

Describe a fall

A

An event where a person comes to a rest inadvertently on the ground

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2
Q

Describe a restraint

A

Any method of physical, mechanical or drug that induces immobilization or reduces the ability of the patient to move

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3
Q

What are some indications for immobilization and how often is MD approval required

A

Patients who pose risk to self or others
Patients who require it in order to render treatment
Need MD approval every 24 hours

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4
Q

What are some restraint risks

A

Strangulation
Asphyxiation
Pneumonia

Pressure injuries
Urinary incontinence

Constipation
Deconditioning

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5
Q

What are some restraint alternatives

A

Diversions
Family members
Alarms

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6
Q

What are some restraint guidelines

A

Slip knots not square knots

Secure but not tight

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7
Q

What are some examples of hippa violations

A

Providing PHI unnecessarily
Accessing PHI unnecessarily
Not being compliant with medical record access

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8
Q

What is a code red

A

Fire

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9
Q

What is a code blue

A

Heart emergency

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10
Q

What is a code orange

A

hazardous materials spill

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11
Q

What is a code grey

A

Combative person

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12
Q

What is a code silver

A

Active shooter

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13
Q

What is a code amber

A

Child missing

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14
Q

What is a code external triage

A

External disaster

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15
Q

What is a code internal triage

A

internal emergency

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16
Q

What would be the diagnosis for a soft shell hemet

A

Craniectomy / surgeries of the skull

Wounds on the scalp at risk of infection

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17
Q

What would be the diagnosis for a soft collar

A

Whiplash

Cervical weakness

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18
Q

What are some rigid collars and what do they do

A

SOMI brace, Miami J

Limit flexion extension (Miami also limits extension)

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19
Q

Describe some max control cervical collars

A

Minerva - non invasive, cervical fractures, small subluxations

Halo - Invasive, fixed to skull with 4 screws, facet subluxations, dislocations

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20
Q

Describe a TLSO

A

Scoliotic brace

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21
Q

Describe some thoracic braces

A

Extension brace
Jewett - restrict flexion
Knight-taylor - rigid posterior frame
Molded - max trunk stability

