Non-Systems Flashcards
(103 cards)
1
Q
Professional Responsibility:
A
This category refers to the responsibilities of healthcare providers to ensure that patient/client management and healthcare decisions take place in a trustworthy environment
2
Q
Patient right:
A
Health Insurance Portability and Accountability Act (HIPAA)
3
Q
Human Resources/ legal issues
A
sexual harassment
4
Q
Roles and responsibilities of assistants
A
PTA
5
Q
Roles and responsibilities of others
A
PT Aide, PT Student
6
Q
Accrediting bodies
A
state licensing entities, Joint Commission, CARF,
CMS
7
Q
HIPAA
A
Patient’s right to continuity in
healthcare
Privacy and security of healthcare
records
Patient’s confidentiality is maintained
in all oral, written and electronic forms
Written consent from the patient
before disclosing information about
personal health
Reduce physical identification of the
patient
Patient’s right to access all their
medical records
8
Q
PHI
A
protected health information
by the privacy rule
9
Q
Core Values
A
Altruism
Autonomy
Professional Judgment
Nonmaleficence
10
Q
Altruism:
A
Therapist shall adhere to the core values of the profession and act in best interest of the patients over therapist’s interest
11
Q
Autonomy:
A
Therapist shall provide all necessary information to allow patients to make informed decisions about care
12
Q
Professional Judgment:
A
Therapist shall be accountable for making sound professional judgments
13
Q
Nonmaleficence:
A
It is the obligation of therapist not to harm the patient
It is also known as the “do no harm” principle
14
Q
Utilization:
A
The physical therapist is directly responsible for the actions of physical therapist assistant related to patient/ client management
15
Q
PTA:
A
may perform selected physical therapy interventions under the directions and at least general supervision of PT
follow POC by PT
16
Q
PT:
A
evaluation
reevaluation
discharge
17
Q
In all practice settings, the performance of selected interventions
by PTA must:
A
be consistent with safe and legal PT practice
18
Q
Modify the POC to include a new modality?
A
PT
19
Q
Add hamstring exercises to a POC that states “LE strengthening”?
A
PT
PTA
20
Q
Supervise a PTA student?
A
PT
PTA
21
Q
Supervise a PT student?
A
PT
22
Q
Physical Therapy Code of Ethics
A
- PT/PTA shall respect the inherent dignity and rights of all individuals
- PT/PTA shall be trustworthy and compassionate in addressing the rights and needs of patients/clients.
- PT/PTA shall be accountable for making sound professional judgments.
- PT/PTA shall demonstrate integrity in their relationship with patients/clients, families, colleagues, students, research participants, other health care providers, employers, payers and the public.
- PT/PTA shall fulfill their legal and professional obligations.
- PT/PTA shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities and professional behaviors.
- PT/PTA shall promote organizational behaviors and business practices that benefit patients/clients and society.
- PT/PTA shall participate in efforts to meet the health needs of people locally, nationally or globally.
23
Q
Agencies Responsible for Quality Improvement
A
JACHO
CARF
CMS
OSHA
24
Q
JACHO
A
Joint commission on Accreditation of Healthcare Organization
accredits hospitals, SNF, home health agencies, PPO, HMO, mental health
institutions
25
CARF
Commissions of Accreditation Rehabilitation Facilities
accredits free standing rehabilitative programs/facilities
26
CMS
Center for Medicare & Medicaid Services
determines what and how much will be reimbursed by Medicare for patient care
27
OSHA
Occupational Safety and Health Administration
responsible for determining the safety of the work environment
28
Safety and Protection:
This category refers to the critical issues involved in patient/client safety and
protection and the responsibilities of health-care providers to ensure that
patient/client management and health-care decisions take place in a secure
environment
29
Emergency preparedness
(e.g., CPR, first aid, disaster response)
30
Infection control procedures
(e.g., standard/universal precautions, isolation techniques, sterile technique)
31
Factors influencing safety and injury prevention
(e.g., safe patient handling, fall prevention, equipment maintenance, environmental safety)
32
*d"ON"ning: ON
1) Gown (Sparkling gown)
2) Mask (Make-up)
3) Goggles (Glasses or contacts)
4) Gloves (to keep her hands clean when going out)
33
d"OFF"ing: OFF
Alphabetical order
1) GLoves
2) GOGgles
3) GOWn
4) Mask
34
contact precautions
MRS WEE
Multidrug resistant
Respiratory infection
Skin infections
Wound infections
Enteric (c diff)
Eye infection
35
droplet precautions
SPIDERMAN
Sepsis/scarlet fever/strep
Parovirus/pneumonia
Influenza
Diptheria
Epiglottis
Rubella
Mumps/meningitis
Adenovirus
36
airborne precautions
MTV
Measles
TB
Varicella
37
Hand Hygiene
contact:
droplet:
airborne:
contact: Hand Wash before entering and after leaving the room
droplet: Hand Wash upon entering and leaving the room.
