Occupational Therapy Acute Care – Flashcards
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hemoglobin/hematocrit
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If a patient has a low value, exercise tolerance can be low and vitals should be closely monitored. A significant drop from one day to another may indicate bleeding.
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platelet count
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Hemorrhage can occur with low values. Be careful not to let the patient fall when performing ADLs. Don't "over-guard" when using a gait belt. This is used commonly especially with cancer patients.
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blood glucose
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If the values are ;70 and the patient is an insulin dependent diabetic, they may be having an insulin reaction. Further exercise would make this condition worse.
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white blood cell count
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May be a sign of infection if values are high. With low values, the patient may need a mask if outside of their room.
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troponin 1
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Test if for diagnosing an MI. When greater than 1.4 it is considered positive.
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BUN/creatinine
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If these values are elevated, it can be a sign of decreased kidney function. The patient may display mental status changes or lethargy.
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INR
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Hemorrhage/bleeding can occur with high values. Check with MD about a value of greater than or equal to 4.
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Xanax
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Medication used to manage anxiety
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Methylprednisone
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Medication to treat inflammation of myelin sheath associated with acute exacerbation of MS
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Nitroglycerin
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Vasodilator medication
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Albuterol
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Medication that stimulates the beta-2 adrenergic receptors of smooth muscle causing bronchial dilation to open the airways but can cause tachycardia
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Prednisone
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Corticosteroid used to relieve inflammation in the body
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Sinemet
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Medication used with Parkinson patients
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Levophed
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Medication used for "critical hypotension" to improve survival in those in septic shock. And, because of the increased peripheral vascular resistance, can cause limb ischemia/death
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Beta-blockers
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Medication used often for treatment of hypertension. May see a "blunted" HR and BP response to activity
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Morphine
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Medication used to control pain
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Methotrexate
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Chemotherapy drug
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Digoxin
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Medication that increases the force of myocardial contraction to more effectively empty the ventricles
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Lasix
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Diuretic
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Prozac
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Antidepressant medication
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Baclofen
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Medication for relief of muscle spasms
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Heparin/Coumadin/Lovenox
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Medications to decrease the blood clotting ability and helps to prevent the development of clots
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Purpose of Arterial Line (A-Line)
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Constant blood pressure, can draw arterial blood gas
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Purpose of epidural/PCA pump
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Pain control, patient administered opioid solution
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Purpose of chest tubes
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removes air, fluid, or pus from inter thoracic space
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What is the normal respiratory rate for an adult and how should you calculate it?
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12-20 breathes per minute, place hand on chest for 1 minute and count
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What is the normal heart rate for an adult and how do you calculate it?
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60-100 beats per minute, place 2 fingers on radial artery and county for 1 minute
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What is a normal SpO2 level and how low do you let it go?
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95-100%, under 88% is too low
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% of oxygen delivered by room air
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21%
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% of oxygen delivered by nasal cannula
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1L - 24%, 2L - 28%, 3L - 32%
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% of oxygen delivered by high flow nasal cannula
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6L - 44%
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% of oxygen delivered by face mask
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35-55%
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% of oxygen delivered by oxymizer
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93%
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% of oxygen delivered by non-rebreather
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6L - 60%, 7L - 70%, 8L - 80%, 9L - 90%, 10L - 100%
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% of oxygen delivered by ambu bag
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75%
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What is an appropriate blood pressure and heart rate response to exercise?
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BP - systolic 7-10, diastolic +/- 10 HR - 20-30 beats per minute
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What muscle groups tend to be weak in the COPD population? What exercises should be considered to help correct this?
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Diaphragm, thoracic muscles - pectoralis stretches, strengthen hips and shoulders
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A patient with COPD is having difficult breathing after exercise. What is the typical position that makes it easier for them to breathe?
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Sitting upright or sidling to reduce tension in throat
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Name 2 things a patient with CHF may report during exercise that is a sign the patient is working too hard.
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Shortness of breath, chest pain
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What are 2 things that the therapist should assess when exercising patients with CHF?
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respiratory rate, blood pressure
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What HR/BP response should a patient s/p heart transplant exhibit?
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Normal vitals - 60-100bpm HR, 120/80 BP
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What is the weight limit of a regular walker?
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300 pounds
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What is the weight limit of a typical bariatric walker?
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750 pounds
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What are typical co-morbidities of the obese population?
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high blood pressure, tissue inflammation, diabetes, heart disease, depression, osteoarthritis, lymphedema, immobility, sleep apnea
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When you are working on bathing tasks, what is important to teach patients regarding skin fold care?
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Clean under skin folds, dry thoroughly, keep dry, educate on mirror use
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What are 2 adaptive strategies used during dressing/toileting that can be used with the obese population?
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Implement reacher or toilet aid
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Why are obese patients susceptible to dehiscence of the incision?
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Decreased blood supply to incision area secondary to the fat cells healing slower than typical cells
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In what position do obese patients have trouble breathing?
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supine
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What is BMI and what is the % needed to be morbidly obese?
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Body mass index, assessment of total body fat. 40%
