Unit 2: Acute Care Flashcards by Lexi Vitale

Why do clients come to acute care?

-Injury
-Exacerbation of an existing condition
-New onset of an illness
-Accident

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Acute Care

General hospital setting that treats all populations who experience: Injury, Exacerbation of an existing condition, New onset of an illness, Accident

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Typical Acute Care Trajectory

ER Physician > Tests > Admitted > Floor

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Acute Care Structure

From emergency room may go to:
-General Medical
-Specialty Floor
-Intensive Care
-Surgery

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Typical Layout

-Cardiology
-Medicine
-Maternity
-Surgical
-Peds
-Lab and Dia
-Emergecy

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Specialty Departments in Acute Care

-ICU
-Oncology
-Vascular
-Nicu
-Other

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Acute Care Patients are treated by

-Primary Doctors
-Consults
-Specialists

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Length of Stay (Acute Care)

3-5 days

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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

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OT Role (Acute Care)

-Varied
-Educator
-Consultant
-Rehab specialist

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OT as Educator

-Environmental or personal adaptations to increase ADLs/IADLs
-Precautions/Contraindications
-Safe transfers
-Educate medical terms/family members

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OT as Rehab Specialist

-ADL/IADL training
-Therapeutic Activities/Exercises
-Cognitive Rehab
-Perceptual Remediation
-Other types of OT intervention

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Effects of Immobility on systems

-Musculoskeletal
-Cardiovascular
Respiratory
-Metabolic/Endocrine
-Integumentary
-Neurological-Psychological
-Gastrointestinal-Urological

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Musculoskeletal (Effects of Immobility on systems)

-Weakness
-Muscle and joint contracture
-Osteoporosis
-Exercise intolerance

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Cardiovascular (Effects of Immobility on systems)

-Deconditioning
-Orthostatic hypotension
-Increased risk for thrombus formation

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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