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NBCOT LAST Attempt > vitals, precautions, inpatient > Flashcards

vitals, precautions, inpatient Flashcards

1
Q

standard precautions purpose

A

prevent spread of infection

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2
Q

standard precautions include

A
  1. hand hygiene
  2. wearing gloves, gown, protective eyewear, PPE with body fluids
  3. bandage to minor cuts/skin lesions
  4. proper handling/disposing of sharp objects
  5. routine cleaning/disinfecting environmental surfaces/equipment before & after patient interaction
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3
Q

what is the purpose of infection control?

A

to minimize/prevent nosocomial infections & spread of health-related diseases

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4
Q

what does infection control include?

A

hand hygiene, isolation systems, sterilization

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5
Q

what is the purpose of hand hygiene?

A

infection control to prevent spread of germs & infection through washing hands when visibly dirty and using alcohol-based sanitizer when not visibly dirty

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6
Q

what is used in conjunction with standard precautions?

A

airborne and droplet precautions

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7
Q

what is the purpose of airborne precautions?

A

transmission-based infection control method to prevent transmission of disease/infection spread via particles

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8
Q

what do airborne precautions include?

A

N95 mask/respirator, intervention in isolation room, equipment only for single-patient use (or can be disinfected)

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9
Q

what is the purpose of droplet precautions?

A

transmission based infection control method to prevent spread of disease/infection via droplets

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10
Q

what is included with droplet precautions?

A

mask, intervention in patient’s room, single use patient equipment (or can be disinfected)

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11
Q

what are universal precautions?

A

assume everything is infectious
- also for emergent phase of burns

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12
Q

basic first aid for bleeding

A
  • assess situation, wash hands/donn gloves
  • clean/sterile dressing over wound
  • apply direct pressure
  • elevate wound surface above heart
  • tell patient not to move wounded extremity
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13
Q

fire safety

A

RACE
Rescue
Alarm
Contain
Extinguish/Evacuate

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14
Q

total parenternal nutrition (TPN)

A

infusion of nutrients via catheter inserted into vein when oral feeding not possible
- avoid occluding/dislodging catheter
- ensure connections intact before/after tx

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15
Q

arterial monitoring line (A line)

A

catheter placed in artery to continuously measure blood pressure or draw blood
- follow patient-specific artery precautions
- avoid occluding/dislodging catheter

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16
Q

pulmonary artery catheter (PAC)

A
  • long IV tube placed in central vein (jugular, subclavian, femoral)
  • connected into R pulmonary artery to measure changes due to medication, stress, activity
  • Avoid occluding/dislodging tubing
  • Avoid ROM near tubing
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17
Q

feeding pump

A

Device that provides nutrients at constant flow to patients unable to ingest, chew, swallow food
- Avoid stress/tension at insertion site
- Respond to alarm, indicating system empty or turned off

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18
Q

intracranial pressure

A

measures pressure inside skull
- normal: below 20 mmHG (client specific)

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19
Q

mean arterial pressure

A

measured via centralized monitoring to determine avg arterial pressure during cardiac cycle
- normal: 70-110 mmHg

20
Q

normal respiratory rate

A

12-20 breaths per min

21
Q

normal O2 saturation

A

95-100%
- measured with pulse oximeter

22
Q

normal BP

A

90-120mmHg/60-80mmHg (systolic over diastolic)

23
Q

hypotension level

A

low BP
- systolic under 90

24
Q

prehypertension

A

120-140/80-89

25
Q

hypertension stage 1

A
  • greater than normal
    140-159/90-99
26
Q

hypertension stage 2

A

> 160/>100mmHg

27
Q

normal heart rate

A

60-100bpm

28
Q

bradycardia

A

less than 60 bpm

29
Q

tachycardia

A

more than 100bpm

30
Q

sterile precautions

A
  • wash hands
  • keep all work surfaces clean & dry
  • touch only outside wrappers with your bare hands when handling supplies
  • mask over your nose and mouth
  • supplies within reach so you do not drop or rub against them
31
Q

where should a gait belt fit on a patient during a transfer?

A

fit snugly around the waist and not move up the trunk

32
Q

steps for a safe transfer

A
  1. position the wheelchair
  2. lock wc brakes
  3. secure gait belt around waist (at all times! if don’t have one, use patient’s pants or belt)
  4. clinicians should follow proper body mechanics to maintain the integrity of their spine, in order to safely support and move the patient (both clinicians position the patient upright and centered, with the front clinician blocking the patient’s knees and feet)
33
Q

if a client reports fatigue after completing a certain activity, what should be done in the next session?

A

reduce the intensity

34
Q

if a client has a progressive disease and is preparing to be discharged home, what can be done to prepare the caregiver for the transition?

