Acute Care

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Author:
gecrouch88
ID:
173074
Filename:
Acute Care
Updated:
2012-09-24 20:49:23
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acute care
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Quiz 1
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  1. What are the components of an evaluation?
    • chart review
    • patient interview
    • physical exam
    • function mobility assessment
    • functional tests
    • documentation
    • communication
  2. What goes into a chart review?
    • physicians orders
    • medical testing
    • discharge plan
    • history and physical exam
    • case management notes
    • nursing notes
    • observation vs inpatient level of care
  3. Describe a patient interview?
    • mental status
    • --alert and oriented 1, 2, 3 &4
    • past medical history
    • --comorbitities
    • --impact on current condition
    • --education needs
    • --medications
    • social history
    • --who do they live with?
    • --prior level of function
    • --are they working?
    • --stairs, rails/no rails
    • --hobbies and activities
    • --support system
    • --driving?
    • --equipment needs
  4. What is done in a physical exam?
    • observation
    • --general appearance/level of alterness
    • --posture- kyphotic, fixed/flexible, chest shape
    • --skin- color, temp, integrity
    • --lines and tubes
    • systems review
    • --integumentary - skin temp, pain, edema, pulses & where
    • --cardiovascular/pulmonary - vital signs, resp rate, SpO2
    • --musculoskeletal - ROM, strength, special tests
    • --neuromuscular - tone, reflexes, control of movement, balance, sensation
  5. What is done in a functional mobility assessment?
    • bed mobility
    • --rolling side to side
    • --bridging
    • --supine to sit
    • --sit to supine
    • --use of bed rail
    • transfers
    • --sit-stand
    • --stand pivot
    • --squat pivot
    • --bed-wheel chair
    • --chair-chair
    • --device needed? how much assistance?
    • ambulation
    • --gait deviations
    • --device
    • --functional tests
    • --type of surface
    • --stairs
    • balance
    • --simple sitting
    • --standing
    • --functional
    • --balance tests
  6. Who is it important to communicate with?
    • nurses
    • interdisciplinary
    • patients
  7. What is normal systolic blood pressure?
    <120 mmHg
  8. What is normal diastolic blood pressure?
    <80 mmHg
  9. What is prehypertensive BP?
    • Systolic: 120-139
    • Diastolic: 80-89
  10. What is considered Stage 1 Hypertension?
    • Systolic: 140-159
    • Diastolic: 90-99
  11. What is considered Stage 2 Hypertension?
    • Systolic: >160
    • Diastolic: >100
  12. What is the normal heart rate range?
    60-100 bpm
  13. What can cause a patient to have a heart rate below 60?
    • Bradycardic
    • Well-trained
    • Medications: Betablocker, digoxi
    • Conduction disturvances or frequent PVCs
    • SSS- type of bradycardia
    • Autonomic dysfunction
  14. Whatcan cause a patient to have a heart rate below 40?
    • 3rd degree heart block
    • emergent if symptomatic-- dizziness
    • poor cardiac output
  15. What can cause a patient to have a heart rate above 100?
    • normal is some people
    • dysrhythmia
    • fever
    • hypotension
    • anemia
    • medications
    • hypoxia
    • stress/pain
    • caffiene
    • dehydration
  16. What is an acute care environment?
    • place for people who need around the clock care and treatments
    • patients need a diagnosis that is severe enough to be admitted
    • --any types of surgeries, major infections in elderly, burn victims, cardiac, syncope, cancer care, ect...
  17. What are the roles of a PT in acute care rehab?
    • return patients back to independence
    • prepare for outpatient clinic
    • optimize and restore functional mobility
    • ensure safe discharge plan
    • prevent skin ulcers
    • support the team
    • patient-family education
    • maintain safe environment
    • adjunt care to medical interventions
    • --determine when appropriate
    • continual dynamic assessment
  18. What is a challenge of an acute care environment?
    work as a team with other health care professionals
  19. Who are the members of the health team?
    • MD
    • nurses
    • PT
    • OT
    • RT
    • ST
    • Registered dietician
    • Case managers
  20. What is the role of the Doctor in acute care?
    oversees care of patient and writes orders
  21. What is the role of nurses in acute care?
    • nurse practioner: can write orders
    • RN: can administer meds
    • LPN: may/may not administer meds, assit with IV set up
    • nurses aids
  22. What is the role of the Physical Therapist in acute care as apart of the health care team?
    functional mobility and chest PT
  23. What is the role of OTs  in acute care?
    • ADLs and IADLs (instrumental - cook, clean)
    • upper extremities and hand strengthening
  24. What is the role of Respirational Therapist in acute care?
    • O2 delivery decives and chest PT, vents, PFT
    • can administer prescribed nebulizer medications
  25. What is the role of the Speech Therapist in acute care?
    swollowing evaluations
  26. What are the 4 CORE construct themes?
    • 1. collect and construct medical info
    • 2. application of specialized PT knowledge
    • 3. communicate to gain info
    • 4. communicate to provide info
  27. What are the 3 encompassing construct themes?
    • 1. continual dynamic assessment - things are always changing
    • 2. professional responsibility - advocate for the patient
    • 3. complex care - anticipate the needs of the patient
  28. Who can order PT?
    • MD
    • PA
    • NP
    • Case Managers via verbal order
  29. What gets documented from the examination?
    • Exam - History, Systems Review
    • Evaluation
    • Diagnosis
    • Prognosis
    • POC
  30. What type of medical testing notes go into the chart review?
    • Lab Values
    • Diagnostic Imaging
    • Pulmonary Studies
    • Other tests
  31. What are some key things you should look for when checking a chart?
    • Change in status: orders, meds, PO status (anything by mouth)
    • always check with nursing staff
  32. What is the center of the evaluation?
    Patient's Goals!!!
  33. What is the difference in blood pressure variation from left to right arm?
    5-10 mmHg
  34. Normal exercise increases BP and how many mets?
    • 1-2 METS
    • 5-10mpp/MET
  35. What HR is too high for PT?
    130
  36. What is the normal pulse ox?
    97-99
  37. What level of pulse ox determines hypoxia?
    <90
  38. Components of good documentation?
    • functional
    • measurable
    • accurate
  39. What are some cardiopulmonary precautions?
    • PICC line/A-line
    • Mastectomy
    • Lymph removal
    • Deep vein thrombosis
    • Fistual
    • Recent Fracture
  40. How many METS and the Avg HR response from resting HR is it for  toileting?
    • 1-2 METS
    • 5-15 bpm
  41. How many METS and the Avg HR response from resting HR is it for bathing?
    • 2-3 METS
    • 10-20 bpm
  42. How many METS and the Avg HR response from resting HR is it for walking?
    • flat surface: 2-2.5 METS
    • 2 mph: 2.5-2.9 METS
    • 2.5 mph: 3-3.3 METS
    • HR ^ 5-15 bpm
  43. How many METS and the Avg HR response from resting HR is it for stair climbing?
    • 1 flight = 12 steps: 2.5 METS, HR ^ 10 bpm
    • Up 1-2 FOS: 4 METS, HR ^ 10-25 bpm
  44. How many METS and the Avg HR response from resting HR is it for UE exercises?
    • while standing: 2.6-3.1
    • HR ^ 10-20 bpm
  45. How many METS and the Avg HR response from resting HR is it for LE exercises
    • 2.5-4.5 METS
    • 15-25 bpm
  46. Define Cardiac Output
    • Stroke volume x HR
    • volume of blood pumped by the heart per minute
  47. Define stroke volume
    the volume of blooe, in mL, pumped out of the hear with each beat

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