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22
Q

Describe sacroiliac orthoses

A

Soft - helps LBP

Rigid - post op fusion, spondylolisthesis

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23
Q

Describe hip abduction orthoses

A

used for total hip revisions

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24
Q

What are posterior approach hip precautions

A

No:
internal rotation
adduction
Flexion past 90

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25
Describe knee immobilizers
Help knee extension with weight bearing
26
Describe short leg walking boots
For fractures of the foot and ankle
27
Describe PRAFO boots
used to relieve pressure injuries
28
Describe resting hand splints
Manages hypertonicity
29
What are some advantages of the electronic health record
Complete and accurate data that is readily available and easily shared
30
Describe physicians orders and who writes these
Log pf all instructions of the POC - meds, diagnostic tests, activity status, diet Written by: physician, PA, NP
31
Describe PT orders section
Order for PT Should be reviewed first If not clear it must be clarified
32
Describe the admission note history
Subjective info Data that identifies patient History of present illness Family history
33
Describe the admission note physical exam
General objective information Skin Extremities Abdomen
34
Describe the admission assessment
Statement of the condition and prognosis of the patient
35
Describe the admission plan
``` Further observations Tests Lab analysis Consultations Interventions Discharge planning ```
36
Describe the acute care index of function domains
4 domains - Mental status, bed mobility, transfers, mobility
37
Describe the acute care index of function scoring
< .3 = SNF .31-.7 = Acute rehab > .7 = home discharge
38
Describe the AM-PAC 6 clicks domains
Basic mobility Daily activity Applied cognitive
39
Describe the AM-PAC 6 clicks scoring interpretation
20.1 = home 17.9 = home with with home care 14 = SNF 13.6 = inpatient rehab 11.5 - long term acute care
40
What are PT goals in the ICU
Minimize immobility effects Help each patient become functionally independent begin discharge planning
41
Describe SBAR
Situation Background Assessment Recommendation
42
Describe discharge recommendations for home PT
Pt home with family Confined to home PT as appropriate
43
Describe discharge recommendations for SNF
Nursing needs on inpatient level | less than 3 hours PT per day
44
Describe discharge recommendations for inpatient rehab facility
At least 3 hours of PT a day Pt needs are complex Needs 2 disciplines
45
Describe discharge recommendations for long term acute care
Medically complex patients Expected to need long term care Emphasis on basic mobility
46
Describe discharge recommendations for outpatient PT
Patient may return home | PT at outpatient facility
47
When should you start mobilization in the ICU
Within 48 hours after admission | Based on medical readiness and clinical judgment
48
What are some barriers to mobilization
``` Inadequate staffing Complex patient cases Fear of lines Increased risk of falls Safety misconceptions ```
49
What is the one day costs in the ICU
$3000 - $10,000
50
What are some advantages to ICU mobilization
``` Shorter time on mechanical ventilation Shorter ICU stays Shorter hospital stays Less costs Prevent long term weakness and disability ```
51
What are some acute negative effects of the ICU stay
Atrophy ICU acquired weakness ICU psychosis Deconditioning
52
What are some long term negative affects of the ICU stay
Long term impairments in respiratory muscle strength Decreased physical functioning Depression and anxiety
53
What is the order to don PPE
``` Hand hygiene Gown Mask Eye Gloves ```
54
What is the order to doff PPE
``` Gloves Eye Gown Mask Hand hygiene ```
55
What conditions are indicated for contact isolation
MRSA, VISA, VRE Clostridium difficile (uncontrolled diarrhea) EVD Zika
56
What conditions are indicated for droplet isolation
Mumps Streptococcus A Neisseria meningitidis Flu
57
What conditions are indicated for Airborne isolation
Measles | Tuberculosis
58
What conditions are indicated for Airborne plus contact
Chickenpox Smallpox Disseminated herpes in the immunocompromised Shingles
59
What is unique about C diff isolation
Dedicated in room equipment
60
What are the considerations are regarded as green for risk of adverse event
``` Endotracheal tube Tracheostomy tube FI02 < .6 PEEP < 10 O2 sat > 90% Tachycardia with ventricular rate > 120 ```
61
What are the considerations are regarded as yellow for risk of adverse event
FIO2 > .6 PEEP > 10 cm H2O + delirium tool, able to follow simple commands
62
What are the considerations are regarded as red for risk of adverse event
O2 sat < 90% Bradycardia < 50 bpm with pharmacological treatment (vasoactive drugs required to maintain blood pressure)
63
Describe MAP considerations
``` Below range with symptoms - red Below range with support - red Above lower limit with no support- green Above lower limit with mod support - yellow Above low limit with high support - red ```
64
What are the norm values for WBC's and what is safe for exercise
Norm: 5-10 | 4.3 - 10.8 ok for exercise
65
What are the WBC levels for leukocytosis, leukopenia and neutropenia
``` Leukocytosis > 11 leukopenia < 4 Neutropenia < 1.5 = moderate < .5 = severe possibly follow neutropenia guidelines ```
66
What are the norm values for platelets and what is safe for exercise
Norm: 140-400 | > 200 ok for exercise
67
What are the platelet values for thrombocytosis and thrombocytopenia and indications
Thrombocytosis: > 450, can lead to venous thromboembolism Thrombocytopenia: < 150, severe if less than 20, fall risk
68
What are the norm values for hemoglobin and what is safe for exercise
Males: 14-17.4 Females: 12-16 > 7 ok for exercise
69
What are the low (anemia) and high (polycythemia) hemoglobin values and what are the indications
low critical = 5-7, can lead to heart failure or death | High critical = > 20 can clog capillaries
70
What are the normal lab values for hematocrit
Males: 42-52% Females: 37-47%
71
What are the critical low and high values for hematocrit and the indications
Low: <15-20%, cardiac failure or death High: >60%, spontaneous blood clotting
72
What are the norm values for glucose
Reference: 70-100 Fasting: 90-130
73
What are the low and high values for glucose and what are the indications
High: >200, decreased activity tolerance Low: <70, may not tolerate exercise until level is increased
74
What are the values for HbA1C and what do they indicate
``` <5.7 = norm 5.7-6.4 = prediabetes >6.5 = diabetes ```
75
Describe the various INR values and what treatment is indicated
>6 = bed rest >5 = no exercise 4-5 = light exercise < 4 = resistive exercise
76
What are the PH value ranges for blood
``` Norm = 7.35-7.45 Acidosis = < 7.35 Alkalosis = > 7.45 ```
77
What outcome measures are used for functional mobility on the acute floor
ACIF | 6 clicks
78
What outcome measures are used for functional mobility on the ICU floor
FSS-ICU | PFIT - S
79
What are some balance and fall risk outcome measures
POMA BBS TUG FIST

TRI 4 - PCM 2 (5 decks)

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