Week 2 AI Interventions

Question 1

what does the Therex before a wound look like

Answer 1

you address modifiable risk factors, and positioning to avoid excessive hip and knee flexion, and gentle flexibility, and aerobic exercise like walking

Question 2

what is the benefit of positioning to avoid excessive hip and knee flexion

Answer 2

to put the major arteries not in a poor position

Question 3

why do we do aerobic think vessels

Answer 3

collateral vessel formation and weight loss too

Question 4

what is the benefit of screening and monitoring

Answer 4

you are considering that a high percent of people with CAD have AI, and excessive exercise will direct blood away from the muscles, which will lead to pain

Question 5

what is the prescriptive exercise listed by Kisner and Kolby

Answer 5

walking or biking until the onset of pain, then rest and repeat to Bettie utilize oxygen, and increase ability for work, and encourage collateralization (with the ischemia)

Question 6

what is the goodman exercise program

Answer 6

progressive conditioning, walk until pain rest then again, and progress to max tolerable pain before you rest. goal is to progress to 30-45 minutes without pain in 6-8 weeks

Question 7

is goodman a good option for an HEP

Answer 7

no, because that is a lot for patients to do on their own

Question 8

what is the McCullough and Kloth program

Answer 8

3x/week, short bouts of treadmill with 40-60 minutes each session, to improve oxygen metabolism, collateralization, improve blood viscosity, and improve walking economy

Question 9

what is the plan for intervention with an AI wound

Answer 9

treat, wait for auto amputation, surgical or conservative

Question 10

what do we want to do with gangrene?

Answer 10

watch that is does not convert over to wet, and protect it, with dry padded NWB type things

Question 11

what else do we want to do when there is a wound

Answer 11

moisturize it, monitor for infection, ROM for the joints and muscles, exercise and walking, and foot care guidelines.

Question 12

what are some referrals we can make for people with AI

Answer 12

dietician to reduce caffeine, smoking and address nutrition and hydration,
diabetic educator
podiatry (especially for toenails)
prosthetics with an amputation

Question 13

with AI, can you use moist dressings

Answer 13

you can never use them on dry gangrene or eschar, and you need to be careful with all other times.

Question 14

how should you treat AI ulcers,

Answer 14

treat them all as if they are unsealable, and proven healable. and keep them dry

Question 15

do we want to use adhesives with AI ulcers

Answer 15

no tape because the skin is fragile

Question 16

what is the PT role in wound care

Answer 16

identify, refer, monitor and educate, also exercise, and treat after re-vascularization occurs

Question 17

describe debridement with AI

Answer 17

there is decreased blood flow and poor healing, you so never go sharp debridement, and you also don’t debride if the ABI is less than or equal to 0.8

Question 18

TF: it is bad to keep hard eschar on the heel

Answer 18

false, it is okay to keep

Question 19

what are the compression guidelines that follow ABI in AI

Answer 19

• ABI less than or equal to 0.8 can compress with 35-40mmHg, below this may see claudication and need MD okay.
• ABI below 0.8 but over 0.6 be cautious with light compression between 17 and 25mmHg
• ABI less than 0.5 no compression and you will get pain at rest

Question 20

what do you do after re-vascularization and Amputation

Answer 20

ensure their status and monitor and go after it with moist wound environment and debride.

stump wrapping and shaping with prosthetics, and ROM, positioning, STR, mobility, balance, offloading and work with the podiatrist for shoes.

Question 21

what are great ways to prevent AI wounds

Answer 21

recognize risk factors and encourage lifestyle changes, smoking cessation, control you DM, take prescription meds, healthy diet and hydration, exercise 30 minutes to control stress, soft shoes, avoid cold, offloading and positioning, and bed sheets and blankets, use a soft heel life boot for bed to not get the shear.