Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 5 PMCP Exam 4 > Mobilizing the ICU patient > Flashcards

Mobilizing the ICU patient Flashcards

1
Q

Skills needed by the PT in the ICU

A
  • Knowledge of CP phys, path, pharm
  • Knowledge of ICU equip
    CP assessment and tx rx
  • Ability to practice effectively under pressure and often in congested an suboptimal working conditions!
  • Knowledge in emergency procedures
  • Sensitive to patients
  • Team player
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Information needed before treating an ICU patient (bold)

A

Existing or potential medical instability
Indications or necessity for intubation and mechanical ventilation
Invasive monitoring, lines, leads, and catheters
Existence of or potential for complications and multi-organ system failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Factors that increase metabolic demand and oxygen consumption in patients - Pathophysiologic Factors

A

1) Fever
2) Thermoregulatory
3) Healing and repair
4) Combating infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Factors that increase metabolic demand and oxygen consumption in patients - Intervention related factors

A

Responses to nursing cares
Feeding
Body positioning
Pharmacologic agents - Diprovan (Propofal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Factors that increase metabolic demand and oxygen consumption in patients - Psychosocial

A

Social contact
Anxiety
Discomfort
Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Factors that increase metabolic demand and oxygen consumption in patients - Misc

A

Noise

ICU psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tone - Decreased tone

A

LMN lesion (GB)
Atrophy
Ployneuropathy
Paralytic medication and sedatives that are used for a prolonged period of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tone - Increased tone

A

UMN lesion - CVA and encephalopathy
Electrolyte imbalance
Bilateral intracranial lesions
Large unilateral intracranial lesion resulting in a midline shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tone - ___ will be a very important part of treatment

A

positioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Strength testing with an ICU patient

A

Modified
Not done against resistance in order to avoid vasalva
In ICU 3/5 is appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Coordination tests include

A 
Finger to thumb opposition
Finger to nose tracking
Rapid alternating hand mvmnts
Heel to shin slide
Rapid foot tapping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bed mobility

A

Supine to sit through sidelying

Need to make sure it is cleared through physicians and nursing prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Assessing balance

A

Sitting and standing

Static, with reaching, with perturbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lab value - Hgb

A

12-16 F

14-17 M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lab value - hematocrit

A

36-44% F

41-51% M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lab value - Hgb A1C

A

4.8-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Aneurysm is

Key for pts with aneurysm repair

A

weakng of the arterial wall from a loss of elastin and collagen
Log roll to side to get out of bed - splinting is huge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

AAA - abdominal aortic aneurysm repair

A

Incision from xiphoid process to pubis

log roll to get out of bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thoracic aortic aneurysm repair

A

Ascending and transverse procedures done through sternal incisions
Descending done through combo of sternal and left thoracotomy incisions
Stenral incision precautions apply!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thoraco-abdominal aortic aneurysm repair

A

Incision is combo of left thoractomoy and abdominal incisions
High risk procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Carotid Endarterectomy is what

A

Surgical procedure involving the left or right common carotid arteries to remove plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Carotid Endarterectomy is performed where and what is a complication

A

Performed through the neck
Complication - CVA intra-operatively
PT usually seeing them for complication - tx as would any other ICU patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Percutaneous Coronary Angioplasty - is what

A

Blockage is either reamed out of destroyed with a balloon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Percutaneous coronary angioplasty is inserted where

A

through the femoral artery

stent can also be placed to keep the artery open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Percutaneous coronary angioplasty - what can occur

A

Restenosis - usually up to 50% and usually within the first 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Arterio-bifem Bypass

A

Diseased portion of the descending aorta and its bifurcation into the common iliac arteries are replaced by a manmade graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Arterio-bifem Bypass - extends from

A

the infrarenal abdominal aorta to the common
femoral arteries
Make sure to check circulation! Log roll to side!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fem-popliteal bypass

A

diseased portion of the femoral artery is replaced by a manmade graft and connected to the popliteal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Fem-popliteal bypass - risk factors

A

diabetes, smokers, high cholesterol, those in jeopardy of having an amputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cerebral vascular accidents can be ___ or ___

A

Space occupying lesions

Anoxic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CVA - Space occupying lesion from

A

tumors, hemorrhage, subdural hematomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CVA - Space occupying lesion cause

A

midline shift of the cerebral contents

33
Q

CVA - Space occupying lesion resulting in

A

bilaeral increases in pressure and bilateral neurological symptoms

34
Q

CVA - anoxic lesions are what

A

clot or thrombus travels to the brain cutting off blood flow to that part

35
Q

CVA - anoxic lesions - what can be done

A

thrombolytic therapy can be used within 3 hours of the event (need to be on bed rest 24 hours after)
Takes 48 hrs to show up on a CT scan

36
Q

TBI may be

A

Subdural hematoma, anoxia, infarction, midline shift and/or damage to the ventricles

37
Q

SCI usually has multiple medical problems such as

A 
orthopedic stabilization of a fracture
sexual dysfunction
respiratory failure
paralysis
depression
incontinence
skin breakdown
contractures
38
Q

