Brainscape's Knowledge GenomeTM

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


See full index

Medcon Rehab III > Oncology: Principles In Onco Rehab Pt. 3 > Flashcards

Oncology: Principles In Onco Rehab Pt. 3 Flashcards

1
Q

PT Imps in terms of Oncology

A
  • Type and Stage of Cx
  • Gen health
  • QOL
  • Financial and social strains
  • Preventative, Restoratitve, Supportive, Palliative
  • SEs from tx
  • Discharge planning from ALL settings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Blood Clots

2 that we are Concerned W/:

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

Deep Vein Thrombosis

DVT

Explaiin

A
  • Clot of cellular material bound to fibrin located in DEEP VEINS
  • Sx’s:
    • ​edema
    • erythema
    • PAIN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pulmonary Embolism

PE

Explain:

A

Blood clot which obstructs the Pulmonary aa/vein

  • Sx’s:
    • ​dypnea
    • LOW O2sats
    • tachycardia (reflex tachy)
    • chest pain***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DVT

PE

Tx’s

A
  • AntiCOAGULANTS (blood unable to clot)
  • IVC filter (Inf. Vena Cava)
    • for LE origin ONLY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

VASCULAR

DVTs

Incidence in Cx Pts

A
  • TWICE AS LIKELY TO DEVELOP DVTs***
  • FREQ. complication
  • 2nd leading cause of death***
  • 90% of pts expe an INC in clotting activity
  • MORE COMMON:
    • ovarian
    • pancreatic
    • lymphatic
    • liver
    • stomach
    • colon cx’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Vascular complications

DVTs

Causes of a Hypercoagulable State

A
  • Immobility
  • SOME tumors release subs that INC blood’s ability to clot
  • Sx OR CHEMO can injure vessel walls—> triggers blood coagulation
  • Cx therapy can DEC body’s ability to produce adequate coagulants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vascular comps

DVTs

PT imps:

A
  • Awareness of Tx***
  • Monitor approp. blood values
  • Monitor SPO2 and HR***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Blood Clot forming

Embolus traveling thru heart INTO lung vessels

A

see pics

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

Sx Resection GOALS:

WHAT ARE THEY TRYING TO ACHIEVE?

A

CLEAN MARGINS

  • Trying to achieve clean margins
    • ​to be sure ALL cx cells removed
  • Tumor can be resected completely BUT
    • ​ALSO want to resect an area of clean tissue or non-cx tissue to see if ACTUALLY CLEAN

​

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

SEs from Sx

A
  • Loss of Function
  • disfigurement or deformities
  • PAIN
  • infection
  • Risk of bleeding or hemorrhage
  • Fatigue
  • dev. of scar tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PT Implications Following Sx

A
  • EARLY mobility and pulm hygiene
  • Respiratory Considerations:
    • ​Chest PT + Airway clearance
    • Chest wall excursion (lateral costal breathing)
  • Soft tissue restrictions:
    • ​ROM restricts
    • WB restricts
    • Scar restriction (after healing)
  • Weakness:
    • ​Nerve resections
    • Nerve traction injuries
  • **Psychosocial implications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chemotherapy

Common SE’s

**remember Chemo attacks ANY rapidly dividing cells (think GI, Hair follicles)

A
  • PAIN
  • Fatigue
  • Bone marrow suppression
    • ​Infection
  • Alopecia**
    • ​remember hair follicles attacked–rapidly dividing
  • Infertility
  • GI effects**
    • ​​remember hair follicles attacked–rapidly dividing
    • nausea, vom, constipation, anorexia
  • Peripheral neuropathy
  • DECd bone density
  • skin rashes
  • Wt. gain OR loss
  • Jt pain
  • Sexual dysf
  • Hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hematological Considerations:

Bone Marrow Suppression:

3 things come from this

A
  1. Anemia
  2. Thrombocytopenia
  3. Leukopenia/Neutropenia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anemia

What is it?

A

LOW RBC Count

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

Anemia

Lab values: HgB

Norms: M vs F?

A

MALE==14-17 g/dL

FEMALE==12-16 g/dL

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

Anemia

S/S

(Anemic)

A
  • FATIGUE
  • irritability
  • lightheadedness
  • HA
  • Loss of concentration
  • pallor
  • SOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anemia

PT Imps:

A
  • Monitor VITALS!!!
    • RR INC, HR INC, SaO2 DEC
  • Monitor LAB VALUES/Tx
  • Monitor FATIGUE LVLS

NOTE: Have to use RPE ***

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

Thrombocytopenia

what is it?

