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PHYSICAL THERAPY > Patient Care > Flashcards

Patient Care Flashcards

1
Q

Outcome Measure

A

Means to determine effectiveness of treatment or performance

–expressed in functional terms

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2
Q

POMR

A

(Problem-Oriented Medical Record)

System that organizes medical record by using a common list of pt problems as its base

-SOAP notes

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3
Q

SOAP

A

Component of POMR –> sections in note of pt’s status:

Subjective
Objective
Assessment
Plan

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4
Q

Stereognosis

A

Recognition of shape/form of an object by touch

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5
Q

Two-point Discrimination

A

Recognition/differentiation of two points when simultaneously applied to skin

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6
Q

ICF Model

A

(Intl Classification of Function, Disability and Health)

System of coding used to classify health conditions and develop a common language in describing health conditions

Codes:
--Functioning and Disability 
       Body function (s)
       Body Structure (b)
       Activities / Participation (d)
--Contextual factors 
       Environment (e)
       Personal
Numerical values
Qualifiers = describe magnitude, severity, 
       and level of function
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7
Q

Nagi Model

A

Medical:
Active Pathology
Impairment

Social:
Functional Limitation
Disability

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8
Q

Preferred Practice Patterns

A

Musculoskeletal
Integumentary
Neuromuscular
Cardiopulmonary

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9
Q

Six Elements of Patient Management

A 
Examination
Evaluation
DIagnosis
Prognosis
Intervention
Outcome
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10
Q

Impairment

A

Any loss or abnormality.

May necessitate functional mobility training (FMT):

  • Weakness (MMT)
  • Loss of ROM (Goni)
  • Balance deficits
  • Cognitive deficits (Name, DOB)
  • Sensory loss
  • Coordination deficits
  • Pain
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11
Q

Active Pathology

A

Interruption of normal processes + body’s efforts to restore itself to homeostasis.

May necessitate FMT:

  • Orthopedic Surgery/Injury
  • Pain condition
  • Rheumatological condition
  • Neurological condition
  • Genetic/Congenital condition
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12
Q

Functional Limitation

A

Decreased ability to perform physical task.

May necessitate FMT:

  • SAFETY
  • Bed mobility
  • Ambulation around home
  • Assistance going to bathroom
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13
Q

Disability

A

Inability to perform task expected in sociocultural contexts

May necessitate FMT:
-Unable to perform function at home, school or 
  work
-Unable to participate in recreational 
  activities/hobbies
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14
Q

Orthosis

A

Orthopedic appliance used to:

–Support, align, prevent or correct
deformities

–Replace function of parts of body
(Brace or splint)

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15
Q

Body Structure (s)

A

ICF Code = Anatomical parts

Examples:
Gait - LE body parts
Eyes
Cardiovascular system

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16
Q

Body Function (b)

A

ICF Code = Physiological function of body systems

```
Examples:
Gait - deviation, impairment
Seeing functions
Hypertension
Joint mobility
~~~

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17
Q

Activities / Participation (d)

A

ICF Code = execution of task or action / involvement in a life situation

Examples:
     (Gait - dist amb, moving using 
         equipment, ability to walk on various 
         surfaces)     
     Learning/applying knowledge
     Mobility
     Self-care, ADL's
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18
Q

Environment (e)

A

ICF Code = surroundings of pt

Examples:
(Gait - public transportation services)
Products/Technology/Natural Surroundings
Support/Relationships/Attitudes
Services/Systems/Policies

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19
Q

Vision 2020

A 
Evidence-Based Practice
Autonomous Practitioner
Direct Access
Practitioner of Choice
Professionalism
Doctor of PT
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20
Q

Core Values

A 
Accountability
Altruism
Caring
Communication
Excellence
Integrity
Professional Duty
Social Responsibility
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21
Q

Differential Diagnosis

A

Systematic process of comparing and contrasting symptoms associated with multiple conditions in order to determine what patient actually has.

–Limits possibility of inappropriate
treatment

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22
Q

Intervention

A

5th of 6 Elements of Patient Management
= Purposeful, skilled interaxn of PT with pt
to improve or alter the pt’s condition /
disease.

