Quiz #4 (readiness parameters) prep Flashcards
What pulmonary measures do you need to look at before determining if your patient is ready for physical therapy interventions?
Patient cannot exercise if any of the following:
SaO2 - 35 breaths/min
PEEP - >10 cm H20
FIO2 - > or equal to 0.6
What cardiovascular measures do you need to look at before determining if your patient is ready for physical therapy interventions?
Patient cannot exercise if any of the following:
MAP - 120 mm Hg or if rises 10 mm Hg lower than normal normal systolic or diastolic BP for patients on dialysis.
Resting HR - 140 bpm
systolic BP - 200 mm Hg
new arrhythmia develops
new onset of angina-type chest pain
What lab values do you need to look at before determining if your patient is ready for physical therapy interventions?
Hematocrit
What metabolic measures do you need to look at before determining if your patient is ready for physical therapy interventions?
Patient cannot exercise if:
Glucose levels 200 mg/dl
If your ICU patient does not have any critical values what is the next step before proceeding to your examination and interventions?
Check the patients cognition by asking assessing their ability to follow one-step commands:
- “open/close your eyes”
- “look at me”
- “open your mouth and stick out your tongue”
- “nod your head”
- “raise your eyebrows when I have counted to 5”
What grip strength measurements are indicative of ICU-aquired weakness?
women - 7kg
men - 11 kg
What is the FSS-ICU?
based upon the FIM but adapted for ICU patients and includes:
- rolling
- sit to supine
- sitting at EOB
- sit to stand
- ambulation
What are two non-verbal ways you can assess your patients for pain/sensation?
“pain” - deep nail bed pressure
“pinch” - inner arm/thigh
What test can you use with your patient that can help with exercise prescription and as an outcome measure?
PFIT
- sit to stand (amount of assistance need score 0-3)
- shoulder flexion & knee extension strength (oxford muscle test scale 1-5)
- marching in place (# of steps & time to complete steps)
- UE endurance (# of times arms are raised of 90° of shoulder flexion & time to complete task)
How is the FSS-ICU scored?
0 = unable 1 = 100% dependent 2 = maxA 3 = modA 4 = minA 5 = CGA 6 = SBA 7 = independent
What balance test could you use with your next ICU patient (depending of course)?
- timed “up and go” (TUG)
- tinetti
- Berg Balance Score
What functional tests could you use with your next ICU patient to asses their ability to ambulate (depending of course)?
- 2 min or 6 min walk test
Why do you and the physical therapist need to be aware if your patient has taken noradrenaline or vasopressor/iontrope medication?
b/c these meds are used to maintain adequate BP and cardiac output, therefore make sure he patients MAP/BP does not fall to low for treatment.
What functional tests could you use with your next ICU patient to asses their ability to stand out of a chair (depending of course)?
- 5 times sit to stand test
What MRC score is indicative of ICU-aquired weakness?
48 or lower