A

LOW Plt count

  • NORM== 150,000-400,000 mm^3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thrombocytopenia

LOW Plts

S/S

A
  • Bruising
  • Bleeding—if too low
  • Petechiae
    • sm. raised rash on skin
    • microtrauma to superficial blood vessels
      • _​_INAD. Plts

​

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

Thrombocytopenia

LOW Plt count

PT Imps:

A
  • Monitor LAB VALUES/Tx
  • FALL PRECAUTIONS
    • train balance but NOT high lvl
  • Focus on Functional Mobility
    • _​_NO risky activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can you remember Plts easily??

A

They are YELLOW

SEE PICS

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

Leukopenia/Neutropenia

What is this ?

A

LOW WBC Count

  • NORM== 3.5k to 10.5k cells/mcL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Leukopenia/Neutropenia

LOW WBCs

S/S

A
  • Freq INFECTIONS
  • Fevers
  • Throat/mouth sores bc DECd ability to fight infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Leukopenia/Neutropenia

LOW WBCs

PT implications:

A
  • Reverse/Protective Isolation—Neutropenic Precautions
    • ​PROVIDER (PT) dons PPE to protect pt
  • Creative tx interventions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bone Marrow Suppression Guidelines

aka Blood Counts outside normal ranges:

WBCs

A
  • <5k–NO EX permitted
  • >5k–light ex, progressive to resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Bone Marrow Suppression Guidelines

aka Blood Counts outside normal ranges:

HgB:

A
  • <7.5g/dL== NO EX permitted
  • 7.5-10g/dL== Lt ex, focus on functional mobility
  • >10g/dL == Resistive ex permitted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Bone Marrow Suppression Guidelines

aka Blood Counts outside normal ranges:

Plts:

A
  • <20k– NO EX OR ADLs/walking
  • 20-30k– Lt ex, AROM, walking
  • 30-50k– MOD ex, aquatic, stationary bike
  • 50-150k– Progressive resist ex’s, swimming, bike
  • >150k– Unrestricted normal act.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Bone Marrow Suppression Guidelines

aka Blood Counts outside normal ranges:

INR

A
  • >4.0– NO EX permitted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Radiation Therapy

Common SEs

And what can occurr from each.

A
  • PAIN
  • Fatigue
  • Bone marrow suppression​
    • ​INFECTION
  • Local hair loss
    • attacks rapidly dividing cells
  • Delayed wound healing
  • DECd bone mass/strength
  • Skin changes
    • fibrosis
    • erythematous skin
    • fragile skin
    • myofascial adhesions
  • GI changes–attacks rapidly dividing cells
    • diarrhea
    • vom
    • PRO deficiency
    • anorexia
  • Wt loss
  • AVN: loss of blood supply==necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Radiation Therapy

Common SEs

Radiation Myelitis

A
  • damage to small blood vessels in spinal column
    • ​–> DECd blood flow
    • –> necrosis
    • –> demyelination
      • ​–> sensory dysf and weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Radiation Therapy

Site Specific SEs

Abdomen and Pelvis

A
  • Nausea
  • bladder discomfort/dysf
  • Sexual dysf
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Radiation Therapy

Site Specific SEs

Head and Neck

A
  • Diff eating
  • dental hygiene
  • Dry mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Radiation Therapy

Site Specific SEs

Breast

A
  • DECd shoulder ROM
  • Soreness
  • Lymphedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Radiation Therapy

Site Specific SEs

Chest

A
  • Swallowing diff
  • SOB***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Radiation Therapy Considerations

A
  • Burns/blisters
  • Radiation fibrosis/necrosis
    • ​brain
    • lungs
    • trismus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

PT Implications following Radiation Therapy

Radiation Induced Fibrosis

*stuck, tight adhesions

Specifically what/where?

