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PTA > Unit 2 Study guide > Flashcards

Unit 2 Study guide Flashcards

1
Q

Principles of Documentation

A
  1. Doc every encounter
  2. Comply w/regulatory reqs
    Id of pt and PT, PTA, SPTA where permitted
  3. Pt full name and ID# on all official docs
  4. Indicate referral source
  5. Dated and signed
  6. Objective statements
  7. Complete statements
  8. Continuity w/progress notes
  9. At home plans should be well documented
  10. Informed consent
  11. Prompt and timely w entries
  12. Standardized abbreviations
  13. No empty lines/open spaces
  14. Outline before writing
  15. Properly countersign
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2
Q

4 sections of SOAP

A

S: subjective. Info from interview from pt, family, caregiver
O: information gathered from intervention.
A: of pt during and after treatment. Used to determine reimbursement. Include STOs.
P: what treatment is planned and its progression

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3
Q

Differentiate between initial note, progress note, and discharge note

A
  • Initial: done by PT or other medical personnel.
  • Progress (interim): written periodically. Includes daily visits, interventions, and reassessments. 3rd party payers require progress notes after every tx.
  • Discharge note: written when tx is discontinued. Gives results of final exam and eval, goals achieved, and a summary of the intervention. Will give a recommendation by provider or d/c plan.
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4
Q

Principles of documentation

3 most important

A

Accuracy: true; objective, correct spelling and grammar.
Brevity: concise, to the point, no room for doubt.
Clarity: clear meaning, don’t shift tenses, legible.

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5
Q

Pt has good rehab potential

A

Assessment

Professional opinion

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6
Q

Hip clearing reproduces pain (L) knee

A

Objective

What PTA observed in tx

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7
Q

GT with crutches, 10% PWB RLE for 50 ft x2 w/min A x1

A

Objective

What was done in tx

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8
Q

Will initiate OT post-op per critical pathway.

A

Plan

(Look for will) something that needs to be done

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9
Q

States Hx of COPD since 2015

A

Objective

Look for reports, states, complains

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10
Q

Pt was difficult to assess due to lack of cooperation as demonstrated by closing his eyes and crossing arms when given a command.

A

Assessment

Says assess in it

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11
Q

Will be seen by PT as an OP beginning 3x/wk & progressing prn

A

Plan

Will

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12
Q

Past experience of PT for low back pain wo relief

A

Subjective

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13
Q

Rx this date: training in w/c propulsion & management, transfer training sliding board w/c mat & sitsupine. Pt required two rest breaks to complete all the activities.

A

Objective

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14
Q

Pt will demonstrate normal gait pattern within 2 wks to enable her to Amb for functional distances.

A

Assessment

STO

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15
Q

Pt reports pain (L) ankle while putting limited weight on LLE

A

Subjective

Pt. reported

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16
Q

Strength: 1/5 in (R) lower trapezius. (Ms strength is on a scale of 0-5)

A

Objective

Muscle tests, what was observed during tx

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17
Q

Talk to PT about progressing AROM exercises to PRE

A

Plan

What needs to be done, discussed

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18
Q

Inc AROM (R) shoulder to WNL writhing 2 wks to enable pt to reach items in overhead cabinets

A

Assessment

STO

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19
Q

Will inquire if Pt can be referred to a dietician

A

Plan

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20
Q

Pulsed US underwater at 1.5 W/cm2 to (R) wrist

A

Objective

What was done during tx

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21
Q

Pt will be (I) in donning/doffing prosthesis within 1 wk in order to stand

A

Assessment

STO

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22
Q

Pt states she lives w/husband in her own home

A

Subjective

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23
Q

Provide instruction to the pt in W/c management and propulsion

A

Plan

Needs to be done

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24
Q

Pt states he would like to return home with his wife following d/c

A

Subjective

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25
Q

Pt will perform lateral sitting transfer independently by next treatment in order to be independent in toileting

A

Assessment

Sto

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26
Q

Pt reported pain 6/10 pre-treatment and 4/10 post treatment

A

Subjective

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27
Q

Pt transferred from wc to mat with min a of one

A

Objective

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28
Q

Increased foot clearance during gait is due to improved LE strength.

A

Assessment

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29
Q

Baseline measurement such as Goni and MMt will always be included in:

A

Initial eval

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30
Q

Where do goals go in SOap

A

Assessment

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31
Q

To assist pt up in bed, PTA should position themselves

A

On patient’s affected side

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32
Q

PTA must have supervising PT approve and co-sign note?

