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25 Cards in this Set
- Front
- Back
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risk reduction |
applies to pt & caregiver
covers care systems, personnel, pt |
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care provision |
PT care must stay c scope of practice
assess referral for appropriateness - respond in a timely fashion if inappropriate
refer to other clinicians if needs fall outside scope |
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scope of practice |
varies by country / state
know it
don't violate
comply c continuing ed requirements |
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personnel management |
PT responsible for all PT care, even that done by subordinates
coordinate care c team members
careful exam of pt status, needs, responses to intervention
oversight & supervision depends on scope of license
may be responsible for training subordinates
ongoing eval & training to ensure competence & qualification
regular training in safety & emergency procedures
clarity in lines of supervision, reporting, & communication |
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policies & procedures |
vary by facility - must know those of the places you practice
scheduling, staffing, supervision record keeping infection control emergency response systems security environmental management (equipment, supplies, maintenance, cleaning) |
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physical environment |
organize & maintain treatment areas ensure that access & privacy are appropriate keep clean & neat manage linens
equipment must be properly stored & maintained
supplies must be available & accessible
eliminate structural hazards
monitor janitorial needs |
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types of adverse responses during PT |
postural hypotension falls seizures insulin rx autonomic hyperreflexia cardiac/vascular events
pt situations may be complex c multiple comoribidities these combine to affect the impact of ex |
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postural hypotension |
cardiac output reduced d/t ↓venous return insufficient reflex vasoconstriction ↓systemic BP CNS hypoperfusion
may result in diaphoresis, light-headed, syncope, dizziness, nausea
may be impacted by drugs need to learn pharmacological SE's
prevention gradual mobilization to upright, LE compression garments, LE ex prior to sitting, tilt table in order of preferred use: premobilization ex, tilt table, compression
response recumbent position,monitor VS, preventive strategies |
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Falls |
age-related ∆ in body systems around posture/gait ↑fall risk
risks age, sensory compromise, strength deficits, balance impairment, incoordination, sedation, poor attention, environmental obstacles, +h/o falls
prevention id impairments & activities, improve where possible, find accomodations for remainder educate re risk, environmental mods, using assistance/adaptation
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sensory & strength inputs to falls |
3 sensory CNS inputs control posture visual, vestibular, proprioceptive lacks in these systems result in getting inadequate/incorrect info about how body is moving
strength must be adequate & coordinated
sensory compromise+strength deficit=balance impairment |
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strategies to prevent falls |
in order of descending utility
strength & balance training if high risk group ex c fxl balance ex, tai chi, slow martial arts OT if high risk expedited cataract surgery multidisciplinary assessment comprehensive geriatric assessment |
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fall response |
don't panic stop, breathe, self-check proceed to seated position if appropriate get any needed f/u care |
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seizure |
abnormal brain activity causing transient ∆ in motor behavior/consciousness
etiology idiopathic or id'd trigger (injury/lesion to brain, SE of meds)
many different kinds of seizures could be sensory only, localized to a limb/body region |
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seizure management |
protect pt - move objects away, keep them from hitting things
respiratory status - monitor & call for help prn
prevent airway obstruction
allow post-ictal rest
help organize f/u care
If pt has known seizure disorder, discuss may not require immediate f/u care |
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insulin-related rx |
hypoglycemia≈hyperinsulinemia too much insulin in relation to food/ex
hyperglycemia/acidosis too little insulin in relation to food/ex |
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hypoglycemia sx |
sudden onset pale/moist skin excited/agitated normal breathing no vomit moist tongue hungry thirsty no glucose in urine |
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hyperglycemia sx |
gradual onset flushed/dry drowsy fruity breath odor labored breathing vomit dry tongue no hunger/thirst elevated glucose in urined |
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managing hypoglycemia v hyperglycemia |
hypo provide sugary food (juice, candy) stop activity to allow state to resolve
hyper medical emergency may be remedied by insulin or saline replacement diabetic coma/death if untreated
If you're not sure which, treat as hypo b/c it's more common & more likely to occur c PT treatment |
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autonomic hyperreflexia |
aka dysreflexia
occurs c high level SC injury - T6 or higher ANS integrated c CNS in that region
causes abnormal signaling to arterial, integmentary, vascular, organs, integumentary level muscle elements resulting in vasoconstriction
may occur in response to noxious stim e.g. bladder/bowel pressure, pressure ulcer, localized pressure
may lead to seizure, respiratory distress, LoC
sx severe HTN (most dangerous), headache, blotchy skin, piloerection |
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LoC |
loss of consciousness |
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managing hyperreflexia episode |
place pt semirecumbent relieve noxious stim (relieve bladder pressure, loosen garments) monitor VS if HTN, seek emergency care |
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cardiac events |
MI sx require emergency care 911/stat/code depending on where you are & severity of sx
angina know pattern, manage activity to avoid episodes, pt may self-medicate get help if anginal pattern is different/nonresponsive |
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stat v code |
calls that can be made inside a medical facility
stat medical emergency short of cessation of heartbeat or breathing
code medical emergency that includes cessation of heartbeat and/or breathing
call appropriately to properly prep response team |
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cerebrovascular events |
transient/permanent ∆ to motor/sensory fx unrelated to activity stroke often follows monitor medical status medical f/u required
clinical s/s of transient ischemic attack duration of s/s seconds to minutes s/s often recur c/in 24 h s/s resolve entirely c/in 24 h No LoC may affect musculature, vision, coordination, balance, gait, headache, confusion, lack of comprehension
If someone appears to be having a stroke call 911/stat treat protectively pt worked up medically intervention depends on cause early treatment may significantly reduce impact |
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stroke & FAST |
Face: drooping/numb, asymmetrical smile
Arm weakness: after lifting both arms, does 1 tend to drift downward?
Speech difficulty: slurring, correctly repeat simple sentence
Time to call 911: call emergency response, note time, call even if s/s resolve
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