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48 Cards in this Set
- Front
- Back
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body fluid loss |
d/t weight loss, diaphoresis, chronic V/D
results in electrolyte imbalance, orthostasis
cramping d/t ↓K interferes c fx of Na-K pump |
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pelvic floor rehab |
can aid c defecatory disorders involving pelvic floor soft tissue
assess during pelvic floor contract/relax for strength, tone, breathing patterns
training to relax sphincters, coordinate abd contractions, relax to avoid straining, toileting-related fxs (transfer, strength, balance) |
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ex & GI fx |
aerobic ex to correct slow-transit constipation strengthening may help
educate that avoiding activity will aggravate constipation, ↑risk of ulceration, GI bleed
Shaker head-lift to reduce dysphagia |
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referred pain patterns |
maladaptive ∆ to spinal movement & muscle contraction d/t thoracolumbar jx pain c acute ulcer back/shoulder pain c GI bleed
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Kehr's sign |
pain in left shoulder d/t free air/blood in abd cavity caused by viscus perforation, laparoscopy, splenic rupture, abd surgical procedures |
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hiatal hernia |
avoid placing pt in flat supine or Rx of ex requiring Valsalva
educate pt how to avoid increasing itraabd pressure |
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ex & GERD |
strenuous ex can induce GERD esp ex with greater body agitation (running, aerobics) inhibits emptying of SI & stomach
ex good to reduce GERD d/t ↓abd fat, thus decr abd pressure |
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GERD & positioning |
avoid flat supine after eating
nocturnal reflux lay on L side |
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esophageal cancer |
minimal aerobic ex to ↑immune fx
if lymph node ∆s detected, medical referral |
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esophageal varices |
avoid positions & Valsalva to reduce intraabd pressure & risk of rupture
be alert for hepatic encephalopathy signs stupor, lethargy, hallucination, neuromuscular dysfx, asterixis
assess sacrum & ankles for dependent edema +edema: use moisturizers rather than soaps, educate to keep skin intact |
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gastritis |
can result from long-term NSAID use
educate pt to seek ER help for hematemesis, N/V |
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peptic ulcer disease |
less likely to present c pain if older, NSAID users
monitor for symptoms assoc c bleeding pallor, activity tolerance, fatigue level, systolic < 100 mmHg, HR > 100, 10 mmHg drop in diastolic + position ∆ + ↑HR
pain may refer to back if peptic ulcer on posterior stomach wall or duodenum perforate/hemorrhage
right shoulder pain may be d/t blood in peritoneal cavity
check hx for GI symptoms hematemesis, coffee-ground vomitus, back pain relieved by antacids
for avg adult reg ex to reduce stress during remission
for competitive athlete monitor food intake, med use, performance schedule |
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gastric CA |
may manifest as epigastric or back pain possibly relieved by antacids
may be asymptomatic prior to mets
umbilical nodule or Virchow's lymph node may be palpable
post-surgery position ∆ q2h, deep breathing, coughing, incentive spirometry |
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malabsorption syndrome |
chronic D can disrupt enzymatic homeostasis establish normal eating to restore homeostasis
may present as paresthesia, muscle weakness/wasting, fatigue, weight loss, tetany, osteoporosis, bone pain, compression fracture, skeletal deformity
problematic nutrients Ca, Mg, K, vit D, protein, vit K, vit B₁₂ |
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intestinal ischemia |
angina d/t atherosclerotic ischemia
may present as intermittent back pain @ thoracolumbar jx during exertion
assess for CAD symptoms/factors |
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Foodborne illness |
medical referral if acute symmetric cranial nerve impairment, descending weakness/paralysis of extremities/trunk, respiratory muscle paralysis
recovery can take up to a year |
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IBD |
periumbicular pain d/t involvement of terminal ileum intermittent, perceived as RLQ
check hx if idiopathic pain of low back, hip, SI
concurrent c low bone mineral content, high osteoporosis prevalence
be aware of hydration/nutrition issues
pt may be susceptible to emotional stresses |
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abx-related colitis |
may present as watery diarrhea or reactive arthritis up to 1 mo after d/c abx
abx upsets normal flora
PT's often see d/t C. difficile treatment in rehab setting |
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IBS |
reg ex to relieve stress & promote bowel fx
retrain breathing if pt holding breath or hyperventilating in response to stress
positive correlation c +h/o emotional/sexual abuse |
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Diverticular disease |
reg ex during remission
avoid positions/Valsalva to prevent ↑intraabd pressure |
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adenocarcinoma of colon/rectum |
treatment depends on presentation & comorbidities
impaired posture results from adaptive shortening of abd muscles d/t pain/surgery
educate re. LE risk & prevention
mets may present as dull/vague/achy pain in sacral/lumbar regions
may need to rehab pelvic floor |
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organic obstructive disease |
PT involved in acute care after treatment
monitor for dehydration
provide movement & deep breathing to promote abd relaxation & restore bowel fx |
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hernia |