A

No false

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33
Q

When segmentally moving pt in bed it’s important to begin with lower torso

A

False, begin at head

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34
Q

In a standing transfer the wc is generally placed

A

Parallel to bed

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35
Q

When operating a mechanical lift the patients buttocks should

A

Just barely clear the bed

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36
Q

When transferring a patient from bed to wc, the wc should be placed on the patients

A

Uninvolved/unaffected side

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37
Q

What transfer would you teach a pt who had an sci with paraplegia just 3 days ago.

A

Since pt has use of UEs, lateral sitting transfer with SB

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38
Q

If a pt is providing 50-75% of the work, how would you document assistance level?

A

Mod assist

39
Q

To perform any lateral transfer w a SB your wc must have

A

Removable armrests

40
Q

Physical requirement for lateral transfer w/o SB is UE strength

A

True

41
Q

Functional outcome

A

Something pt will be able to do. To eat meal w family, to return to work, clear foot during gait

42
Q

3 principles

Accuracy

A

True; objective; correct spelling and grammar

43
Q

3 principles:

Brevity

A

Clear; concise. Give enough info to leave no doubt

44
Q

3 principles:

Clarity

A

Meaning is immediately clear to reader
Don’t shift tenses
Legible handwriting

45
Q

Identify content of POMR

A

Database: current/past info about pt
Problem List: problems treated by various practitioners
Identification of specific treatment plan by each provider on the case.
Assessment of effectiveness of treatment plan across time.

46
Q

Identify between 4 sections of physical therapy note

A

S: subjective-information gathered from Pt during interview.
O: objective-information gathered during the intervention
A: assessment of pt during and after treatment. Used for reimbursement. Includes STOs
P: plan-what treatment is planned and its progression

47
Q

Long term goal

A
  • Correspond to problem list.
  • States final status to be achieved by therapy.
  • Written for extended time frames
  • Help plan the treatment and guide the POC.
48
Q

Short term goal

A
  • Intermediate steps that lead to the LTG
  • Task analysis
  • Written in shorter time frames, 1-2 wks and direct treatment to specific needs and problems
49
Q

6 criteria necessary to write an STO.

A
  • Audience: who will exhibit the skill
  • Behavior: what is the activity
  • Condition: circumstances involved w behavior
  • Degree: measurable portion
  • Expected time: time to reach goal
  • Function: what should they be able to do when goal is met
50
Q

4 reasons to write goals

A
  • Prioritize treatment
  • Measure effectiveness of treatment
  • Used to monitor cost-effectiveness
  • Communication with other health professionals
51
Q

Define teaching

A

To impart knowledge, skill or instruction. The act, practice or profession of a teacher; something taught, especially doctrine.

52
Q

Define learning

A

The acquisition of knowledge or skills through experience, study, or by being taught.

53
Q

Cognitive style

A

Preferred way an individual processes information. Styles describe a persons’s typical mode of thinking, remembering, or problem solving.

54
Q

Learning style

A

Specifically deals with characteristics styles of learning and seem to be useful in terms of creating teacher awareness of individual differences in learning.

55
Q

Transfer of learning

A

The ability to apply something learned in one situation to another setting. Defined operationally as improved performance on one task as a result of something acquired on a previous task.

56
Q

Pedagogy

A

Method and practice of teaching, especially as an academic subject or theoretical concept.

57
Q

Principles of pedagogy

A

Learning is:
•dependent upon capacities of the learner.
•A function of conditions of practice imposed.
•easily mastered when meaningful
•transfer is dependent upon similarities between tasks/work methods that can be applied
•Related to aspiration and experience
•Related to quality of motivation
•active participation is better than passive learning
•meaningful is more effective than rote memory.

58
Q

Define androgogy

A

Method and practice of teaching adults

59
Q

Principles of androgogy

A

Adults are:
•autonomous and self-directed
•bring established beliefs, values, opinions into learning environment
•goal oriented
•prefer relevant topics
•learn from mistakes but can be overly sensitive to failure
•like practical information
•favor different learning settings
•learn best when they succeed
•monitor own progress
•when what they learn is customized for them
•problem-centered in approaching learning