-Uses PT procedures and techniques:
Procedural (Restorative/Compensatory/Preventative)
Patient instruction
Coordination / Communication / Documentation

-Look out for:
     Safety
     Environment
     Pt privacy (draping/positioning)
     Body Mechanics
     Motor planning
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23
Q

Functional Mobility Training

FMT

A

Primary Intervention provided for pts with:

 - Pathologies
 - Impairments
 - Functional/Activity Limitations 
 - Disabilities

Includes:

 - Bed Mobility
 - Positioning
 - Transfers
 - Wheelchairs
 - Gait Training
 - Exercise
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24
Q

ADL’s

A

(Activities of Daily Living) - Independent vs dependent/needs assistance

May necessitate FMT:

Basic: Instrumental:

  • Grooming -Money mgmt
  • Bathing/showering -Funct Commun.
  • Dressing -Health maintenance
  • Feeding -Community mobility
  • Toileting
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25
Q

Clinical Reasoning

A

Wide range of cognitive skills used by PT to process info, make decisions, and take action.

Show how PT’s bring value to setting:

  • Skilled
  • Purposeful
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26
Q

Examination

A

1st of 6 elements of Patient Management
= Gathering data and ID problems

  • History
  • Systems Review
  • Tests & Measures
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27
Q

History

Hx

A

Component of Examination (Pt Mgmt)
=Systematic gathering of past and present data
about the pt

  • Chief complaints
  • PLOF
  • Pt goals
  • Medical background
    • Medications
    • Diagnostic/lab tests
    • Pain patterns
  • Demographics
  • Employment
  • Living environment
    • Assistance
    • Equipment
    • Stairs
  • Social/health habits
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28
Q

Systems Review

A

Component of Examination (Pt Mgmt)
=brief exam of anatomical/physiological
functions of MINC
–> PT uses to assess pt’s ability to
initiate, sustain and modify
interventions for maximum functional
potential

  • Communication ability
  • Affect
  • Cognition
  • Language
  • Learning Style
  • Red flags
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29
Q

Tests and Measures

A

Component of Examination (Pt Mgmt)
=gathering data to rule in/out links between
probs/impairments and functional limitations
–>Establish diagnosis, prognosis, goals, and
interventions.

Examples:

 - Strength testing
 - Balance/Gait analysis
 - Endurance testing
 - Neuromotor/sensory integration
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30
Q

Evaluation

A

2nd of 6 Elements of Patient Management
= Assessment based on exam and ID of
problems list

-Enablement vs Disablement terms

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31
Q

Diagnosis

A

3rd of 6 Elements of Patient Management

= ID impact of condition on function

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32
Q

Prognosis

Px

A

4th of 6 Elements of Patient Management
= Precicted optimal functional improvement
attained by intervention and time to reach
that level
–>POC

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33
Q

POC

A

(Plan of Care); part of Prognosis (Pt Mgmt)

=Determination of anticipated goals and
expected outcomes + interventions to
achieve them

-Goals/Outcomes:
Short-term
Long-term
Specific / Measurable / Time-Frame / Functional

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34
Q

Outcome

A

6th Element of Patient Management
= ongoing process of reexamination of pt to
assess efficacy of treatment

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35
Q

Discharge Planning Components

A 
Patient Education
Follow-up / Referral
Home Education Program (HEP)
Home modification
Equipment recommendation
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36
Q

FIM Levels of Assist

A

(Functional Independence Measure)
= Scale indicating pt independence level and
necessary amount of assistant from clinician

7 = Independent (100%, no equip)
6 = Mod Independent (100%, addtl time/equip)
5 = Supervision (100%, SBA / verbal cueing)
4 = Min Assist (>75%, CGA)
3 = Mod Assist (>50%)
2 = Max Assist (>25%)
1 = Dependent (<25%, 1 or more assistants)
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37
Q

Positioning

A

Treatment intervention used to prevent tightness, contractures, and pressure ulcers

Principles:

 1. Support
 2. Stabilization
 3. Alignment
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38
Q

Positioning Guidelines

A 
Introduction
Rationale
Motor Planning
Draping
Support materials/equipment

*See Fairchild p. 87

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39
Q

Positioning:

Rationale

A
  1. Prevent pressure ulcers
  2. Prevent contractures
  3. Support/stability
  4. Access to area of treatment
  5. Optimal function of organ system
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40
Q

Contracture

A

Shortening or tightening of skin, muscle, fascia or joint capsule that decreases ROM and function

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41
Q

Orthopedic

A

Branch of medicine dealing with musculoskeletal system

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42
Q

Pressure Ulcer

A

Bed sore caused by breakdown of skin and tissue.

