Non-Systems Flashcards
Who can make decisions if the pt is unable to consent?
FIRST: power of attorney.
SECOND: case manager or social worker if POA unavailable.
If a pt refuses treatment, what’s the appropriate response?
FIRST: educate pt.
SECOND: If they still refuse, respect their decision.
Appropriate response if pt is harassing therapist?
-Stop treatment & find another therapist to take over.
-Ignoring the behavior & continuing treatment may escalate things.
Appropriate response if staff member is being harassed by another staff member?
Report to HR
When would the PT be held responsible for the actions of a PTA?
At all times, as long as PTA is following the plan of care written by the PT.
When would the PTA be held responsible for their actions (e.g., pt gets injured)?
If they deviate from the PT’s plan of care.
When would an Aide or Student be held responsible for their actions?
NEVER bc not licensed.
PT is held responsible.
Appropriate response if a pt suggests they want to end their life?
Stay with them until mental health professional arrives.
Licensed person must stay with pt.
Which accreditation agencies are focused on patients?
-JCAHO
-CARF
-CMS
Which accreditation agencies are focused on staff?
-OSHA
What does JCAHO do?
accredits hospitals, SNFs, and home health agencies.
What does CARF do?
accredits free-standing facilities
What does CMS do?
determines what services & how much can be reimbursed by Medicare
What does OSHA do?
work environment safety for employees
Contact Precautions: PPE, pt room, & pt transport
PPE: gloves & gown (remove BEFORE leaving room).
Room: private.
Transport: pt must wash hands before leaving room.
Droplet Precautions: PPE, pt room, & pt transport
PPE: surgical mask.
Room: private.
Transport: pt wears surgical mask outside of room.
Airborne Precautions: PPE, pt room, & pt transport
PPE: N95 (discard upon leaving room).
Room: negative air flow.
Transport: pt wears surgical mask outside of room.
Order of donning PPE
- gown
- mask
- goggles
- gloves
Order of doffing PPE
- gloves
- goggles
- gown
- mask
*Alphabetical order
When to use CONTACT precautions?
-MRSA/VISA/VRE
-C. diff
-Uncontrolled diarrhea
-Lice, Scabies, Dermatitis
-Hep A
-Hep B
-Gram (-) bacteria
-Aminoglycoside resistant infections
-Impetigo
-Rotavirus
When to use DROPLET precautions?
-Influenza
-Pneumonia
-Strep A
-Mumps, Rubella
-Meningitis
-Pertussis
When to use AIRBORNE precautions?
-Herpes Zoster
-Chickenpox
-Smallpox
-Measles
-SARS
-TB
-Varicella
Sexual abuse includes…
-Assault
-Indescent exposure
-Sexual gratification (with or without physical contact)
Physical abuse includes…
-Pain
-Injury
-Permanent or temporary disfigurement
Emotional abuse includes…
-Threats
-Intimidation
-Humiliation
-Isolation
Adult to child:
-Blaming
-Rejecting
-Withholding affection
Mental abuse includes…
impacts wellbeing, intellectual, or psychological functioning
Where must the PT be licensed for Telehealth visits?
In the state where the PATIENT is located.
PT does not need to be physically located in that state, just licensed.
CPR compression depth
> 2in
5cm
CPR compression rate
100-120bpm
CPR how often to re-check pulse?
every 2min
Considerations with urinary catheters
-Hang below level of bladder.
-If overfilled, empty it if output NOT being monitored.
-If output being monitored, do NOT empty, alert nursing if overfilled.
Hickman Catheter is used for…
Antibiotics
Nutritional solutions
Blood samples
Swan Ganz Catheter: where is it placed & what is it used for?
-Internal jugular or femoral vein.
-Goes into pulmonary artery to measure heart function & blood flow.
Central Venous Pressure Catheter: where is it placed & what is it used for?
-Superior vena cava.
-Measure BP.
Arterial Line: where is it placed & what is it used for?
