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Neuromuscular (KK) > Vital Signs and Lab Values for Early Mobilization > Flashcards

Vital Signs and Lab Values for Early Mobilization Flashcards

1
Q

What is our role at a PT?

A

prevent decline with early mobilization

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2
Q

Delayed treatment with neurologic patients can lead to barriers in recovery time and compensation: _________ neuroplasticity principle

A

time matters

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3
Q

Cardiovascular systems review

A

HR, RR, and BP
Temp
Pulse Oximetry (O2)
Pain

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4
Q

Heart rate/ pulse
def:
normal values:

A

movement of blood in an artery
Adult: 60 to 100 BPM

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5
Q

Blood Pressure (BP) normal values:

A

120/80 mm Hg

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6
Q

Acute Hypertensive Crisis is an URGENT referral. T or F

A

false: Emergency

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7
Q

Another name for positional or postural hypotension

A

orthostatic hypotension

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8
Q

Orthostatic Hypotension:

A

form of low blood pressure that happens when you stand up from sitting, sit up from lying down

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9
Q

what is the therapeutic window?

A

spontaneous recovery and neuroplasticity have been shown greatest in patients 3-6 months post stroke

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10
Q

start with ______ intensity early

A

light

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11
Q

what are 3 clinical signs of orthostatic hypotension?

A
  • systolic decrease/drop of 20 mmHg
  • diastolic decrease/drop of 10 mmHg
  • within 3 min of positional change
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12
Q

hold therapy if MAP is ______ due to?

A

< 60
inadequate tissue perfusion

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13
Q

one respiration =

A

one inspiration and one exhalation

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14
Q

normal RR

A

12-18 respirations a minute

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15
Q

terms related to observation of respiration:
- number of breaths per minute ______
- volume of air exchanged with each respiration ______
- regularity of pattern _____
- deviations from normal ______

A
  • rate
  • depth
  • rhythm
  • character
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16
Q

normal body temp

A

96.8-99.3 F

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17
Q

pulse ox measures _____
normal value?

A

blood oxygen levels, monitors pulse rate, and calculates HR

95-100%

18
Q

what is the most reliable indicator of pain?

A

self-report of pain
(subjective)

19
Q

what are signs of high ICP? do you mobilize when high?

A

headache, vomiting, secondary cell death
no

20
Q

what is normal ICP? severe?

A

4-15 (20) mmHg
>40

21
Q

if hemoglobin is ______ don’t ambulate

A

under 8

22
Q

what percentage of hematocrit is unsafe to ambulate pt?

A

<25%

23
Q

when do you hold therapy with abnormal INR?

A

5.0-6.0 (if too high)

24
Q

if the patient’s vitals are out of normal values do you automatically defer treatment?

A

no
consider other factors, meds, trend over 24 hours
ask! - clinic policy, patient’s feelings, nurse/MD opinion

25
Q

how can we address the challenges that neuro patients present?

A

develop standardized protocols
monitor patients individually

26
Q

what are mobility goals for your patient?

A

get upright
base them on level of function needed for independence
based off diagnosis - what is realistic for this pt

27
Q

what is an arterial catheter and why must we as PTs be aware of this?

A

goes directly into an artery to measure BP
when moving pt, if it gets pulled there will be heavy bleeding and physician will have to come to replace it

28
Q

if an art line is placed in the wrist, what may that limit?
femoral artery?

A

wrist: limits UE use of AD
femoral: limits hip flexion (not past 60-80) and ability to sit

29
Q

what is a bolt drain? what must you consider when wanting to move a pt with a bolt drain?

A

allows for real time measurement of ICP
hole drilled into skull to measure subarachnoid pressure

pt with a bolt is usually too sick to mobilize –> consider PROM & monitor ICP carefully

30
Q

what is an external ventricular drain (EVD)?
what must you consider when wanting to move a pt with an EVD?

A

measures ICP, drains CSF

EVDs are calibrated to pt head position –> consult with team before mobilizing

31
Q

central venous catheters (central line) and peripherally inserted central catheter (PICC) are used in __?

A

delivering medication directly into circulatory system

32
Q

what must you consider when wanting to move a pt with a central line or PICC line?

A

they insert into the heart –> DO NOT pull them
may cause arrythmias and pneumothorax
if pulled, medication delivery becomes very difficult

33
Q

who are ventilators used for? if on a vent for more than _______ days, pts get a tracheostomy

A

patients who cannot adequately breath on their own
14-21 days

34
Q

what should you consider when wanting to move a pt on a vent?

A

vents are not very portable –> if ambulating, call RT
high likelihood of desaturation (watch SpO2) and high risk of barotrauma
consider buffer room before moving as there is a risk for other complications

35
Q

what is a high flow nasal cannula and what should you consider when wanting to move this pt?

A

way to deliver high amounts of oxygen without needing to intubate

consider how much they can go up on their oxygen –> if at max it could tax the cardiopulm system and if you push them too hard the next step is intubation

36
Q

what is a fecal management system? what is a foley catheter?

A

collects fecal matter into a bag
urine collection
* both are gravity dependent

37
Q

what needs to be taken into consideration when moving a patient with a FMS bag or catheter?

A

easy to pull and messy and painful if pulled
gravity dependent –> keep below waistline

38
Q

two types of feeding tubes are nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG).
describe where each is placed and if they are short or long term solutions?

A

NG:
through nose to stomach. short term solution

PEG:
directly into abdomen. long term solution. *be cautious w/ gait belts

39
Q

what must you consider when working with a pt who has a feeding tube?

A

they are likely NPO –> do NOT give food or water, they may aspirate
easy to pull
consider malnutrition/weightloss

40
Q

what are 3 telemetry units and their considerations for moving?

A

VS, BP cuffs, pulse ox
may get noise so double check findings
look for changes in response to exercise
portable –> can be unplugged

Neuromuscular (KK) (21 decks)

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