Week One Material Flashcards
What to do if there is a fall unwitnessed and witnessed?
- Unwitnessed falls: what to do? stay with them, call for help and don’t touch them until they are assessed and okay to get up
- witnessed: If they start to fall, act quickly and supportively. Lower pt. down, get help. Be proactive with fall prevention. Document the incident (can be time consuming)
What to do for Burn
OTA must contact skilled personnel if skin is charred, missing, or blistered
•First-degree burns can initially be treated by the OTA with basic first-aid procedures
- Rinse/soak in cold water; apply sterile dressing
- No use of creams ointments, or butter, tomatoes, etc
- Incident report will be required
What to do when client is bleeding
•DON PPE
- Attempt to control bleeding
- Prevent contamination of the wound
- Place clean towel or sterile dressing over would
- Apply pressure
•Can use gloved hand if no towel is available
- Elevate
- Cleanse w/ antiseptic or water (minor bleeding)
•Encourage client to avoid using the extremity
Skin tear considerations and prevention
- DM
- Blood thinners
- Infection
Prevention:
- Elbow pad
- Stockinette
- Educate patient and caregivers/family
Insulin Glucose reaction
If low :
- Provide the patient sugar in some form (usually juice or crackers in rehab settings)
Always
- Hold therapy and notify medical staff (RN and/or MD)
Acidosis/ Ketoacidosis:
what is it?
what to do?
- Decrease in insulin, body cannot use sugar, fat is being used as fuel
- Life-threatening and requires urgent medical care;
- No form of sugar should be given
What to do if client is having a seizure?
Get help but stay with the patients.
Nothing in pt.s mouth.
Clear area and make pt. feel safe.
Wait until seizure is done while timing it and think about where and how it started
Orthostatic/Postural Hypotension what to do?
- Monitor vitals in patients with:
- cardiac conditions, neuro conditions, deconditioning, medical fragility, etc
Return patient to starting position, tap their toes.
Be prepared it happens often
- Return to sit or supine,
- If supine lower head of bed, elevate feet
- Retake BP
- Gradual tolerance of upright
- Use of tilt table in some setting if ongoing intolerance
types of hospital beds:
Precautions:
Considerations:
- Manual and/ or electrically operated bed, Air-fluidized Support Beds
- Patient and therapist body mechanics
- Side rails may be considered a restraint
- Attention to IV lines or other tubing
Think about how the bed works, alarms on beds when working with patient, bed locks.
what is Fowlers position?
can be used to:
Be aware of:
- when you bend knees a bit and put head up.
- can use it to prevent sliding down.
- Need to be aware of hip precautions or orthostatic injuries/ conditions
Pressure sores
what are they?
Where do they typically occur?
whats a way to prevent them?
Skin breakdown due to sustained pressure over a concentrated area
Sacral, ITs, elbow, heels, back of head
raise feet off bed with pillow or soft heel protector boots, encourage turning patient and weight shift to releive pressure, use specialized cusions for sitting.
IV vs. PICC
Intravenous Line= one insertion and one port
Peripherally Inserted Central Catheter = one insertion with multiple ports
What is it?
what does it treat?
What does it do?
Considerations?
- Treats blood clots
- Helps with blood flow, like a blood pressure cuff for the legs. Pushes blood out, then releases so blood fills back down. On a machine
- When working with clients make sure your mindful of the long cords. Important to remove before you move the patient.
What is it?
What does it do?
How is it useful for therapy?
Electrocardio gram
ECD, EKG
- monitors heart rate.
- Can document during
therapy what the
changes are for the
patient to help the heath care team
What is this?
Holter Monitor
type of EKG
intracranial pressure monitor (ICP)
- probe that gets stuck through the brain.
- Monitors pressure in the brain.
- Usually OT is not working with these patients
Nasogastric tube (NG tube)
- nostril to stomach
- avoid neck flexion
Gastric tube (G tube) goes directly in stomach
J Tube goes directly in jejunum
PEG
- the tube must not be disturbed or removed
Intravenous feeding (IV), total parenteral nutrition (TPN)
deliver nutrients into the subclavian vein
- disrupted connection could be life-threatening
- Make sure not twisted
Feeding devices may be administered as…
- As a bolus
- Intermittently per MD orders
- Continuous
- Kangaroo pack if available
OTA must work around the patient’s feeding schedule
Urinary Catheters:
WHat are they?
What to look out for?
Foley
removes urin from bladder
Think about tubing and placement in the bed. Make sure bag and chords are on floor as well as not in their lap or above the bladder.
Risk of infection; observe precautions and facility protocols for catheter care
Foley
Indwelling catheter for both males and females
External Female Catheter
Catheter leg bag
texas condom/ external catheter for males
Catheter precautions
- Avoid disrupting or stretching tube
- Do not put tension on tubing or catheter
- Do not allow bag to be placed above the level of the bladder for more than a few minutes
- Do not place bag in the patient’s lap when the patient is being transported
- Observe production, color, and odor of urine
- Report to RN: foul smelling, cloudy, dark or bloody urine or a reduction in flow or production
- Empty collection bag when full – USE proper PPE, ask for instruction!