A
  • Trismus
    • ​unable to open mouth by 30cm or 3knuckles
  • Limtd cervical ROM
  • Head drop—-literally
  • Limtd chest wall excursion
  • Osteoradionecrosis
    • ​Jaw bone
  • Neuralgia
    • loss of nerve conduction
    • loss of flexibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Radiation Therapy

Common SEs

CNS Effects: 3

A
  1. Radiation Necrosis
  2. Encephalopathy
  3. Myelopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Radiation Therapy

Common SEs

CNS effects: Radiation Necrosis

A

Lg mass of dead tissue that forms @ SITE of irradiated tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Radiation Therapy

Common SEs

CNS Effects: Encephalopathy

A

FOCAL neuro sx’s assoc’d w/ white matter changes (DECd)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Radiation Therapy

Common SEs

CNS Effecs: Myelopathy

A

Functional or pathological disturbance of Spinal Cord

**can be transient (short term) or chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Breast Cx: Radiation SEs

A

LEFT= burn + fibrosis

RIGHT= radiation burn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Radiation SEs

Radiation desquamation + skin changes

A

see pics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Radiation Therapy SEs

Pulmonary fibrosis

A
  • Possible after lung or breast radiation
  • NO current tx’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

PT Implications

Radiation Therapy

PRECAUTIONS:

A
  • Blood values/lab results
  • Infection control
  • PAIN
  • fatigue
  • WB status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Radiation Therapy: PT Implications

Interventions:

A

ROM

FALL PREVENTION, Assess for approp. AD

pt+fam edu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

PT implications Following Radiation Therapy

A
  • Nerve injury
    • weakness
    • pain
    • parasthesias
  • Lymphedema
  • Fatigue
  • Compromised skin integrity
  • Psychosocial imps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Stem Cell Transplant usually combined w/….

A

HIGH DOSE CHEMO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

SES from Stem Cell Transplant

A
  • GVHD
    • ​Graft vs. Host Dis.
      • ​body REJECTS stem cells
  • Immunosuppression
  • Isolation
  • Delayed wound healing
  • Nausea and vom
  • Osteoporosis
  • 2* malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Graft vs. Host Disease

GVHD

A
  • Transplant Rejection:
    • ​Donor cells (graft) recognize body’s cells (host) as foreign and implement immulogic attack
  • skin, liver, gut
  • Tx:
    • ​INCd immunosuppressive drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Graft vs. Host Disease

when is it ACUTE

A

w/in First 100 days

52
Q

Graft vs. Host Disease

When is it Chronic?

A

>100 days

53
Q

General NEUROLOGIC Considerations

3:

A
    1. Cognition
      * ​A&Ox4
  • 2. Hydrocephalus: INCd ICP
  • 3. Neuropathy/Radiculopathy: chemo affects nerves
54
Q

Gen Neurologic Considerations

PT Imps:

A
  • Safety awareness
  • Orientation
  • Ability to follow commands
  • MEMORY
55
Q

Gen NEUROLOGIC Considerations

Hydrocephalus

*incd ICP

PT Imps:

A
  • AVOID valsalve maneuvers
  • NO excess bending or heavy lifting
  • **HOB elevated to 30deg or HIGHER
  • MONITOR:
    • ​HA’s
    • Nausea
    • Dizzy
    • INCd BP

​

56
Q

Gen. NEUROLOGIC Considerations

Neuropathy/Radiculopathy

PT Imps:

A
  • Assess/Monitor:
    • sensation to lt. touch
    • Proprio.
    • balance
    • coord.
57
Q

Gen. MSK Considerations

Name them

A
  • Bone pain
    • Know WB precautions
  • Bony Mets
    • Pain w/ WB, not responsive to PT, pain w/ Valsalve
  • Sk mm wasting
  • Osteoporosis
  • Steroid Myopathy ****
  • Bedrest/Decond.
58
Q

Gen MSK Considerations

Bony Mets

PT Imps:

A
  • WB status
  • ROM restrictions
  • Spinal precautions**
    • ​No BLT
      • ​Bending
      • Lifting
      • Twisting
      • LOG ROLL
59
Q

Gen MSK Considerations

Steroid Myopathy**

PT Imps:

A
  • PROX MM weakness
    • monitor strength
60
Q

Gen MSK Considerations

Bedrest/Deconditioning

PT Imps:

A
  • VITALS*** t/o Tx
  • Monitor loss of bone density
61
Q

W/ Goal Setting

What should we keep in mind?