  • Interfere with functional recovery
  • Cause pain & Infection
  • Lead to excess length of stay
Blood/lymph flow obstructed
   Ischemia + Edema
      Redness
         Open Sores
             Muscle/bone destruction
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43
Q

Ischemia

A

Lack of oxygen delivery to organs

44
Q

Pressure Ulcer Predisposing/Risk Factors

A 
Poor nutrition
Dry skin
Immobility
Weight loss
Decreased sensation
Impaired circulation
45
Q

Erythema

A

Redness or rash

46
Q

Lymphopenia

A

Decreased WBC count

47
Q

Stages of Pressure Ulcer

A

I: Intact skin with non-blanchable erythema over
bony prominence

II: Partial thickness with loss of dermis

III: Full thickness of tissue loss; bone, tendon,
muscle not yet exposed

IV: Full thickness of tissue loss; bone, tendon,
muscle exposed

48
Q

AIDET

A

Communication tool for improving patient compliance and improving clinical outcomes:

Acknowledge
Introduce
Duration
Explanation
Thank you, is there anything else I can do for you?
49
Q

Bed Mobility

A

Component of FMT –> activities for patient independence

Increases: Decreases:

  • Confidence -Tightness
  • Independence -Contractures
  • Safety -Pressure ulcers

Ability to:

  • Supine movements
  • Roll
  • Scoot
  • Bridge
  • Supine to sit
  • Sit edge of bed
50
Q

Body Mechanics

A

Use of one’s body to produce motion that is safe, energy conserving, and anat/phys efficient to maintain balance and control

  • Motor planning
  • Reduce adverse effects of gravity/friction
  • Keep patient/object close
  • CoG close to patient/object
  • Increase stability (widen stance)
  • Use major muscles
  • Avoid trunk flexion/rotation
  • Know your own limits
51
Q

Lifting Techniques

A

Maintain neutral lordosis in lumbar spine
-reduces stress on lumbar ligaments and
interverterbral discs

52
Q

Orthostatic HTN

A

Sudden increase in BP after sitting up / standing

53
Q

Morbidity

A

Incidence of disease

54
Q

Pre-Mobility Screen

A

Checkpoints to assess in patient before getting them out of bed:

  1. Able to follow commands?
  2. Hemodynamically stable?
  3. Perform straight leg raise against gravity?
  4. Able to sit unsupported in midline?
55
Q

Vital Signs

A
  1. Respiratory Rate
  2. Heart Rate
  3. Blood Pressure
  4. Temperature
  5. O2 Saturation
  6. PT/INR (clotting ability)
56
Q

RR

A

(Respiratory Rate)
= Breaths per minute (R/min)

Normal:
Adults: 12-18
Infants: 30-50

57
Q

HR

A

(Heart Rate)
= Beats per minute (BPM), measured by taking pt’s pulse
-Increases with activity
-Gradual return to normal at rest
(Fitness increases speed of return to normal)

Normal:
Adults: 60-100, (Avg = 75BPM)
1-7yrs: 80-120
Infants: 100-130

Max: 220 - Age
Target: Within 50-85% of Max

58
Q

Locations to measure HR

A 
Neck: Carotid A
Ventral elbow: Brachial A
Ventral wrist: Radial A
Groin: Femoral A
Behind knee: Popliteal A
Medial Malleolus: Tibial A
Dorsum of foot: Dorsal Pedis A
59
Q

Auscultation

A

Listening to cardiovascular, respiratory and GI sounds using a stethoscope

60
Q

BP

A

(Blood Pressure)
= Force of blood against walls of arteries
-Measured as Systolic/Diastolic mmHg

Normal:
Adults: 120 / 80
Elderly: (120-140) / (80-90)
Children: 60-100

61
Q

Temperature

A

Normal: 96.8 - 99.3, (Avg: 98.6)

Pyrexic: >100
Hyperpyrexic: >106

62
Q

Pyrexia

A

= Fever, temp > 100

63
Q

O2 Sat

A

(Oxygen Saturation)
= Level of oxygen dissolved in blood and carried by
RBCs/hemoglobin to systemic organs
-Measured by pulse oximetry

Normal: 97-99%, can be as low as 95%
Hypoxemia: <95%

64
Q

Hypoxemia

A

Low concentration of dissolved O2 in blood (O2 Sat)

