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Acute Care Module 1 > ortho part 1 > Flashcards

ortho part 1 Flashcards

1
Q

what are the primary goals for PT for acute ortho patients

A
  1. early restorative mobility for max function

2. reduce risk of secondary complications

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2
Q

what kind of image is an xray?

A

negative image: the more dense, the more absorption

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3
Q

what method is used to read images?

A

ABCS - alignment, bone, cartilage, soft tissue

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4
Q

how does a bone scan work?

A

greatest concentration of radiation absorption is the site of greatest metabolic activity

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5
Q

what does a T1 weighted MRI tell you?

A

anatomic detail (think neuro pics)

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6
Q

what does a T2 weighted MRI tell you?

A

underlying pathology

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7
Q

what are signs of severe anemia?

A

fainting, chest pain, angina, and heart attack

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8
Q

how does anemia present in the eyes

A

yellowing

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9
Q

how does anemia present in the skin

A

pale, yellow, cold

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10
Q

how does anemia present in respiratory system

A

SOB

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11
Q

how does anemia present in the MSK system

A

weakness

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12
Q

how does anemia present in the GI system

A

change in stool color

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13
Q

how does anemia present in the CNS

A

fatigue, dizziness, and fainting (severe)

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14
Q

how does anemia present in the blood vessels

A

low blood pressure

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15
Q

how does anemia present in the heart

A

palpitations, increased HR, chest pain (severe), angina (severe), heart attack (severe)

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16
Q

how does anemia affect the spleen

A

enlarges it

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17
Q

what does general anesthesia do

A

produces a progressive and reversible CNS depression

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18
Q

how might a general anesthesia patient present after surgery

A

drowsy, impaired cognition, weak, increased bronchial secretions, ventilation may be necessary

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19
Q

where does anesthesia go?

A

needle into the subarachnoid to CSF

20
Q

how does an epidural work?

A

intermittant delivery of pain meds via PCA pump

21
Q

how does a peripheral nerve block work?

A

anesthetic bolus or catheterized into a specific nerve

22
Q

what type of anesthetic is given for TKA?

A

local femoral nerve block - effects quad activation/strength

23
Q

what is the most common anesthetic for and why should i care

A

exparel (bupivicane) - non opiod lasts up to 72 hours but side effects are dizziness, drowsiness, nausea, and constipation

24
Q

what anticoagulant is given post op to prevent DVT

A

low molecular weight heparin (warfarin) can be given up to 6 weeks post op

25
Q

name some types of opioids

A

oxycodone, hydrocodone, morphine, codeine, buprenorphine, fentanyl, tramadol

26
Q

how are opioids delivered in the acute setting

A

patient controlled analgesia (PCA) pumps

27
Q

when do you wanna schedule tx for a patient on opioids?

A

at max dose effect

28
Q

what is your primary informant in a CVP review of systems?

A

vitals

29
Q

what do you review in an MSK ROS?

A

observe for abnormalities and general strength screen

30
Q

upon primary observation of a patient, what should you consider

A

lines/tubes/equipment as well as how the room is set up

31
Q

what are the three scales for pain?

A

NPRS, VAS, and Wong-Baker

32
Q

what four things should you consider for integumentary integrity?

A
  1. scars
  2. bruising/cuts
  3. surgical site/incision
  4. limb color
33
Q

what do you screen for in sensory integrity

A
  1. compartment syndrome
  2. peripheral nerve injury
  3. peripheral neuropathy
34
Q

what do you do in the involved extremity for ROM?

A

goni (for knees mostly), functional ROM, note what is limiting full range

35
Q

what do you do in the involved extremity for muscle strength

A

MMT, functional strength, what they can do before getting OOB

36
Q

approximately how much more effort is required to use a standard walker versus unassisted ambulation? versus a wheeled walker?

A

200%

100%

37
Q

what are four performance measures

A

10 meter walk test
TUG
6MWT
activity measure for post acute care (AMPAC) 6-clicks

38
Q

where do most in patient ortho patients end up

A

return to home

39
Q

exhaustive list of post op complications

A 
Adhesions
Constipation
Contracture
Delayed Wound Healing
DVT/PE
Infection
Mal-union
Muscle Guarding/Spasm
Orthostatic hypotension
Prosthetic Failure
40
Q

how do you decrease post op pain muscle guarding or spasm?

A

gentle rom, cold/heat depending on location of pain/spasm, and TENS

41
Q

how do you decrease post op edema?

A

elevation and active muscle pumping

42
Q

how do you prevent CVP complications post op

A

active LE exercise, deep breathing/coughing exercises, aerobic activities

43
Q

how do you prevent unneccessary joint stiffness/contractures post op

A

ROM exercises

44
Q

how do you decrease muscle atrophy across immobilized joints

A

isometrics

45
Q

how do you minimize loss of motion and strength in areas prox/distal to involved structures?

A

AROM and resistive exercises

46
Q

how do you improve functional mobility while protecting involved structures

A

AD, education, mobility training

47
Q

what do you education a patient and family on post op?

A

positioning
post op precautions or contraindications
exercise programs

Acute Care Module 1 (6 decks)

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