A
  • Prognostic Indicators
    • ​be Realistic
  • Communication
    • ​b/w PT, pt, family
    • goals may be diff!!!
  • Caregiver Training
    • ​If pt returns home–may need assist
  • When is PT Approp?
    • ​if achieved max lvl of benefit
      • ​communication!!!
62
Q

Discharge Planning

A
  • Various Settings:
    • ​acute, subacute, SNF, assist living, hospice,
    • HOME–may req other services
  • Considerations:
    • ​prognosis
    • Pt/family desires
    • futher tx
    • Immunocompromised state
  • PT’s input is extremely vital to discharge process***
63
Q

Cancer Pain

A
  • acute vs chronic
  • several etiologies
  • described as Intractable
64
Q

Cancer Pain

Acute

A
  • BRIEF duration
  • Cause usually known
65
Q

Cx Pain

Chronic

A
  • Extends beyond 3mos
  • Cause may be UNknown
66
Q

Etiologies Cx Pain

Cx Pain Syndrome

A
  • Diff types of pain
  • Diff etiologies
  • Diff tx methods
  • Can be from:
    • ​sx pain
    • hardware
    • painful neuropathy from hardware
    • DIFF REASONS!!!
67
Q

MOST COMMON FORM OF Cx PAIN….

A

BONE PAIN

68
Q

Cx Pain

Bone Pain

A

MOST COMMON

  • Can be primary or 2* dis
69
Q

Cx Pain

Visceral Pain

*organs

A
  • Organs in thoracic and abdominal areas (sx in abdomen)
  • Gnawing, Crampy, Constant, Aching, DEEP
70
Q

Cx Pain

Neuropathic Pain

A
  • FROM:
    • peripheral OR central sensory nerve trauma
      • ​causes abnormal firing
  • CHARACTERIZED:
    • Burning
    • Shooting
    • Tingling
71
Q

Cx Pain

From Cx Tx

A
  • Sx
  • RT
  • chemo

**ALL CAN EXACERBATE PAIN

72
Q

Cx Pain

Pain UNRELATED to Cx

A

NOTE: Cond’s other than Cx cause pain

73
Q

Cx pain

Factors affecting response to pain

A

Anxiety

Personal life experience

Culture/Religion

74
Q

Mgmt of Cx Pain

FIRST STEP?

A

Determine Source

Attempt to Remove It

  • Sx
  • Radiation
  • Chemo

**BUT remember these can all CAUSE PAIN as well***

75
Q

Meds and Routes of Admin

A
  • Oral
  • Buccal/transmucosal
  • Rectal
  • Transdermal
  • Subcutaneous
  • IV
  • Direct CNS admin
  • Pt-Controlled Analgesia
    • PCA pump—-LET THEM CARRY THIS DURING Tx
76
Q

Delivery of Pain meds and Coordinating w/ PT and scheduling

A
  • Scheduling
  • Breakthru Pain
    • ​X avail all the time, Y if X not enough
  • Coord w/ Pt and other HC providers
77
Q

Other Methods Pain mgmt

A

Behavioral intervents

Modalities

  • Modalities
    • ​Cutaneous Stim (STM’s)
    • heat, cold
    • TENS
78
Q

Cx PAIN

PT Role

A
  • ROM, gen therex
    • mobs
  • Positioning
  • ADs
  • Bracing
  • Modals
79
Q

PT Imps:

Cx Pain

Considerations

A

Assessment of Pain (1-10)

Pre-medication of pt (for comfort during tx)

SEs of meds***

80
Q

Cx FATIGUE

*Overwhelming fatigue**

A

“Distressing, persistent, subjective, sense of physical, emotional and/or cognitive tiredness or exhaustion related to cx or its Tx that is not proportional to recent activity and interferes w/ usual functioning”

*present in those indiv’s w/ advanced cx

81
Q

Cx Fatigue

ACUTE

A
  • Expected occurrence after energy is expended
    • when you SHOULD feel tired, you do…but it is still overwhelmingly tired
  • SHORT duration
  • Usually alleviated by REST
82
Q

Cx Fatigue

CHRONIC

A
  • Abnorm or Excessive
  • Can involve ENTIRE BODY
  • NOT alleviated by rest
  • Can be overwhelming

**Fatigue that takes over you

83
Q

Pathophys of Cx Fatigue

Contributing factors?

A

Cx itself

Progress. of dis.