airborne: Hand Wash upon entering and leaving the room
38
PPE
contact:
droplet:
airborne:
contact: Gloves and Gown only when in
direct contact with patient or items in patient room. (Remove before leaving the room).
droplet: Mask when working within
3 feet of patient. Contact precautions only when skin lesions present.
airborne: N-95 Mask (Fit Tested). Gown and Gloves if severe contamination. Discard mask upon leaving the room
39
Room
contact:
droplet:
airborne:
contact: Private room or cohort patient with same infection
droplet: Private room without negative air flow
airborne: Private room with negative air flow. Keep door closed
40
Patient Transport
contact:
droplet:
airborne:
contact: Minimize transport and patient
washes hands if they leave the room
droplet: Minimize transport. Patient wears a surgical mask when leaves the room. Patient follows cough etiquettes
airborne: Minimize transport. Patient wears a surgical mask when leaves the room. Patient follows cough etiquettes
41
ABUSE:
Infliction of physical or mental injury or the deprivation of food, shelter, clothing or services needed to maintain physical or mental health
types:
> sexual
> physical
> emotional
> mental
42
Sexual abuse:
Sexual assault, sexual intercourse without consent, indecent exposure, deviate sexual conduct, or incest adult using a child for sexual gratification without physical contact is considered sexual abuse
43
Physical abuse:
Physical injury results in pain, impairment or bodily injury of any bodily organ or function, permanent or temporary disfigurement or death
44
Emotional abuse:
Anguish inflicted through threats, intimidation, humiliation isolation, embarrassing, blaming or rejecting behaviors from adult towards child, withholding love affection and approval.
45
Mental abuse:
Impairments of a person’s wellbeing, intellectual or psychological functioning
46
Telehealth
Responsibility for and Appropriate Use of Technology:
A patient’s appropriateness to be treated via telehealth should be determined on a case-by-case basis, based on the PT’s judgment, patient preference, technology availability, risks and benefits, and professional standards of care.
47
Telehealth
Verification of Identity:
Both the patient and the physical therapy provider’s identities should be verified at the onset of the telehealth visit
48
Telehealth
Informed Consent:
Provider must follow state law requirements and best practices for acquiring informed consent for in person encounters, and these same requirements should be followed for telehealth communications
49
Telehealth
Licensure:
PT delivering care must be legally authorized in the jurisdiction in which the patient is physically located, however, the provider should not be required to be physically located in that same jurisdiction
50
Telehealth
Supervision:
PT may provide supervision while either onsite or virtual. Physical therapy statutes and regulations should include the supervision of PTAs for telehealth visits
51
Telehealth
Standards of care:
Providers should ensure that the services provided are included in both the legal scope of practice as well as personal competency, including their education, training, experience, and ability to perform safely and effectively
52
Telehealth
Privacy and Security:
Providers should be aware of the requirements for privacy and confidentiality associated with the provision of telehealth services at both the originating and remote sites
53
Telehealth
Technical Guidelines:
All providers should ensure that the equipment is sufficient to support
the encounter, is available and functioning properly and they are trained in equipment operation and troubleshooting
54
Telehealth
Emergencies and Patient/Client Safety Procedures:
If the clinician feels that the patient is
experiencing a medical or clinical complication or an emergency, the treatment session should be immediately terminated, and a local emergency response initiated
55
Ergonomic Guidelines
Workstation Recommendations:
Monitor should be 18-28 inches away (arms length from screen)
Monitor screen top slightly below eye level
Elbows bent 90 degrees, wrist in neutral and free while typing
Use a mouse that contours the hand
