Lecture 7 Flashcards
(31 cards)
PT roles in acute care
reverse or limit complications of bedrest
understand clinical implications of vitals/labs/tests
prescribe exercises & teach mobility
proper fitting of AD
caregiver training
discharge recommendations
Discharge recommendations
from their evaluation, PTs determine the pt’s current and anticipated needs for assistance and medical equipment and makes recommendations for discharge destination
PTs are KEY in determining discharge destination
when its not followed, pt are 3x more likely to return to hospital
Standard hospital beds
there are NO standards across hospitals
usually have brakes, height adjustment, tilt adjustments, siderails, bed alarm
usually handle 350 to 500 lbs
Bed and chair alarms
used for pts at increased risk for falls
will go off any time pt tries to get up
notifies the care team
Low beds
goes as low 7” from the floor
for shorter pts or those w/unique mobility impairments
Bariatric beds
typically have a weight capacity of 1,000lbs
Overhead trapeze
increases patient independence
decreases friction and shear during transfers
Air mattresses
can be either an entire mattress or simple mattress overlay
variable number of air cells for pressure dispersion
air cells alternate pressure to allow blood flow to reach all areas of body
you still have a turning schedule
Air-fluidized beds
-2,000 lbs of glass beads, covered by polyester sheet
warm pressurized air is pushed through beads
polyester cover allows moisture and air to pass through
skin is kept drier and warmer, pressure is relieved
Problems of air-fluidized
expensive
heavy
difficult to transfer pts out of
Cardiac chair
recliner that allows person to be in more of upright position
allows patient to avoid bedrest and tolerate gravitational challenges
Sequential compression devices
decrease likelihood of deep vein thrombus formation in the LEs. used in conjunction with multiple strategies, including mobility and anti-coagulant medications
simulates muscle contractions, helps to pump blood
Low-flow oxygen
delivery via nasal cannula or mouth mask w/bag
oxygen is MEDICATION, PT does not alter
Room air = 21% O2. Usually about 24-40% given to pt
non-emergency if detaches, just reattach
Oxymask
increasingly common delivery choice when higher flow of oxygen is required, or pt is a mouth breather
mask with holes
non-emergency if detaches, just reattach
Urinary catheters
indwelling or external
do not allow to become kinked or pulled out. can cause infection or spillage
do not allow collection bag to touch the floor, or raise bag above level of pts bladder
non-emergency if disconnected. contact nursing to reconnect
Indwelling urinary cathether
called foley catheter
don not allow collection bag to touch the floor, or raise bag above level of pts bladder
drain bag if full
External urinary catheters
purewick, usually for those with vaginas
condom, usually for those with penises
Chest tubes
drain fluid and/or air out of pleural cavity
helps to reinflate collapsed lung, connected to a drainage tube
container must remain upright and below output tube at all times. Kickstand must be 90° from container when set on floor
can kink, clog, or disconnect
if detaches, EMERGENCY. Get help ASAP as lung can recollapse
Peripheral intravenous lines
named for where the line ends up in the body
PT can mobilize pt with IV lines
you can have nursing disconnect for more mobility.
most common sites are anterior forearm or dorsum of hand
not an emergency if detached, but messy and painful. Get nursing ASAP
Infiltrated IV site
when IV fluids goes into the tissue instead of the vein
symptoms include swelling, pain, numbness tingling, blanched/cool skin, dampness in dressing over IV site
Central lines
centrally located tube or line that is passed through a vein to end up in the thoracic portion of the vena cava or in the right atrium.
Most common placement: femoral, subclavian, jugular
EMERGENCY if disconnected.
Purposes of central lines
administers certain drugs, fluids, total parenteral nutrition, blood transfusion, monitor central venous pressure, obtain venous blood
can be temporary or long term
types: traditional, PICC, port
PICC line
peripherally inserted central catheter. two areas of insertion
precautions as PT:
avoid taking BP in limb with the PICC line
avoid pressure under axilla (no crutches but can use walker)
Nasogastric tube
for feeding or suctioning fluids out of stomach
Precautions as PT:
HOB must be >30° when feeding
PT can push hold button if pt needs to lie flat for mobility. can be disconnected
they come out easily
avoid neck flexion
if disconnected, non-emergency but turn off pump and contact nursing