-Wrist, arm, groin, or foot.
-Monitor blood gases.
What to do if arterial line is dislodged?
Firm pressure.
Call nursing.
Chest Tube: where is it placed & what is it used for?
-Incision in chest.
-Removes the bad junk from chest & pleural cavity.
What to do if chest tube is dislodged?
-Place gauze or gloved hand over incision.
-Call nursing.
Considerations with chest tubes
Collection bottle kept below level of inserted tube
Considerations with femoral lines
No hip flex >45deg.
Avoid repeated hip flex.
Considerations with IV
No holding arm above head for prolonged time.
Visible air bubbles indicates fluid is running low; alert nursing.
How to measure WC seat height
Heel to politeal fold
+2in
How to measure WC seat depth
Posterior butt to popliteal fold
-2in
How to measure WC seat width
widest aspect
+1.5 to 2in
How to measure WC back height
seat to axilla
-4in
+cushion thickness
How to measure WC armrest height
seat to olecranon
+1in
+cushion thickness
Issues if WC seat height too big?
footrest issues
transfers more difficult
Issues if WC seat height too small?
propulsion more difficult
Issues if WC seat depth too big?
circulation issues
poor posture
Issues if WC seat depth too small?
sliding
Issues if WC seat width too big?
propulsion more difficult
Issues if WC seat width too small?
discomfort
WC modification for amputees
rear wheels moved more posterior d/t changes in COM
Safe methods to ascend curbs in WC
Wheelie: lift castors, then push rear wheels up.
Safe methods to descend curbs in WC
Forward Wheelie: descend with rear wheels, then bring castors down.
Backward: slowly roll rear wheels off.
When is a 3-person lift appropriate?
transfer from stretcher to bed or treatment table
When is a 2-person lift appropriate?
-transfer btwn surfaces of different heights.
-transfer to floor.
When is a squat pivot transfer appropriate?
pt cannot stand independently but can tolerate some WB
When is a hydraulic lift appropriate?
-obese.
-only 1 therapist available.
-totally dependent.
Correct positioning of Axillary crutches
-2in space in axilla to prevent N/vascular compression.
-bottom of crutch ~2in lateral & ~4-6in anterior to pt’s toe.
-20-25deg elbow flex.
Correct positioning of Lofstrand crutches
-top of cuff 1 to 1.5in below olecranon.
-bottom of crutch ~2in lateral & ~4-6in anterior to pt’s toe.
-20-25deg elbow flex.
Correct positioning of cane
-opposite side.
-bottom of crutch ~2in lateral & ~4-6in anterior to pt’s toe.
-20-25deg elbow flex.
Stair negotiation with cane - correct order?
-Ascend: good first, then bad + cane.
-Descend: bad + cane first, then good.
What device is most appropriate for WB restrictions?
Bilateral axillary crutches
What device is most appropriate for full WB?
Single crutch or cane
Correct positioning for guarding on level ground?
-Stand being & slightly toward weaker/involved side.
-Hold gait belt w/ forearm supinated.
-PT moves foot fwd when pt moves device fwd.
Correct positioning for guarding when ascending stairs?
-Stand being & toward weaker/involved side.
-Advance up 1 step after pt advances 1 step.
Correct positioning for guarding when descending stairs?
-Stand in front & toward weaker/involved side.
Indication for Longitudinal Arch (Scaphoid Pad) foot orthosis?
pes planus
Indication for UC Berkley Lab foot orthosis? What does it limit or promote?
-hindfoot valgus.
-limits subtalar motion.
-limits pronation.
Indication for Medial Post/Wedge foot orthosis?
excessive pronation
Indication for Lateral Post/Wedge foot orthosis?
-excessive knee varus.
-medial KOA.
AFOs for weak DF
-posterior leaf spring
-klenzak
AFOs for PF tightness or foot drop
Plastic hinged AFO with posterior stop (AKA PF resistance).