Thighs horizontal and feet resting flat on floor
Space under the desk should be at least 30 inches wide, 19 inches deep, 25- 34 inches in height, should be 2-3 inches between the top of the thighs and desk
56
Lifting Guidelines:
Always attempt to increase your base of support
Maintain a proper lumbar curve while you lift
Pivot your feet while lifting; do not twist your back
Maintain a slow and consistent speed while lifting
57
Different types of lifting
stoop
squat
semi squat
58
Stoop Lift
Trunk flexes forward from the hips; knees remain mostly extended
Primarily hip and back extensors (glutes, erector spinae, hamstrings)
For light objects that are close to the body
Higher spinal stress, not ideal for patients with low back issues
59
Squat Lift (Deep Squat)
Full squat with hips and knees fully flexed, back remains upright
Strong use of quads, glutes, hamstrings
For heavy or bulky objects from the floor
Requires good knee and hip mobility
Safest biomechanical lift for the spine if performed properly
60
Semi-Squat Lift (Power Lift)
Partial squat with hips back, knees flexed ~45°, trunk inclined forward but straight
Combines legs and back, engages core
Common for moderate-weight lifting when full squat isn’t practical
Safer than stoop, easier than full squat
61
When performing a stoop lift, ____ is one of the biggest contributors to increased compression forces on the spine
the moment arm (distance between the object and the lumbar spine)
62
The farther the box is from the spine, the greater the ___ required to lift it =
torque
This increases shear and compressive forces on the lumbar vertebrae, especially L4–L5 and L5–S1
63
BLS - high-quality CPR
rescuers should:
perform chest compressions at a rate of 100-120/min
compress to depth of at least 2 inches (5cm)
allow full recoil after each compression
minimize pauses in compressions
ventilate adequately (2 breaths after 30 compressions, each breath delivered over 1 second, causing chest rise)
64
Hickman Catheter:
central line tunneled under the skin
This is used for providing
antibiotics, nutritional solutions, and blood samples
65
Swanz Ganz Catheter:
balloon flotation device that is inserted through the internal
jugular vein or femoral vein into the pulmonary artery to monitor blood flow and the function of the heart
66
Central Venous Pressure Catheter:
measures blood pressure directly from right atrium and superior vena cava
67
Arterial Line:
used to monitor arterial blood gases
flexible
68
Chest drainage tubes:
may be used to remove air,
blood, purulent matter from the patient’s chest or pleural cavity.
They are inserted through an incision in the chest and may be connected to a mechanical or
gravity-based suction system
69
Chest tubes:
If dislodged, have the patient exhale, place gauze or a gloved hand over the area and call nursing staff
70
Catheters:
Hang below level of bladder, do not empty bag if output is being monitored, empty or alert staff if overfilled
71
IV lines:
Arm should not be held above head for extended periods, alert staff if fluid is low due to air bubbles
72
Arterial line:
If dislodged, apply firm pressure and alert nursing
immediately
73
Femoral line:
Avoid repetitive hip flexion and hip flexion >45 degrees
74
Wheelchair Measurements
seat height:
Heel to popliteal fold + 2 inches
average: 19.5 to 20.5 inches
75
Wheelchair Measurements
seat depth:
Posterior buttock along lateral thigh to popliteal fold - 2 inches
average: 16 inches
76
Wheelchair Measurements
seat width:
Widest aspect of buttocks or thighs + 1.5 to 2 inches
average: 18 inches
77
Wheelchair Measurements
back height:
Chair seat to axilla - 4 inches (consider any seat cushions and add thickness to final value)
average: 16 inches
78
Wheelchair Measurements
armrest height:
Seat of chair to olecranon + 1 inch (consider cushions)
average: 9 inches
79
Wheelchair Axle Positioning
Normal axle positioning= in line with the shoulder or slightly
posterior
Bariatric Patients → move the rear wheel axle forward
Bilateral Transfemoral Amputation → move the rear wheel axle behind the patient's shoulders
80
Propulsion phase:
Apply a smooth, continuous
push on the push rims, extending your arms forward.
