non-systems Flashcards
if a pt makes inappropriate comments to you and you are uncomfortable, what should you do?
refuse to treat the pt and refer to another PT
if a PTA deviates from the POC, who takes the blame?
the PTA, they didn’t follow the POC made by the PT
who can modify POC? PTA or PT or both?
PT
who can add exercises to POC? PTA or PT or both?
PT and PTA but PT has to approve
if a pt tells you they plan to end their life, what should you do?
stay with the pt until help arrives (mental health specialist)
what organization accredits hospitals SNF, home health agencies, etc?
JACHO
what organization accredits free standing rehab facilities?
CARF
what agency determines what and how much will be reimbursed by Medicare for pt care?
CMS
what agency is responsible for determining the safety of the work environment?
OSHA
what PPE would you need for pneuomina?
surgical mask, droplet precautions
what PPE do you need for airborne precautions? name some clinical syndromes with airborne precautions
N95, gloves and gown if severe contamination.
MTV: measles, TB, varicella, herpes zoster
what PPE do you need for droplet precautions? name some clinical syndromes
surgical mask
mumps (rubella), strep A, pneumonia, flu, sepsis, adenovirus
what PPE do you need for contact precautions? name some clinical syndromes
gloves and gown only when in direct contact with pt or items in pt room
MRSA, VRE, lice, C diff, dermatitis, hep A&B, conjunctivitis
if you treat someone and suspect signs of abuse, what would you do?
examine the pt and report to the appropriate authorities
state the rules for telehealth
- both PT and pt need to verify ID at onset of visit
- you need to be licensed in the state you pt is located
- need consent
- need to be able to see/supervise the pt
what are the workstation measurement recs? (monitor, keyboard, mouse)
- monitor should be 18-20 in away
- monitor should be 10 degrees below horizontal, 20 in away from eyes
- wrist should rest on front of keyboard
- use a mouse that contours the hand
- space under desk should be 30 in wide, 19 inches deep, 27 incues in height, 2-3 in between top of thighs and desk
when you are lifting a box off the floor, what will increase compression forces on the spine besides the weight of the box?
the distance the box is from the base of the spine. that’s why it’s good to keep items close to you when lifting them
the distance increases the moment arm which would increase torque (T=F*d)
when performing adult high quality CPR, what rate would you perform chest compressions?
100-120/min
when performing adult high quality CPR, what depth do you compress to?
at least 2 in (5cm)
when performing adult high quality CPR, to ventilate adequately, perform __ breaths after ___ compressions, each breath delivered over ___ second, each causing chest rise
20, 30, 1
what is the correct sequencing for doffing PPE?
Gloves, goggles, gown, mask (alphabetical order)
whats the correct sequencing for donning PPE?
gown, mask, goggles, gloves
what is a swan ganz cath used for?
monitoring blood flow and function of the heart
what is a Hickman cath used for?
provides antibiotics, nutritional solutions, and blood samples
what does an arterial line monitor?
arterial blood gasses
what does a central venous pressure cath measure?
blood pressure directly from right atrium and superior vena cava
what is a potential complication if a chest tube is left out?
pneumothorax (collapsed lung)
catheters should be hung…
below the level of the bladder
collection bottles should be kept below the….
level of inserted tube
what to do in chest tube is dislodged?
have pt exhale, place gauze or gloved hand over the area and call for nurse (cover & call)
how do you measure seat height for a WC?
heel to popliteal fold +2 inches (avg 19.5-20.5 in)
how to measure seat depth of WC?
posterior butt along lateral thigh to popliteal fold -2 inches so it’s not digging into back of knee (avg is 16 in)
how to measure seat width of WC?
widest aspect of butt/thighs + 1.5-2 inches (avg 18 inches)
how to measure back height of WC?
chair seat to axilla - 4 inches (add seat cushions to value) (ang 16 in)
how do you measure armrest height of WC
seat of chair to olecranon +1 inch (avg 9 inches)
before any transfer to/from WC, what is the most important thing to do?
