PCM Midterm Basics Flashcards
What is the AMPAC 6 clicks used to measure?
-Functional activity (Basic mobility, Daily Activity, Applied cognition)
Where should you discharge a patient who scores a 20.1 on the AMPAC 6 Clicks?
-Home
Where should you discharge a patient that scores a 17,9 on the AMPAC 6 Clicks
- Home with home care
Where should you discharge a patient that scores a 14 on the AMPAC 6 Clicks
-SNF
Where should you discharge a patient that scores a 13.6 on the AMPAC 6 Clicks
-inpatient rehab
Where should you discharge a patient that scores a 11.5 on the AMPAC 6 Clicks
-LTAC
What is a code red?
-Fire
What is a code blue?
-cardio/pulm emergency
What is a code orange?
-biohazard waste spill
What is a code grey?
-combative person
What is a code silver?
-weapon/hostage
What is an aber aler?
-missing child
What are considered coommon identifiers under HIPPA?
-Name, DOB, Address, SSN
What else can be considered an identifier under HIPAA?
-data that relates to physical or mental health, healthcare provided, payments or demographic
What does HIPPA allow the patient to control with their health information?
-view it and control what providers do with it
What are the 3 deminsions of cultural competense?
-self awareness, respectful communications, collaborative partnerships
What type of language accounts for the most communication?
-non-verbal
What are the 3 ways to build rapport?
-active listening, empowerment, empathy
What are the indications for restraints?
-if the patient may cause harm to themselves or other, or if they are needed for treatment
How often does the MD order for restraints need to be updated?
-every 24 hours
What is the normal WBC count?
-5.0-10
What does a WBC count greater than 11 indicated?
-Luekocytosis (trending upward)
What should you do with a patient with a WBC greater than 11?
-consider timing therapy in the morning because counts will be lower
What does a WBC less than 4 represent?
-Luekopenia (trending downward)
What does a WBC count less than 1.5 indicate?
- nuetropenia (trending downward)
- Mod: 0.5-1
- severe: less than .5
What is a normal platelet count?
-140-400
What does a platelet count greater than 450 indicate?
-Thrombocytosis (trending up)
What can a patelet count over 450 cause?
-Thromboembolism
What does a platelet count less than 150 indicate?
-thrombodytopenia (trending down)
What do you need to be careful of with a patient with a platelet count less tan 150?
-fall (can bleed out)
What is the normal Hgb level for male?
-14 to 17.4
What is the normal Hbg count for females?
-12 to 16
What can high Hbg level (>20) cause?
-clogging of capillaries
What can low Hbg levels (5-7) cause?
-Heart failure
What should you do before mobilizing a patient with abnormal Hgb levels cause?
-get a consult
What is the normal Hct levels in male?
-42 to 52
What is the normal Hct levels in females?
-37-47
What is the normal glucose level?
-70 to 100 mg per dl
What is the normal fasting plasma glucose?
-90-130
What does blood glucose over 200 indicate?
-Trending upwards
A patient with high blood glucose (>200) with present with what to activity?
-decreased tolerance
Blood glucose less than 70 indicate what?
-trending downward
How will a patient with a blood glucose less than 70 respond to activity?
-may not be able to tolerate it until levels increase
What is the target blood glucose for patient in noncritical care?
-140-180
what is the normal HB1AC levels?
-<5.7
what will the HB1AC levels be for those that are prediabetic?
-5.7-6.4
What will HB1AC levels be for those how are diabetic?
->6.5
What should you perform for patients with diabetes?
-monitor vitals, educate on importance of exercise and blood sugar control
What activity levels can a person with INR greater than 6 perform?
-bed rest only
Patients with an INR great than 5 not perform?
-exercise
A patient with an INR between 4 and 5 can perform what?
-light exercise
Patients with an INR less than 4 can perform what?
-4
Acidosis is a pH below what?
-less than 7.35
What is normal blood pH?
-7.35 to 7.45
What pH is considered alkalosis?
-greater than 7.45
What is the function of the pulse ox?
-measure O2 sats and HR
Where can pulse ox be placed?
-finger, ear or forehead
What precuations should be taken with pulse ox during mobilization?
-make sure it does not detach
What type of diagnoses usually use a pulse ox?
-cariopulm or neuro
What is the function of the swan ganz catheter?
-measure pulmonary artery pressure
Where can a swan ganz catheter be inserted into the body?
-juggular, subclavian and femoral vien
If the swan ganz catheter is inserted into the subclavian, what percautions should be made?
-no shoulder flexion
if a swan ganz cather is inserted into the femoral artery what percautions are there?
-no hip flexion past 30, limit abduction
What type of patients might have a swan ganz?
-post CABG
Where is a ICP monitor located?
-through the skull into the left ventricle
What precautions should be taken with an ICP monitor?
-avoid valsalva, limit neck flexion, no hip flexion past 90, no laying in prone or 15 degree from horizontal
What is the function of the arterial line?
-monitors BP and for sample
What is the most common artery for an arterial line to be place?
-The radial artery
What percautions should be taken with an arterial line?
-limit ROM near insertion site
What is the function of the hickman catheter?
-administration of medication, samples and measure central venous pressure
Where is the hickman catheter inserted into the body?-
-into the right chest wall through the juggular vien
What is the function of a folley cather?
-drain the bladder of urine
What is the function of the NG tube?
-removes fluid or gas, monitors digestive activity or administer medication
what precautions should be taken with an NG tube?
-no food or water by mouth, caution of cervical flexion and rotation, no laying supine past 30 deg
What precautions should be taken with a gastric tube?
-before mobilization place feeding on hold, then make sure it is secured and no infections
When mobilization a patient with a nasal cannula or tacheostomy mask, what should be monitored?
-O2 sats (dont go below 92)
Where is chest tube drainage inserted into the body?
-into the plueral cavity on the lateral chest
What precuations should be taken with chest tube drainage?
-must keep drain below chest cavity
What should you do before mobilizing a patient on mechanical ventilation?
-Make sure the tube is long enough
What is the function of an external ventricular device?
-monitor ICP and drain fluid
What precuations do you need to take with a patient with an external ventricular device?
-Must keep head inline with the transducer
What precautions should you take for those with a jackson pruit drain?
-do not dislodge, no tugging, must maintain suction
What was passed in 2014 that made health care providers digitalize health records?
-The HITECH Act
What should be the only formal exercise post spine surgury?
-Gait
What a spine surgury patient is ambulating with a walker, what should be prevented?
-lifting of the walker (breaks lifting precaution)
What is the normal HR for newborns?
-100 to 130
What is the normal RR for children?
-30 to 50
What type of orthotic would be used for a patient with an amputation or wound of the foot?
-fore foot offloading boot
What can be placed on a immobile patient to prevent pressure wounds on the heal?
-pressure releivin AFO
What is normally used on patient S/P TKA for prevent knee buckling?
-knee immobilizing brace
What are the THA precautions?
-No IR, NO Abd, NO hip flexion past 90
What is used to protect the head after craniotomy?
-soft shell helmet
a s/p craniotomy patient must have on what to do anything out of the bed?
-soft shell helmet
What cervical orthosis is thought to have better stabilization than the HALO except for c1/c2?
-Menerva
What Jewitt thoracic orthosis restricts flexion by encourages what?
-Hyperextension
What is a problem with the jewitt orthosis in sitting?
-it may put pressure on the throat and genitals
What must you do with a GERD patient after feeding?
-Elevate the bed
What a patient with ICP monitoring needs to have the bed angled to what?
-30 to 45 degrees
What should the bed position be for a CHF patient?
-semirecumbent to 45 degrees
A patient with the g tube should not be reclined past what?
-30 deg
What is albation used for?
-to remove ectopic foci causing heart abnormalities
What is the first step to evaluating cognitive status?
-see how the patient reacted when you entered the room
If a patients cognition is impaired, what should determine?
-if impairment occured in the hospital or before admission
How can we mobilize unconscious patients?
-PROM, positioning
All patients should be considered for mobilization within how many hours of admission?
-48
Patients should be considered for mobilization how soon after beginning mechanical ventilation?
-72 hours
What are the 4 themes at the care of clinical reasoning process in acute care?
-Collection and analyzation of medical data, application of specialized PT knowledge, communication to gain information, communication to provide information
What are the 3 goals of PT in the ICU?
-minimize or prevent effects of inactivity, help person become functionally independent, being information intake and ideas regarding discharge planning
ICU acquired weakness can occur if patient is on mechanical ventilation for a little as how many days?
-4 to 7
ICU acquired weakness is often associated with what?
-Sepsis or ARDS
If bicarbonate is less than 24, acidosis is caused by what?
Metabolic
The physician orders contain what?
-the entire POC for the patient
What should you view in the medical record before performing a PT eval?
-that there is order for one, WBS, activity level, parameters, changes in medication of health status
The admission note is often called what?
-history and physical
What is in the admission note?
-what lead the patient to the hospital, vital signs upon admission, medical Hx, current medication, social history