This motion propels the wheelchair
81
Recovery phase:
After the push, release the
push rims and bring your hands back to the starting position, ready for the next push
82
Turns:
Pull one side wheel backward and other side forward
83
To turn right:
Push the left wheel forward while pulling back on the right wheel.
84
To turn left:
Push the right wheel forward while pulling back on the left
wheel
85
Wheelie:
Patient places hands back on hand rims, then push them forward abruptly and forcefully
86
Ascending curb:
Lift the front casters onto the curb by performing a small wheelie
Push forward on the push rims to lift the rear wheels onto the curb
87
Descending curb:
Perform a wheelie and descend with rear wheels off the curb followed by castor wheels
OR
Descend backwards: Allow the rear wheels to slowly roll off the curb, followed by the castor wheels
88
Three-person lift/carry:
Used to transfer a patient from a
stretcher to a bed or treatment plinth.
89
Two-person lift:
Used to transfer patients of different heights or surfaces or transferring to the floor.
90
Dependent squat pivot transfer:
Used to transfer a patient who cannot stand independently but can bear some weight through the trunk and lower extremities
91
Hydraulic lift:
Used for dependent transfers when the patient is obese, there is only one therapist available to
assist with the transfer or patient is totally dependent.
92
Standard Crutches (Axillary Crutches)
Axilla space of approx. 2”
Crutch is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
Elbow flexion approx. 20-25 degrees when grasping handpiece
using wrong/too long -> axillary a. or radial n. injury
93
Forearm Crutches (Lofstrand Crutches)
Top of forearm cuff is just distal to elbow, approx. 1-1.5” below olecranon process
Crutch is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
Elbow flexion approx. 20-25 degrees
progression from axillary crutches
94
Cane
Always goes on the opposite side = cane AWAY from pain
Cane is approx. 2” lateral and 4-6” anterior to the patient’s toe of the shoe
Elbow flexion approx. 20-25 degrees
Ascending = Good foot goes up first, followed by bad foot and cane
Descending = Bad foot and cane first, followed by good foot
95
Position during Ambulation on Level Ground:
Stand behind and slightly toward
the patient’s or involved lower
extremity
PT’s hand should be nearest to
the patient to grasp under the
back of the gait belt with forearm
supinated
PT should move forward in step
with the patient; PT’s forward
foot moves with the assistive
device
96
Position During Ambulation on Stairs
ascending:
Therapist should be positioned
posterolateral (to the patient’s
weak side)
Grasp the gait belt with one hand; be prepared to use your other hand to control the trunk
Advance your feet up one step
after the patient has advanced
one step, but maintain your feet
in an anteroposterior position
97
Position During Ambulation on Stairs
descending:
Therapist should be
positioned anterolateral (to
the patient’s weak side)
Grasp the gait belt with one hand
Do not allow the patient to develop momentum when descending the stairs
98
Longitudinal Arch (Scaphoid pad) –
Pes planus (flatfoot)
Support the medial longitudinal arch
- Elevates and supports the navicular (scaphoid)
Reduces arch collapse
May help with plantar fasciitis and pronation issues
99
UCBL Orthosis (University of California Berkeley Lab) -
- Severe flexible pes planus
Control hindfoot and midfoot alignment
Overpronation
Deep heel cup
Medial/lateral walls for 3-point counterforce system
Controls subtalar joint motion (eversion/inversion)
Helps realign the calcaneus and forefoot
100
Dorsiflexion assist AFO’s:
DF weakness
Posterior leaf spring – It recoils during swing phase to produce dorsiflexion
Klenzak joint – Dorsiflexion spring assist incorporated into stirrup
101
Plantarflexion stop/resistance AFO:
PF tightness
Plastic hinged AFO with a posterior stop
102
lead to the same gait deviations:
Inadequate dorsiflexion assist and weak ___
hip flexors
103
lead to the same gait deviations:
Inadequate dorsiflexion stop and ____
pes equinus deformity