84
Q

Pathophys of Cx Pain

Physical Factors that influence

A
  • sleep/rest patterns
  • nutrition
  • GI probs
  • bone marrow suppression
  • mult meds
  • overall phys condition***
  • tx
  • infection
  • Meds SEs
85
Q

Pathophys of Cx Fatigue

Psychosocial Factors that influence

A
  • Depress/isolation
  • anxiety
  • appearance
  • lack of control
  • relationship changes
  • sexual dysf
  • finances
86
Q

Measuring Fatigue

Clinical S/S

A
  • DEC strength
  • INC dyspnea
    • rate, depth
  • Tachycardia
  • Diff concentrating
  • DEC ability to perform ADLs
  • DEC nutritional intake
  • Change in sleep/rest cycles
87
Q

PT Imps Cx Fatigue

Considerations:

A
  • Help det possible causes of fatigue
    • refer out
    • RD
    • sleep docs
  • Measure VITALS!!!
88
Q

PT IMPS

Cx Fatigue

PT Role

A
  • Daily energy log
  • EXERCISE—-#1 WAY TO TX FATIGUE!!!
  • energy conservation
  • ADs
89
Q

Physiotherapy Program Reduces Fatigue In Pts w/ Adv Cx Receiving Palliative Care: RCT

Psyzora A, Budzynski J, et al.

A

See Study below

90
Q

Lymphedema

What is it?

A

Disruption in lymphatic system which results in a chronic accumulation of lymphatic fluid

*PRO-rich lymphatic fluid

91
Q

Lymphedema

Risk factors

A
  1. Lymph node dissection
  2. Radiation to lymph nodes
  3. Tumor impeding lymph flow
92
Q

Common areas for Lymphedema

A
  • Breast, arm, trunk following ALND (Axillary Lymph Node Dissection)
  • Head and Neck following RND (Radical Neck Dissection)
  • LEs and Genitals following PLND (Pelvic Lymph Node Dissection)
93
Q

Lymphedema Prevention + Education

A
  • Maint healthy wt.
  • PREVENT any trauma to affected area
    • ​cuts, scrapes, burns
  • AVOID BP in Affected Extremity
  • AVOID IVs, injections, needles in affected extremity
  • Proper nail and skin care
    • ​AVOID cutting cuticles
  • Avoid tight fitting jewelry, clothes, bags
94
Q

Complete Decongestive Therapy

For Lymphedema

Components of this?

A
    1. Manual Lymphatic drainage—-must be trained
    1. Compression–bandaging
    1. Self-care
      * exercise
      * skin care
    1. Compression Garments
      * TEDS

​

95
Q

Axillary Web Syndrome

*Think Palpable Cord******

A
  • Visible web of axillary skin which overlies a palpable cord of tissue including blood vessels, nerves, lymphatics
  • MAY extend to medial ipsilat arm, antecubital space, base of thumb
  • Pain w/ shoulder FLEX and ABD
96
Q

Effects of a PT Program Combined w/ MLD on Shoulder Function, QOL, Lymphedema Incidence, and Pain In Breast Cx Pts w/ Axillary Web Syndrome Following Axillary Dissection

A

see study below

97
Q

Superior Vena Cava (SVC) Syndrome

what is it and what will you see?

A
  • Invasion of tumor (typ lung tumor) INTO SVC causing edema of neck and face
    • ​Thoracic vein distention
    • Tachypnea (>20breaths/min)
    • Cyanosis (blue)
    • Edema of UEs
    • paralyzed vocal cords
98
Q

SVC Syndrome

Tx

A

EBRT (Ext Beam Radiation Therapy) and Chemo (less common option)

Steroids for edema

99
Q

Head and Neck Cx

Trismus

A
  • Impaired mouth ROM
  • Impaired jaw mobility
  • INCd PAIN
100
Q

Head and Neck Cx

Sx can cause

A

immobility and pain

scar tissue

101
Q

Head and Neck Cx

Radiation can cause:

A

Fibrosis of jaw mm’s, skin, fascia

102
Q

Trismus

Tx’s

A
  • Myofascial Release
  • Intra & Extraoral massage
  • Jt mobilization
  • Therex
  • Splinting (see pics)
    • Dynasplint
    • LLPS—Low Load Prolonged Stretch
103
Q

Pediatric Considerations

A
  • Long term SEs (for survivors as children)
    • ​Cardiac or Pulm toxicity
  • QOL
    • ​developmental OR educational delay
    • MSK considerations and growth
    • fertility
  • Long term survival and Gen health follow-ups!!!
104
Q

Outpatient Oncology Services

A

To manage the MSK, NMSK, integumentary and CP rehab needs of pts resulting from the tx of cx. This includes acute or chronic sequela of cx tx such as sx, RT, chemo.