–>Cyanosis

65
Q

Pulse Oximeter

A

Device for measuring level of O2 Sat and HR

-Uses sensor of 2 light sources –> hgb –> photodector

66
Q

Cyanosis

A

Bluish skin color due to lack of O2 in blood

67
Q

Raynaud’s Phenomenon

A

Condition in which cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose
–>Cyanosis

68
Q

Coagulate

A

Clot

69
Q

Anticoagulant

A

Blood-thinning medication

Heparin

70
Q

PT/INR

A

(Prothrombin Time / Intl Normalized Ratio)
= Measures ability of blood to clot and how long it
takes
-Increased = bleeding
-Decreased = clot

Normal:
PT: 11-16 sec
INR: 0.8 - 1.3

71
Q

Recumbent

A

Long sit position

72
Q

LRAD

A

(Least restrictive assistive device)

73
Q

Bed Mobility:

Assistive Equipment

A

Bed rails
Overhead bar/frame
Loops
Draw sheet

74
Q

Bed Mobility Principles

A 
Raise bed
Reduce friction
Use gravity to help
Lock bed
Body mechanics
75
Q

Supine Movements

A

Bed mobility activities:

  • Side to side
  • Upward
  • Downward

*Can use draw sheet / equipment

76
Q

Anoxia

A

Absence of O2 in tissues

77
Q

Apnea

A

Absence of breathing

78
Q

Arrhythmia

A

Abnormal heartbeat

79
Q

Bradycardia

A

HR < 60bpm

80
Q

Tachycardia

A

HR > 100bpm

81
Q

Cardiac Output

CO

A

Volume of blood pumped out of heart during contraction (systole)

82
Q

Diaphoresis

A

Excessive perspiration/sweating

83
Q

Dyspnea

A

SOB, labored breathing

84
Q

Expiration

A

Exhalation

85
Q

Inspiration

A

Inhalation

86
Q

Intubation

A

Insertion of tube into larynx to maintain open AW

87
Q

Occlusion

A

Obstruction or blockage

88
Q

Pulse

A

Palpable wave of blood in walls of arteries with each heart beat / contraction

89
Q

SOB

A

Shortness of breath, dyspnea

90
Q

Rale

A

Abnormal “crackle” sound heard on auscultation of chest

91
Q

Stridor

A

Abnormal shrill, harsh sound heard during inspiration on pt with laryngeal obstruction

92
Q

Syncope

A

Fainting

93
Q

Prosthesis

A

Artificial replacement of body part

Artificial Limb

94
Q

Valsalva Maneuver

A

Increased pressure in chest due to forced exhalation against closed epiglottis

95
Q

Spasticity

A

Resistance to stretch bc of abnormal increased tension/stiffness

96
Q

CoG

A

(Center of Gravity)

Located in center of pelvis ~ level of S2

97
Q

How to Increase Stability

A

Increase BoS
Lower CoG
Maintain vertical gravity line + feet positioning

98
Q

Rolling Progression for Treatment

A

Quarter roll –> Full supine
Legs: Bent –> Crossed at ankles –> uncrossed
UE: Adds resistance & increases momentum
Head

Amputees: Avoid compression of residual limb
CVA: Roll either side but position weaker UE appropriately
Post-Op Spine: Log roll only
Post THR: Avoid rolling Hip Precautions

99
Q

THR Precautions

A 
(Total Hip Replacement)
AVOID:
1. Hip internal rotation (toes in)
2. Hip adduction (crossing legs)
3. Hip flexion
100
Q

Log Rolling Steps

A
  1. Supine - Bend pt’s knees
  2. PT’s hands at opp shoulder and hip –> roll to
    side-lying
  3. Drop pt’s legs using your thigh as support
  4. Reach under trunk/neck to support scapula
  5. Have pt push up with opp arm or rest it on PT’s
    shoulder
  6. On 3, drop legs and swing trunk up at same time.
  • Bed height
  • Draw sheet
101
Q

Phlebitis

A

Inflammation of a vein

102
Q

Hemiparesis

A

Weakness on one side of body

103
Q

Hemiplegia

A

Paralysis of arm, trunk and leg of one side of the body

104
Q

Paraplegia

A

Paralysis of the lower body

105
Q

Tetraplegia

A

Paralysis from neck down

PHYSICAL THERAPY (13 decks)

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