LOCK (safety is #1)
how do you go up and down curb in a WC?
do a wheelie (push hands forward abruptly), lifting the front casters
list the posterior hip precautions
no flexion past 90
no IR
no crossing legs
no twisting cuz that causes IR
no FABIR combined movement
list the anterior hip precations
no ER, flexion, abduction, extension
no FABER combined movement
what’s the best AD for a pt who is PWB (50%) on one side?
axillary crutches
what does a posterior leaf spring do?
recoils during swing phase to produce DF
what’s pes equinus?
too much PF
differentiate between time based codes and service based codes
time based codes: billed based on the actual time spent providing a service
service based codes: billed per service, regardless of time spent (examples: evals, unattended estim)
what are the time thresholds for 8 min rule?
1 unit: 8-22
2 units: 23-37
3 units: 38-52
4 units: 53-67
5 units: 68-82
what is the role of PTs with IDEA (the individuals with disabilities education act)?
- evaluation
- develop SMART goals
- document progress
- plan transition to higher education and independent living
the IDEA is a federal law that ensures _______ with __________ are provided with Free Appropriate Education (
FAPE) tailored to their specific needs
children, disabilities
ADA is a civil rights law act that prohibits ______ against individuals with ________
discrimination, disabilities
what are the K levels used to categorize?
functional level of those who use prosthetic devices
which K level describes an individual who is WC bound and has no ability to amb or transfer safely with or without assistanc?
K0
*not eligible for prosthetic
which K level describes the ability to perform transfers or ambulation on LEVEL surfaces at a fixed cadence?
K1
*single axis ankle and knee joints
which K level can navigate curbs, stairs or uneven surfaces with limited community mobility?
K2
*constant friction mechanism at knee and multi axial foot to walk on uneven surfaces
which K level can you variable cadence and has unlimited community mobility?
K3
*variable friction mechanism (resistance changes with gait) at knee and multi axial foot
which K level has high ambulation skills and participation in sports?
K4
advanced microprocessor-controlled knees, dynamic response feet designed for high-performance activites
how do you respond if someone is having a seizure|
- remove any nearby objects that could be hazardous
- place the pt on the side to reduce risk of choking or aspiration
- time beginning and end of seizure, if it exceeds 5 min call 911
DO NOT RESTRAIN THEM AND DO NOT PUT ANYTHING IN THEIR MOUTH
what are some signs of a seizure?
aura (disturbance)
sudden unresponsiveness or LOC
muscle jerking or twitching
stiffening of muscles or loss of muscle tone
incontinence
what are some signs of a concussion
headache
nausea
balance probs
fatigue
blurred vision
sensitivity to light or noise
numbness or tingling
cognitive, emotional, and sleep related deficits
how would you respond to a concussion (3 steps)?
- stop activity immediately
- monitor for worsening sx
- consult a healthcare professional promptly for thorough eval, even if the sx are mild
when would you seek emergency help for someone with a concussion?
LOC
repeated vomiting
severe headache
seizures
unequal pupil size
prolonged confusion
slurred speech
weakness or numbness
unusual behavior
difficulty waking up
what are the sx of mild dehydration?
thirsty and dry lips
what are the sx of moderate dehydration?
cracked lips, orthostatic hypotension, poor skin turgor, headache, sunken eyes
what are the sx of severe dehydration?
rapid and weak pulse
confusion
lethargy
rapid breathing
seizures
inability to pee or cry
how to respond to dehydration?
- ID sx early to prevent worsening
- start by drinking water or oral rehydration solutions
3 . if the person is nauseous, have them take frequent, little sips - severe cases may require IV fluids
When fitting a patient for axillary crutches, the base of each crutch should be placed where in relation to the patient’s body?
6 inches anterior, 2 inches lateral
If a patient using bilateral axillary crutches loses their balance forward (anteriorly), they should:
reach forward with both arms, bend elbows to absorb force and slow the fall
When issuing a walker to a patient, what bony landmark would most approximate the height of the handgrip?
greater troc
Weakness in which muscle would make it extremely difficult to ambulate on crutches?
lats
medially rotates, adducts, and extends the shoulder joint.
depresses scapula
What injury may occur if a patient bears weight through their axilla on their crutches when ambulating?
axillary nerve compression
The primary rationale for using a reverse walker instead of a traditional walker is to improve:
postural alignment
Why is a slight anterior pelvic tilt important when positioning a patient in a wheelchair?
allows for weight bearing on the ischial tuberosities