105
Q

PT Dx’s oncology pts in Outpatient setting

A

see list below:

106
Q

Outpatient: Tx Interventions Cx Pts

A

see list below

107
Q

Assesment of PT Strategies for Recovery of Urinary Incontinence after Prostatectomy

A

see study below

108
Q

Outpatient Modalities for Cx pts

Indications (when to use):

A
  • MAY reduce pain and spasm
  • NOT proven effective for tx of deep cx pain or bone pain
109
Q

Outpatient cx pts: Modalities

ABSOLUTE Contraindications

DO NOT USE WHEN:

A
  • DIRECTLY over tumor
  • Bleeding or hemorrhage
    • long term corticosteroid or chemo
  • Damaged OR regenerating nerves
    • ​RT or chemo induced
    • ​they cannot give you response to modality!!!
  • Implants in Tx area
110
Q

Recognizing Red Flags

Examples

A
  • Recognizing skin cx’s
    • ​PTs VERY close to pts—we see all over body–ex. back where pt may not see
  • Palpation of abnorm tissue
  • Pain
  • Neurologic changes
111
Q

Red Flags

PAIN related…

A
  • Insidious onset (just crept up)
  • Worse @ night, interferes w/ sleep—-this is HUGE Red Flag**
  • Unable to reproduce w/ positioning
112
Q

Recognizing Red Flags

Neurologic Changes

A
  • Mm weakness
  • Numb/tingling
  • Loss of B&B control
  • Burning or shooting pain
113
Q

Skin Cx’s

2 Types:

A
    1. Melanoma–
      * occurs in DEEPEST part of epidermis
    1. Basal Cell Carcinoma–
      * occurs in epidermis
114
Q

Skin Cx

Melanom

DEEPEST part of epidermis

A
  • Pigmented blackish or brownish color
  • IRREGULAR, ill-defined borders
  • Spreads QUICKLY to skin and other parts of body
115
Q

Skin Cx

Basal Cell Carcinoma

*in epidermis

A
  • PEARLY ROUND appearance OR darkly pigmented
116
Q

Skin Cx’s

ABCDE

A
  • A: Asymmetry
    • one half of mole or birthmark NOT match other half
  • B: Border
    • edges irreg, ragged, notched, blurred
  • C: Color
    • color NOT same all over–brown, black, sometimes patches of pink, red, white, blue
  • D: Diameter
    • spot LARGER than 6mm across (1/4in–size of pencil eraser)
    • NOTE: melanomas CAN BE smaller than this
  • E: Evolving
    • mole is changing in size, shape, color

​

117
Q

CARDINAL SIGNS for Cx OCCURRENCE

A
  • Unusual, non-reducible fatigue
  • fever
  • Unexplained wt loss
  • weakness
  • PAIN
  • skin changes
  • Night sweats
118
Q

Oncology considerations for PT intervents

Considerations of Cx Hx

A
  • explanation of current rehab Dx
  • *Common PRIMARY cx’s to develop Bony Mets
    • ​Breast
    • Prostate
    • Lung
    • Kidney
119
Q

*Common PRIMARY cx’s to develop Bony Mets

A

​Breast

Prostate

Lung

Kidney

120
Q

Oncology considerations for PT Intervention

Dev of Mets

A
  • Altered mental status
  • Altered balance
  • Unresolved pain
    • Bone pain—-common loc. for mets
    • Nerve pain
  • SUDDEN onset of weakness
    • ​SC compression
  • SOB
121
Q

PT Imps

Bony Mets

PRECAUTIONS

A
  • PAIN
  • MMT
  • WB status
  • Cautions of Patho fx’s ***
122
Q

PT Imps

Bony Mets

INTERVENTIONS

A
  • Therex
  • Orthotics
    • ​support/prevent Fx’s
  • ADs
  • pt edu/safety
123
Q

CNS Mets Disease

Cx that has spread to brain

*NOTE: usually NOT the other way around***

PRESENTATION?

A
  • HA’s
  • Mm weakness
  • Sensation changes
  • Impaired balance/coord
  • Behavioral changes
124
Q

CNS Mets Disease

INTERVENTIONS

A
  • Orthotics, ADs
  • Therex
  • NMSK re-ed
  • safety assess/fam training
125
Q

Cx Pts Multidisciplinary TEAM

COMMUNICATION IS KEY***

A

SEE LIST OF TEAM Mbrs

Medcon Rehab III (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions