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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
Q

Describe knee immobilizers

A

Help knee extension with weight bearing

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26
Q

Describe short leg walking boots

A

For fractures of the foot and ankle

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27
Q

Describe PRAFO boots

A

used to relieve pressure injuries

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28
Q

Describe resting hand splints

A

Manages hypertonicity

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29
Q

What are some advantages of the electronic health record

A

Complete and accurate data that is readily available and easily shared

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30
Q

Describe physicians orders and who writes these

A

Log pf all instructions of the POC
- meds, diagnostic tests, activity status, diet
Written by: physician, PA, NP

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31
Q

Describe PT orders section

A

Order for PT
Should be reviewed first
If not clear it must be clarified

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32
Q

Describe the admission note history

A

Subjective info
Data that identifies patient
History of present illness
Family history

33
Q

Describe the admission note physical exam

A

General objective information
Skin
Extremities
Abdomen

34
Q

Describe the admission assessment

A

Statement of the condition and prognosis of the patient

35
Q

Describe the admission plan

A 
Further observations
Tests
Lab analysis
Consultations
Interventions
Discharge planning
36
Q

Describe the acute care index of function domains

A

4 domains - Mental status, bed mobility, transfers, mobility

37
Q

Describe the acute care index of function scoring

A

< .3 = SNF
.31-.7 = Acute rehab
> .7 = home discharge

38
Q

Describe the AM-PAC 6 clicks domains

A

Basic mobility
Daily activity
Applied cognitive

39
Q

Describe the AM-PAC 6 clicks scoring interpretation

A

20.1 = home
17.9 = home with with home care
14 = SNF
13.6 = inpatient rehab
11.5 - long term acute care

40
Q

What are PT goals in the ICU

A

Minimize immobility effects
Help each patient become functionally independent
begin discharge planning

41
Q

Describe SBAR

A

Situation
Background
Assessment
Recommendation

42
Q

Describe discharge recommendations for home PT

A

Pt home with family
Confined to home
PT as appropriate

43
Q

Describe discharge recommendations for SNF

A

Nursing needs on inpatient level

less than 3 hours PT per day

44
Q

Describe discharge recommendations for inpatient rehab facility

A

At least 3 hours of PT a day
Pt needs are complex
Needs 2 disciplines

45
Q

Describe discharge recommendations for long term acute care

A

Medically complex patients
Expected to need long term care
Emphasis on basic mobility

46
Q

Describe discharge recommendations for outpatient PT

A

Patient may return home

PT at outpatient facility

47
Q

When should you start mobilization in the ICU

A

Within 48 hours after admission

Based on medical readiness and clinical judgment

48
Q

What are some barriers to mobilization

A 
Inadequate staffing
Complex patient cases
Fear of lines
Increased risk of falls
Safety misconceptions
49
Q

What is the one day costs in the ICU

A

$3000 - $10,000

50
Q

What are some advantages to ICU mobilization

A 
Shorter time on mechanical ventilation
Shorter ICU stays
Shorter hospital stays
Less costs
Prevent long term weakness and disability
51
Q

What are some acute negative effects of the ICU stay

A

Atrophy
ICU acquired weakness
ICU psychosis
Deconditioning

52
Q

What are some long term negative affects of the ICU stay

A

Long term impairments in respiratory muscle strength
Decreased physical functioning
Depression and anxiety

53
Q

What is the order to don PPE

A 
Hand hygiene
Gown
Mask
Eye
Gloves
54
Q

What is the order to doff PPE

A 
Gloves
Eye
Gown
Mask 
Hand hygiene
55
Q

What conditions are indicated for contact isolation

A

MRSA, VISA, VRE
Clostridium difficile (uncontrolled diarrhea)
EVD
Zika

56
Q

What conditions are indicated for droplet isolation

A

Mumps
Streptococcus A
Neisseria meningitidis
Flu

57
Q

What conditions are indicated for Airborne isolation

A

Measles

Tuberculosis

58
Q

What conditions are indicated for Airborne plus contact

A

Chickenpox
Smallpox
Disseminated herpes in the immunocompromised
Shingles

59
Q

What is unique about C diff isolation

A

Dedicated in room equipment

60
Q

What are the considerations are regarded as green for risk of adverse event

A 
Endotracheal tube
Tracheostomy tube
FI02 < .6
PEEP < 10
O2 sat > 90%
Tachycardia with ventricular rate > 120
61
Q

What are the considerations are regarded as yellow for risk of adverse event

A

FIO2 > .6
PEEP > 10 cm H2O
+ delirium tool, able to follow simple commands

62
Q

What are the considerations are regarded as red for risk of adverse event

A

O2 sat < 90%
Bradycardia < 50 bpm with pharmacological treatment
(vasoactive drugs required to maintain blood pressure)

63
Q

Describe MAP considerations

A 
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
Q

What are the norm values for WBC’s and what is safe for exercise

A

Norm: 5-10

4.3 - 10.8 ok for exercise

65
Q

What are the WBC levels for leukocytosis, leukopenia and neutropenia

A 
Leukocytosis > 11
leukopenia < 4
Neutropenia 
< 1.5 = moderate
< .5 = severe 
possibly follow neutropenia guidelines
66
Q

What are the norm values for platelets and what is safe for exercise

A

Norm: 140-400

> 200 ok for exercise

67
Q

What are the platelet values for thrombocytosis and thrombocytopenia and indications

A

Thrombocytosis: > 450, can lead to venous thromboembolism
Thrombocytopenia: < 150, severe if less than 20, fall risk

68
Q

What are the norm values for hemoglobin and what is safe for exercise

A

Males: 14-17.4
Females: 12-16
> 7 ok for exercise

69
Q

What are the low (anemia) and high (polycythemia) hemoglobin values and what are the indications

A

low critical = 5-7, can lead to heart failure or death

High critical = > 20 can clog capillaries

70
Q

What are the normal lab values for hematocrit

A

Males: 42-52%
Females: 37-47%

71
Q

What are the critical low and high values for hematocrit and the indications

A

Low: <15-20%, cardiac failure or death
High: >60%, spontaneous blood clotting

72
Q

What are the norm values for glucose

A

Reference: 70-100
Fasting: 90-130

73
Q

What are the low and high values for glucose and what are the indications

A

High: >200, decreased activity tolerance
Low: <70, may not tolerate exercise until level is increased

74
Q

What are the values for HbA1C and what do they indicate

A 
<5.7 = norm
5.7-6.4 = prediabetes
>6.5 = diabetes
75
Q

Describe the various INR values and what treatment is indicated

A

> 6 = bed rest
5 = no exercise
4-5 = light exercise
< 4 = resistive exercise

76
Q

What are the PH value ranges for blood

A 
Norm = 7.35-7.45
Acidosis = < 7.35
Alkalosis = > 7.45
77
Q

What outcome measures are used for functional mobility on the acute floor

A

ACIF

6 clicks

78
Q

What outcome measures are used for functional mobility on the ICU floor

A

FSS-ICU

PFIT - S

79
Q

What are some balance and fall risk outcome measures

A

POMA
BBS
TUG
FIST

TRI 4 - PCM 2 (5 decks)

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