60
Q

Extrovert

A

Try things out; focus on outer world

61
Q

Introvert

A

Think things through; focus on world of ideas

62
Q

Sensors

A

Practical; detail oriented; focus on facts and procedures

63
Q

Intuitors

A

Imaginative, concept oriented, focus on meanings and possibilities

64
Q

Thinkers

A

Skeptical; tend to make decisions based on logic and rules

65
Q

Feelers

A

Appreciative; tend to make decisions based on personal and human considerations

66
Q

Judgers

A

Set and follow agendas; seek closure even with incomplete data

67
Q

Perceivers

A

Adapt to changing circumstances; resist closure to obtain more data

68
Q

Felder-Silverman Style Model

A 
Classifies students as:
•Sensing/intuitive learners
•visual/verbal 
•Indicative/Deductive
•sequential/global
69
Q

Sensing/Intuitive

A
  • concrete, practical, oriented towards facts and procedures

* conceptual, innovative, oriented toward theories and meanings

70
Q

Visual/Verbal

A
  • prefer visual representations of presented material (pictures diagrams flow charts)
  • prefer written/spoken explanations
71
Q

Inductive/deductive

A
  • prefer presentations that proceed from specific to general

* prefer presentations that go from general to specific

72
Q

Active/reflective

A
  • learn by trying, working w others

* learn by thinking things through, working alone

73
Q

Sequential/global

A
  • linear, orderly, learn in small steps

* holistic, systems learners, learn I large leaps

74
Q

Kolb’s learning style model

A

Students have a preference for concrete experience or abstract conceptualization (how they take information in)
Active experimentation or reflective observation (how they internalize information)

75
Q

Divergers

A

Why?
Explain how material related to their experience, interests, and future careers.
Instructor should be motivator
Strength: imaginative ability
Humanities/liberal arts, counsellors, developmental consultants, personnel managers

76
Q

Assimilators

A 
What?
Info presented in logical, organized fashion with time for reflection
Instructor should be expert
Strength: create theoretical models
Basic sciences and math
77
Q

Convergers

A

How?
Work actively on well defined tasks. Trail and error and room to fail safely.
Instructor: coach, guided practice/feedback.
Strength: practical application of ideas
Physical sciences/engineering

78
Q

Accommodators

A

What if?
Applying course material in new situations to solve real problems.
Instructor: stay out of the way.
Strength: doing things, carrying out plans, experiments.
Risk takers, more than other 3
Technical or practical oriented jobs, marketing/sales

79
Q

Herman brain dominance

A

Classified students in terms of their relative preference for thinking in 4 modes based on task-specialized functioning of the physical brain.

80
Q

Quadrant A

Left brain, cerebral

A

Logical, analytical, quantitative, factual, critical

81
Q

Quadrant B

Left brain, limbic

A

Sequential, organized, planned, detailed, structured.

82
Q

Quadrant C

Right brain, limbic

A

Emotional, interpersonal, sensory, kinesthetic, symbolic

83
Q

Quadrant D

Right brain, cerebral

A

Visual, holistic, innovative

84
Q

Multiple intelligence model

A

States there are 7 different ways of learning anything and are 7 intelligences.

85
Q

7 intelligences

A
  1. Body/kinesthetic
  2. Interpersonal
  3. Intra-personal
  4. Logical/mathematical
  5. Musical/rhythmic
  6. Verbal/linguistic
  7. Visual/spatial
86
Q

4 steps for effective instruction

A
  1. Preparation of learner
  2. Activity presentation
  3. Try out activity performance
  4. Follow up
87
Q

Preparation of learner

A
  • Build a rapport
  • determine learners starting point
  • make sure learner knows goal/objective.
  • establish a learning environment
88
Q

Activity presentation

A
  • Clear oral instructions
  • Demo provided
  • Go step by step
89
Q

Try out activity performance

A
  • Allow learner to attempt task step by step.
  • correct errors as they occur
  • have learner explain the process
  • repeat activity to develop motor skill.
90
Q

Follow up

A
  • Allow pt to work independently
  • Assign a mentor
  • check progress frequently
91
Q

Strategies designed to foster adherence to an exercise program

A
  • consider beliefs about exercising
  • help identify benefits to sticking to exercise program
  • explain rationale of each exercise/functional activity
  • explain how specific exercises are designed to meet goals
  • let pt have input. Selection, scheduling, and progression
  • keep it brief
  • ways to do exercise during every day tasks
  • follow up to review/modify
  • point out exercise related progress
  • identify barriers/suggest solutions.
92
Q

Define communication and its components

A 
Exchange of ideas or information
•messenger
Message
Receiver
Feedback loop
93
Q

Identify at least 5 ways to increase effectiveness of communication skills

A
  1. Reduce noise
  2. Get feedback
  3. Listen effectively
  4. Restate
  5. Be aware of body language

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