Ileus is what

A

bowel motility stops

39
Q

Ileus symptoms include

A

abdominal pain
distention
absent bowel sounds

40
Q

Ileus cause

A

surgery, medication, immobility, general anesthesia

41
Q

Ileus treatment

A

NG to suction, NPO

42
Q

GI bleed - what will fall

A

Hb/Hct

Hgb can be as low as 4

43
Q

GI bleed - cause

A

malignancy, meds, gastric ulcer, diverticulitis, hemorrhoids, esophageal varices

44
Q

Sepsis is what

A

infection that has become systemic

can lead to multisystem organ failure

45
Q

Subcutaneous emphysema is what

A

air that has leaked out from the lung following a pneumothorax into the spaces between tissue layers
Pt will have puffy appearance

46
Q

Guillain Barre is what

A

Ascending polyneuropathy

47
Q

GB is thought to be caused by

A

an infection

48
Q

GB has varying degrees of progression and recovery - what is the treatment

A

Plasmaphoresis, IGg, therapy

49
Q

Myasthenia Gravis is what

A

An acquired autoimmune disorder associated with acetylcholine receptor deficiency at the motor end plates

50
Q

Myasthenia gravis will show

A

fluctuating weakness of commonly used voluntary mm with symptoms of diplopia, ptosis, difficulty swallowing, limb weakness
Abnormal fatigueability

51
Q

Post polio syndrome

A

polyneuropathy of viral origin

Those that survived polio yrs ago are developing new dennervation resulting in additional weakness

52
Q

Post polio syndrome - exacerbated by

A

acute illness

53
Q

ALS - Amyotrophic lateral sclerosis

A

Irreversible hypoventilation will lead to mechanical ventilator dependence
May see in later stages

54
Q

Bariatrics - BMI

A

30 obese

40 morbidly obese

55
Q

Pathophysiology of obesity

A

Alveolar hypoventilation (pickwickian syndrome)
Results in hypoxemia and cardiopulm failure (low O2 and high CO2)
Poor cardiopulm reserve capacity
Stress of illness

56
Q

Procedures to reduce weight

A

Gastric bypass surgery
Gastric banding
Sleeve gastrectomy
Gastric plication

57
Q

Egress test includes what 3 components

A

Sit to stand
Step in place
Step forward and return

58
Q

Egress test - sit to stand

A

patients were requested to complete three reps of sit to stand

59
Q

Egress test - step in place

A

while standing at a self selected stance width, patients took alternate steps in place

60
Q

Egress test - step forward and return

A

Patients steps away from the bed once and then returns to starting position

61
Q

Egress test - pass if

A

completed test independently or with no more than minimal assistance
shows that they are okay to get up and walk

62
Q

Glascow coma scale
1 What does it rate
2 Highest score
3 When intubate?

A

rates patient on eye opening, verbal response, motor response
The highest score is 15
below 8 = intubate!!!

63
Q

0-10 numeric scale for who

A

adults and children over 9 years old

64
Q

FLACC scale for who

A

2 months to 7 years old

65
Q

CNVI for who

A

nonverbal patients

behavioral or cognitive impairment

66
Q

Encephalopathy - how does it present

A
  • often confusion, memory deficits, anger
    (depends on what part of the brain it is impacting though)
    can be reversible or not
    treat their deficits
67
Q

Reversible encephalopathy

A 
Hepatic liver disease - toxins (can be)
Hypertensive BP (can be but usually not caught in time)
Toxic metabolic - infection or toxins - best case of these - can be reversible if reverse toxins
68
Q

TIA

A

s/s last less than 24 hours

symptoms can be subtle

69
Q

Brain tumor

A

know where tumor is located and the procedure used to remove it

70
Q

Aneurysms are often discovered

A

when they rupture to cause bleeding to the brain

71
Q

Unruptured aneurysm

A

Coiling
Clipping
Radiation

72
Q

Bariatrics - exercise - THR

A

220-age
60% earlier stages
Can progress to 80%

73
Q

Glascow coma scale - eye opening points

A

1 - never opens
2 - open to pain
3 - open to sound
4 - spontaneous opening (active arousal mechanism)

74
Q

Glascow coma scale - verbal response

A 
1 - none
2 - incomprehensible 
3 - inappropriate 
4 - Confused
5 - Oriented to person place time
75
Q

Glascow coma scale - motor response

A

1 - none
2 - extension synergy
3 - decorticate flexion rigidity with painful stimuli
4 - entire arm flexed n response to painful stimuli
5 - localized - moves a limb to attempt to remove stimulus
6 - obeys commands - no involuntary mvmnts

76
Q

Glascow coma scale - linked to difficulty they will have later on - mild score

A

Mild - 12 to 15

they will recover fully in 3-6 months or so

77
Q

Glascow coma scale - linked to difficulty they will have later on - moderate score

A

moderate - 9 to 12

they may not have full recovery, maybe some limitations

78
Q

Glascow coma scale - linked to difficulty they will have later on - severe score

A

below 8

Will definitely have deficits and could be for up to a yr

79
Q

Wong Baker Face pain rating scale for who

A

adults and children over 3 years old

Semester 5 PMCP Exam 4 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions