PT Exam and Intervention In The Acute Care Setting Flashcards
what things should we do b4 enter the pt’s room?
chart review
SBAR with nursing (assistance, meds, meals, precautions)
reason for admission/HPI/PMH/PSH
bring any anticipated equipment
who are the ones to decide if a pt is stable for PT?
the PTs
what should we ask nursing instead of “am I good to work with this pt?”
“I am planning to see this pt, how are they doing today?”
what should we look for when we first enter a pt’s room?
pt appearance (pain, disarray, eating, toileting)
room setup
clues about the pt (photos, books, magazines)
orientation TO the pt
orientation OF the pt
what is orientation TO the pt?
checking lines and tubes (are they connected, where do they come from and go to)
what is orientation OF the pt?
introducing yourself to the pt and anyone else in the room
A&Ox4
safety
wounds
skin changes (if necessary)
in the systems review for CVP, what should we be looking at?
BP
HR
RR
what should we look for with BP?
trends (to know their normal)
if the monitor is connected
if BP is increased, what should we do?
sit and do deep breathing
DON’T lay them down
what are the s/s of high BP?
diaphoresis, anxiety, redness, headaches
if BP is low, what should we do?
ankle pumps
what should we look for with HR?
trends (to see their normal)
BP (ig HR goes up and BP goes down)
a decrease in HR is often due to what?
an arryhthmia
if we see a decrease in HR, what should we do?
stop activity and check VS
recommend to nursing/doctor that the pt has an EKG to rule out a new arrhythmia
if HR changes, what should we do?
look at the pt, do pursed lip breathing if anxious, do diapragmatic breathing, do placed breathing, use a calm voice if increased
what should we look for with RR?
SpO2
make sure the increase is relative to exertion
what conditions would lead to lower than normal SpO2?
COPD
pulmonary fibrosis
interstitial lung disease
CHF
CF
when someone has anemia, what would we see with their SpO2? what does this mean?
their SpO2 may appear normal bc the decreased hemoglobin will oxygenate quickly but it doesn’t mean that it meets the body’s oxygen needs
what are we looking at in the MSK screen?
AROM
strength
anthropometrics
why may AROM be limited?
atrophy
fx/precautions
pain
trauma
fear
edema
neuro impairment
what can we do about limited AROM?
time PT w/meds for pain management
AAROM, PROM
think about their fxn in order to get out of bed and go to the bathroom and what they need to complete that
positioning to protect jts
fxnal mobility practice
isometrics
why might strength be limited?
prior LOF
immobility/rest
nutrition
deconditioning
meds and psychological factors
fever/infection
age
disease specific
what can we do for decreased strength?
think about their fxn and what muscles and motions are needed
practice what they are limited in during your assessment
pt safety (VS, facials, pain, effort)
postural exercises
therapeutic exercises
neuro re-ed
energy conservation
fxnal mobility
what are anthropometrics?
body weight
what things may causes changes in anthropometrics?
hydration
edema
muscle atrophy
what can we do for anthropometrics?
???? need these notes from Zappin bc she moved too damn fast
what things are we looking for in the NM screen?
pain, weakness, swelling, surgical restrictions, immobilization, or neuro impairment
what NM aspects can we work on?
changing positions (bed mobility)
transfers
what interventions may be involved in changing positions (bed mobility)?
log rolling
scooting
weight shifting
assistance
breathing
what interventions are involved in transfers?
adjusting the bed
chair positioning
hand placement
cueing
slow controlled movt
