Unit 2: Acute Care Flashcards
Why do clients come to acute care?
-Injury
-Exacerbation of an existing condition
-New onset of an illness
-Accident
Acute Care
General hospital setting that treats all populations who experience: Injury, Exacerbation of an existing condition, New onset of an illness, Accident
Typical Acute Care Trajectory
ER Physician > Tests > Admitted > Floor
Acute Care Structure
From emergency room may go to:
-General Medical
-Specialty Floor
-Intensive Care
-Surgery
Typical Layout
-Cardiology
-Medicine
-Maternity
-Surgical
-Peds
-Lab and Dia
-Emergecy
Specialty Departments in Acute Care
-ICU
-Oncology
-Vascular
-Nicu
-Other
Acute Care Patients are treated by
-Primary Doctors
-Consults
-Specialists
Length of Stay (Acute Care)
3-5 days
When does discharge planning generally begin? (Acute Care)
When they arrive, as soon as physician sees them first and figures out referrals
-OT starts thinking about it the first time they see them
OT Role (Acute Care)
-Varied
-Educator
-Consultant
-Rehab specialist
OT as Educator
-Environmental or personal adaptations to increase ADLs/IADLs
-Precautions/Contraindications
-Safe transfers
-Educate medical terms/family members
OT as Rehab Specialist
-ADL/IADL training
-Therapeutic Activities/Exercises
-Cognitive Rehab
-Perceptual Remediation
-Other types of OT intervention
Effects of Immobility on systems
-Musculoskeletal
-Cardiovascular
Respiratory
-Metabolic/Endocrine
-Integumentary
-Neurological-Psychological
-Gastrointestinal-Urological
Musculoskeletal (Effects of Immobility on systems)
-Weakness
-Muscle and joint contracture
-Osteoporosis
-Exercise intolerance
Cardiovascular (Effects of Immobility on systems)
-Deconditioning
-Orthostatic hypotension
-Increased risk for thrombus formation
Respiratory (Effects of Immobility on systems)
-Hyperventilation
-Atelectasis
-Increased risk of pneumonia
Metabolic/Endocrine (Effects of Immobility on systems)
-Decreased metabolic rate
-Impaired protein and fat metabolism
-Bone loss
Integumentary (Effects of Immobility on systems)
-Pressure Ulcers
-Systemic Infection
Neurological-Psychological (Effects of Immobility on systems)
-Confusion
-Sensory deprivation
-Depression
-Impaired coping
Gastrointestinal-Urological (Effects of Immobility on systems)
-Constipation
-Reflux
-Urinary retention
-Reduced peristalsis
Evidence-Based Practice Principles
Clinical Expertise
-Clinical state & circumstance
-Client Preference
-Research Evidence
Too Low (Adult BP)
<60/<40
Hypotension (Adult BP)
<90/<60
Borderline Low (Adult BP)
90/60
Low Normal (Adult BP)
110/75
Normal (Adult BP)
<120/<80
Prehypertension (Adult BP)
120-139/80-89
Hypertension Stages (Adult BP)
1: 140-159/90-99
2: 160-170/100-109
3: 180-209/110-119
4: >210/>120
Ejection Fraction (EF)
Amount of blood that the heart ejects relative to the amount that it receives
-Indicates how well the heart is pumping
-Average adult value = 60%
-<40% usually associated with systolic dysfunction or failure
-WNR with signs and symptoms of CHF = Diastolic Failure
-EF 5-10% have severe heart disease (poor endurance, SOB, LE edema)
Normal Heart Rate
60-100 bpm
Bradycardia
<60 BPM
Tachycardia
> 100 BPM
SpO2
95-100%
Abnormal SpO2
<95%
Respiratory Rate (RR)
12-20 breaths/min
Abnormal Respiratory Rate (RR)
<12 or >20 breaths/min
Mean Arterial Pressure (MAP)
70-110 mmHg
Abnormal Mean Arterial Pressure (MAP)
<65 mmHg indicates impaired perfusion of vital organs
OT as Consultant
We consult with the health care team and offer our unique perspective as OTs in order to make recommendations about where we think the next optimal level of care would be for the clients we serve