id & treat congenital muscle weakness + obesity + ↑intraabd pressure
early Dx to prevent bowel incarceration/strangulation screen if presents c chronic cough, pregnancy, pain of back/hip/groin/SI
must see physician before wearing truss inappropriate truss could ↑risk of strangulation, block lymph/venous systems, atrophy of fascial aponeurotic structures
diff dx: psoas abscess
postop: avoid straining & heavy lifting 4-6 wks |
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adynamic/paralytic ileus |
may result from anterior lumbar fusion procedures + immobility
TENS to ↓pain to encourage mobility
↑activity stims air out of bowel, restore fx |
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appendicitis |
early Dx important pain in right thigh, groin, testicular, pelvic, hip cough should produce localization of painful symptoms to site |
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peritonitis |
considerations according to cause & complications
monitor VS regularly |
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rectum |
may present as severe muscle spasm of anal sphincter resulting in pain of groin/pelvis or trigger points in pelvic floor & glutes
refer any anorectal ∆ to physician
hemorrhoid pt positioning prone & side-lying |
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hepatic disease - signs & symptoms |
medical referral if undx/untreated jaundice
avoid active/intense ex c compromised liver
may have coagulopathy |
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jaundice |
resolve in 4-6 wks after successful treatment may resume/begin ex |
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cirrhosis |
watch for signs of fluid retention: wt gain, edema blood loss: hematemesis, tarry stools, bleeding gums, nosebleeds, excessive bruising
avoid things that ↑intraabd pressure
2° to alcohol use incr N excretion reduces synth of skeletal muscle protein
ex should be light c rest periods to avoid overstressing the liver
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portal HTN |
patterns depend on assoc complications
portal pressure dynamic highs: night, after eating, response to cough/sneeze/ex
variceal bleed d/t pressure surges
teach modification/reduction of pressures avoid anything that ↑intraabd pressure |
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Hepatic encephalopathy |
low protein diet reduce fall risk
aid in prevention of pneumonia or skin breakdown
rest between activities avoid strenuous ex
immediately report anemia, ↓Hgb, weakness, dyspnea on exertion, easy fatigability, pallor, tachycardia |
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ascites |
Fowler's position for comfort
monitor for bacterial peritonitis onset of fever, chills, abd pain/tenderness
↓serum albumin levels & malnutrition risk great < 2.5 g/dl moderate 3.5 gdl
edema may mask muscle wasting may be assoc c LE edema
participate in reporting fluid intake/output |
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viral hepatitis |
IG if direct contact c blood or body fluid of HBV or HCV pt HBV vax advised enteric precautions for HAV/HEV
frequency of arthralgia as symptom increases c age unk if PT helps c athralgia
watch for signs of fluid shift orthostasis, dehydration, pneumonia, vascular problems, pressure ulcers, recurrence |
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HBV & athlete |
concern re. contagious nature no evidence that intense competitive training is harmful if asymptomatic |
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drug-related hepatotoxicity |
be alert to drug toxicity/rx in pts taking multiple meds/supplements |
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autoimmune hepatitis |
try to balance ex to prevent deconditioning against conserving energy during active liver disease |
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alcohol-related liver disease |
protect liver as c viral hep careful handwashing prior to treatment d/t ↑infection susceptibility
coagulopathy may be present |
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primary biliary cirrhosis |
bone disease c impaired osteoblastic activity & accelerated osteoclastic activity monitor Ca & D, supplement prn
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cavernous hemangioma |
if large, avoid activities/positions that ↑intraabd pressure teach proper breathing techniques |
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primary hepatocellular carcinoma |
liver tumors that elevate diaphragm may cause R shoulder pain or respiratory symptoms
PT may observe ascites or peripheral edema |
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liver abscesses |
rare for PT to see outside ICU
assess VS regularly to detect high fever + rapid pulse
promote movement, coughing & deep breathing to prevent/limit pulmonary complications |
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liver injuries |
2° trauma
common complications pulmonary infection, abscess formation
assess for signs of infection fever, chills, dyspnea
PT focused on prevention of respiratory complications |
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acute pancreatitis |
seen by PT when early presentation is back pain (may also have GI pain) acute respiratory distress syndrome (ARDS) as complication
↓spinal ext may occur d/t pancreatic inflammation/scarring
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chronic pancreatitis |
may present as back pain in upper thoracic region or pain at thoracolumbar jx
screen for +h/o of pancreatitis
note factors that aggravate/relieve |
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pancreatic CA |
may present as vague back pain Virchow's node if mets
may cause intractable back pain |
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cholelithiasis |
30 min endurance training 5 x wk recommended to prevent symptoms
post-surg PA & activity as tolerated heating pad to abd
typical postop exercises |
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choledocholithiasis |
922 |