A

involve the caregiver in the patient’s sessions

35
Q

maximum height a clinician should handle before using a lift

A

35 lbs

36
Q

Levels of weight bearing

A
  • NWB (non weight bearing): no weight on involved extremity
  • TTWB (toe touch weight bearing): only toe placed on ground for balance while standing (90% on unaffected leg)
  • PWB (partial weight bearing): 50% of person’s weight on affected leg
  • WBAT (weight bearing as tolerated): patient judges how much weight to put on affected leg without causing too much pain
  • FWB (full weight bearing): 100% of weight on affected leg without causing damage
37
Q

When applying a hot pack, what is the method of application?

A

Place a folded towel or two between body part to be treated & hot pack (hot packs are heated in hot water bath of 160 degrees F)
- good warm up for exercise prep, adjunct to functional activity
- increases muscle extensibility (helpful with ROM restriction)

38
Q

If an OT is using a goniometer on a patient and is getting varying measurements after 4 times of measuring, they should

A

Verify correct goniometer placement

39
Q

MMT Grading Scale

A

0: NONE (no contraction seen/felt)
1: TRACE (no movement but can contract muscle)
2-: POOR MINUS (incomplete ROM w/ GRAVITY ELIMINATED)
2: POOR (complete ROM with GRAVITY ELIMINATED)
2+: POOR PLUS (less than 50% ROM against gravity)
3-: FAIR MINUS (more than 50% ROM against gravity)
3: FAIR (complete ROM against gravity)
3+: FAIR PLUS (complete ROM against gravity & SLIGHT resistance)
4: GOOD (complete ROM against gravity & MOD resistance)
5: NORMAL (complete ROM against gravity & MAX resistance)

40
Q

MMT Grading Scale interventions

A

0: NONE (no contraction seen/felt- maintain PROM to prevent contractions, adhesions, deformity)

1: TRACE (no movement but can contract muscle) - facilitate stronger contraction by tapping, rubbing, vibrating muscle; AAROM - patient contracts muscle & OT or mechanical device completes entire ROM (slings, pulleys, weights, springs, elastic bands- graded by reducing assistance until patient performs active exercises)

2-: POOR MINUS (incomplete ROM w/ GRAVITY ELIMINATED) - complete ROM for them passively when they stop actively moving extremity in gravity eliminated plane; incorporate a goal into exercise such as using a suspension mobile arm support with meaningful activity

2: POOR (complete ROM with GRAVITY ELIMINATED) - use powdered surface/skateboard to reduce resistance produced by friction on surface when in gravity-reduced plane (EX: place client’s arm on top of table covered with powder & have them do table top activity to slide arm on table surface through complete ROM in gravity eliminated plane. Board game with light pieces)

2+: POOR PLUS (less than 50% ROM against gravity) - complete ROM gravity eliminated slight resistance (EX: introduce weighted game pieces as resistance to a board game)

3-: FAIR MINUS (more than 50% ROM against gravity) - activity to encourage client to lift arm up in vertical plane against gravity with goal at highest level client can reach

3: FAIR (complete ROM against gravity) - can structure activities against gravity (E: balloon volleyball, throwing balloon at a target requiring patient to lift arm against gravity)

3+: FAIR PLUS (complete ROM against gravity & SLIGHT resistance) - resistive exercise is used to complete strength (EX: tossing a beach ball)

4: GOOD (complete ROM against gravity & MOD resistance) - resistance used to increase strength (EX: toss beach ball with weighted cuffs strapped to client’s wrists. Tossing a therapy ball)

5: NORMAL (complete ROM against gravity & MAX resistance)- resistive exercise to increase strength (EX: tossing a medicine ball while standing)

41
Q

Shoulder ROM norms

A

Flexion: 0-180
Extension: 0-60
Abduction: 0-180
Horizontal Abduction: 0-45
Horizontal adduction: 0-135
IR: 0-90
ER: 0-100

42
Q

Elbow & FA ROM norms

A

Elbow f/e: 0-150
Supination/Pronation: 0-80

43
Q

Wrist ROM norms

A

Flexion: 0-80
Extension: 0-70
Ulnar deviation: 0-30
Radial deviation: 0-20

44
Q

Thumb ROM norms

A

CM flexion: 0-15
CM extension: 0-20
MP f/e: 0-50
IP f/e:0-80
Abduction: 0-70
Opposition

45
Q

The physician’s order, which was not signed by the physician, requests a splint for this patient’s wrist, with no specifications stated. How should the OTR proceed with this request?

A

DO NOT CONTACT OR APPROACH MD! THEY ARE RELYING ON OT TO GIVE THE CORRECT TYPE OF SPLINT
- issue a prefabricated wrist splint to give patient more flexibility
- do not ask patient to return to the physician for a signed order (violates beneficience)

NBCOT LAST Attempt (50 decks)

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