Tracheostomy
Balloon that inflates and blocks air way. valve is placed below balloon that then becomes the one-way air flow. There is also a small tube-when tube is inflated balloon is inflated, when it is flat and deflated the balloon is inflated. IMPORTANT to know because if providing CPR you need to be aware of how balloon works
Passy Muir/Speaking Valve
Trach cap
Trach collar
O2 tank.
- When working with the client make sure you know what number their on before you walk in and check that it matches. If it doesn’t check with nurse immediately.
BiPAP vs CPAP
BiPAP:
- Continuous pressure
- Pressures are different between inhalation and exhalation (ie, 12/8 cm/H20)
- Not commonly used in the field or at home due to the complexity of delivery/devices
- Needs monitoring of delivered pressures
- Expensive
CPAP
- Continuous pressure
- Same pressure during exhalation and inhalation
- Used in the field and out at home
- Less complicated deviced for delivery
- Needs little monitoring
- Set it and its good
- Cheaper
- Used with snoring and stuff
Ventilator
- Used when normal respiration is decreased
- OTA must avoid disturbing or bending tubing or disconnecting a tube from the endotracheal tube
- Patient can participate in activity while monitored for signs of respiratory distress
- Client may have difficulty talking: consider this & ask simple questions
Safety Recommendations for the Clinic
- Wash hands
- Observe correct medical orders for the correct patient
- Ensure adequate space
- Ensure good visibility when transferring
- Furniture and equipment must be stable and properly stored
- Floor must have an uncluttered, nonslip surface
- Do not leave the patient unattended
- Treatment area and supplies must be prepared
- Procedures for handling and storage of hazardous materials must be followed
- Emergency exits and evacuation routes must be clearly marked
- Emergency equipment such as fire extinguishers must be easily accessible
POD #
postoperative day # (the amount of days since surgery
Spinal Laminectomy
is a type of surgery in which a surgeon removes part or all of the vertebral bone (lamina). This helps ease pressure on the spinal cord or the nerve roots that may be caused by injury, herniated disk, narrowing of the canal (spinal stenosis), or tumors.
Back Precautions
BLT
No Bending of your back. •
No Lifting/push/pull – more than 5 to10 pounds.
No twisting the back
OX3
Orientation x3
- referring to a patient who is responsive to his or her environment (alert), and knows who he or she is, where he or she is, and the approximate time.
Assist x#
Assist level, can be x1 x2 x3 etc.
THA
And precautions
Total hip arthroplasty
Anterior: no hip extension, external rotation, adduction (crossing legs)
Posterior: No hip flexion more than 90 degrees, No internal rotation, no adduction
CGA
Contact guard assist. keep contact with pt. at all times when ambualting.
A-fib
Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.
Cardiac/sternal Precautions
Don’t reach both arms overhead.
Don’t reach both arms out to the side.
Don’t reach behind your back.
Don’t lift more than 5 to 8 pounds.
Don’t push with your arms. For example, don’t push yourself up from a chair.
Don’t pull with your arms. …
Pacing wires
- In temporary cardiac pacing, wires are inserted through the chest (during heart surgery), or a large vein in the groin or neck, and are directly connected to the heart.
ORIF
Open reduction and internal fixation
type of surgery used to stabilize and heal a broken bone.
CHI
Closed head injury
- Ability to use one or both UEs to assist in pushing during sit to stand motion.
- Sufficient strength in one or both LEs to come to a standing position and pivot on one or both LEs.
- Diagnoses (examples): TKR, TKR, Generalized weakness
- Typically, the therapist provides only minimal to stand-by assistance.
What type of transfer?
Stand Pivot Transfer
- Client unable to assume a standing position.
- Concern about skin breakdown/abrasion with use of sliding board.
- Ability to place wheelchair close to surface transferring.
- Concern about maintaining equal weight bearing on both LEs.
- Need for greater assistance due to overall weakness. Assistance can be 1 or 2 persons.
- Client diagnoses are varied and can include orthopedic or neurological (PNS or CNS) conditions.
What type of transfer?
lateral transfer
- Client unable to weight bear on LEs
- Some trunk control/balance
- Need to “bridge” space
- paraplegia, quadriplegia, LE amputations, SCI
What kind of transfer?
Transfer precautions
Assessing of the DME for Bathroom Transfers
what to consider?
- Need to assess the environment and space availability
- Need to assess the patient’s or family members acceptance of the equipment.
- What is the progression of the disease process or how long is needed?
- What is critical for the patient safety & caregiver safety?
- What is are the financial status for the patient?
- What is insurance willing to cover and what is the process?
- When is the equipment needed and how can be accessed.
- What equipment is most appropriate?
Warning signs and Symptoms of Insulin-Related Illnesses: Insulin reaction
sudden onset:
skin- moist, pale
behavior- excited, agitated
breath odor- normal
breathing- normal-shallow
tounge- moist
vomiting- absent
hunger- present
thirst- absent
Warning Signs and Symptoms of Insulin-Related illnesses: Acidosis
gradual onset
skin dry, flushed
behavior, drowsy
breath odor fruity
breathing deep, labored
tounge dry
vomiting present
hunger absent
thirst present
