Week 1 Session 1 - PPT: Medical Issues Flashcards
Define Dyspnea
Describes a condition where a person is
short of breath or having difficulty breathing (feeling
out of breath, labored breathing, air hunger)
What is the Dyspnea Index?
One measure of shortness of breath
for determining exertion levels
How is the Dyspnea Index test conducted?
Take a deep breath in and count to 15.
Match the Dyspnea Index with the correct description.
Level 0 _____
Level 1 _____
Level 2 _____
Level 3 _____
Level 4 _____
A. No shortness of breath; can count to 15 (takes about 8 seconds) without taking a breath in the sequence.
B. Mild shortness of breath; can count to 15 but must take one short breath in the
sequence.
C. Moderate shortness of breath; need to take 2 breaths to count to 15 in the sequence.
D. Definite shortness of breath; must take three breaths in the sequence of counting to 15. Reduce the level of intensity and use breathing control techniques.
E. Severe shortness of breath; unable to count or speak. Stop the activity immediately!
Level 0 = A
No shortness of breath; can count to 15 (takes about 8 seconds) without taking a breath in the sequence.
Level 1 = B
Mild shortness of breath; can count to 15 but must take one short breath in the
sequence.
Level 2 = C
Moderate shortness of breath; need to take 2 breaths to count to 15 in the sequence.
Level 3 = D
Definite shortness of breath; must take three breaths in the sequence of counting to 15. Reduce the level of intensity and use breathing control techniques.
Level 4 = E
Severe shortness of breath; unable to count or speak. Stop the activity immediately!
What is considered the norm for blood pressure?
A. 120/60 mm HG
B. 140/80 mm HG
C. 120/80 mm HG
D. 100/60 mm HG
C. 120/80 mm HG
What range of blood pressure is considered hypertension?
140/90 mm HG or higher
What range of blood pressure is considered prehypertension?
120-139/80-89 mm HG
Blood pressure norms for children vary based on gender, age, and height.
True
False
True
What is orthostatic hypotension and what are some symptoms?
Also called postural hypotension — is a form of low blood pressure that happens when standing after sitting or lying down. Orthostatic hypotension can cause dizziness or lightheadedness and possibly fainting.
What is considered the norm for heart rate for adults?
A. 80 - 120 BPM
B. 70 - 110 BPM
C. 60 - 105 BPM
D. 60 - 100 BPM
D. 60 - 100 BPM
What is tachycardia and what is the range for an adult to be considered to have tachycardia?
An increased heart rate for any reason. If a fast heart rate is caused by exercise or stress, it’s called sinus tachycardia. Sinus tachycardia is a symptom, not a condition.
A heart rate greater that 100 BPM is considered tachycardia.
What is bradycardia and what is the range for an adult to be considered to have bradycardia?
A slower than normal heart rate. A heart rate less than 60 BPM is considered to have bradycardia.
What is the normal range for oxygen saturation for PaO2?
Between 75 - 100 mm HG at sea level.
What is deep vein thrombosis (DVT) and where is it most common?
A blood clot that forms in the vein deep in the body.
It is most common in the leg and pelvis, and less common in the UE.
Why is DVT dangerous?
Because it the blood clot can break off and travel to the lungs and cause a pulmonary embolism (PE).
What are risk factors to DVT?
Immobilization
Postoperative state
Cardiac disease
Older than 40
Obesity
Coagulation disorders
What are symptoms to DVT?
Redness
Swelling
Pain
Tenderness
*If in the leg, usually behind the knee or calf.
*Some people have no symptoms.
How does one diagnose DVT?
Doppler Ultrasound
As an OT, what do you do if you see a patient with symptoms of DVT?
- If symptoms, tell nurse and do not treat patient
- Patient will be sent for tests to confirm.
- If confirmed, will be placed on blood thinner (ex. heparin,
coumadin, warfarin) - Do not treat patient until on therapeutic dose and cleared
- Prothrombin time is a test to evaluate blood clotting
- Measure the amount of time
- International Normalized Ratio (INR)- allows for
easier comparison from different labs
- Normal is 2 to 3, but may vary per person - After stroke (if not hemorrhagic), some patients are placed on DVT prophylaxis to prevent DVT.
What are the STANDARD PRECAUTIONS?
- Washing hands: alcohol-based hand soap is more effective than soap and water
- Personal Protective Equipment (PPE):
i. gloves
ii. gown
iii. mask
iv. goggles/eye shields - Prevention of injury
When are CONTACT ISOLATION PRECAUTIONS used, and what are some examples?
Used for patients with known or suspected illness easily transmitted by direct patient contact or by indirect contact with objects in the environment.
Examples:
- Gastrointestinal
- Skin infection
- Wound infections
- Multi-drug resistant organisms (MDROs) including Methicillin-resistant Staphylococcus aureus (MRSA)
What are 3 interventions used for contact isolation?
- Glove & Gown: Don before entering the room & remove before leaving the room and observe hand hygiene.
- Washing hands: (hand gel or washing hands)
- Equipment: Use disposable equipment if possible or implement patient-dedicated
equipment. If shared equipment clean and disinfect it before use with another
patient. Use approved EPA disinfectant. Bleach wipes for C-Diff
When are DROPLET ISOLATION PRECAUTIONS used and what are some examples?
Used for infections transmitted by large respiratory droplets that travel short distances and do not remain in the air for long periods. Usually generated by a sneeze, cough, or talking.
Examples:
- Influenza
- Pneumonia
- Neisseria meningitis
- Mumps
- COVID-19
What are interventions used for DROPLET ISOLATION PRECAUTIONS?
- Meet patient in single room
- Surgical mask (a must)
- Eye protection (plus may use gowns and gloves)
When do you use RESPIRATORY/AIRBORNE ISOLATION PRECAUTIONS and what are some examples?
Used for infections transmitted by airborne droplets. These particles can be in the air for long periods and travel long distances.
Examples:
- Tuberculosis (TB),
- Smallpox
- Measles
- Chickenpox
- Severe Acute Respiratory Syndrome (SARS)
- Disseminated herpes zoster
What interventions can be used for RESPIRATORY/AIRBORNE ISOLATION?
- See patient in a single room with negative pressure: airborne infection isolation room (AIIR)
- Staff and visitors are required to wear a fit-tested NIOSH N-95 Respirator (surgical masks not sufficient)
What are COVID-19 PRECAUTIONS?
- Contact & Droplet
- Wash hands, avoid touching face
- Gowns, gloves, N-95 masks, surgical mask, face shield and/or goggles
- Tend to wear head coverings (scrub caps or surgical bouffants)
What are the steps to don PPE?
Before donning PPE, wash your hands.
Don PPE before entering the patient care area.
- Don gown
- Don mask/respirator; do not use a respirator if the seal is not working.
- Don goggles or face shield
- Wash hands
- Don gloves; cuff of gloves should go over the sleeves of the gown.
https://www.youtube.com/watch?v=iwvnA_b9Q8Y&t=264s
What are the steps to doff PPE?
Doff PPE in the patient care area.
- Remove gloves
- Remove gown
- Wash hands
- Remove goggles/face shield
- Remove mask/respirator (remove respirator outside of patient care area).
https://www.youtube.com/watch?v=iwvnA_b9Q8Y&t=264s
