Patient Care Skills Flashcards
(117 cards)
1
Q
What is the difference between sign and symptom?
A
Sign- what you see.
Symptom- what you feel.
2
Q
What are the 3 things you look for when taking PR?
A
- Rate
- Rhythm
- Volume/strength
3
Q
Name factors that affect PR.
A
Age, gender, emotions, exercise, systemic or local heat, medications, post COVID Px.
4
Q
What are the normal ranges for PR for neonates, infants, children, and adults?
A
Neonates- 120-160 BPM
Infants- 100-120 BPM
Children- 80-100 BPM
Adults- 60-100 BPM
5
Q
Where are the points of assessment for PR?
A
Apical
Temporal
Brachial
Radial
Dorsal pedal
Popliteal
Femoral
Carotid
6
Q
How do we find max target heart rate? How do we find regular THR? How about modified THR?
A
Max: 220-age
THR: max THR x 85%
Modified: resting HR + 20 BPM
7
Q
What are some red flags in heart rates?
A
Irregular pulse, weak pulse, resting above 60 (tachycardia), resting below 60 (bradycardia).
8
Q
What do you look for in respiration rate?
A
Rate
Depth
Rhythm
Cough
Character- dyspnea, labored, wheezing, crackles, stidor, stertor, pleural rub
9
Q
What factors affect RR?
A
Age, body size, exercise, body position, medications, emotions.
10
Q
What are the normal ranges for RR in neonates, infants, children, adults, and older adults?
A
Neonates: 40-60
Infants: 25-60
Children: 15-30
Adults: 12-20
Older adults: 15+
11
Q
What are some red flags to look for in RR?
A
Shortness of breath, irregular breathing pattern, noisy breathing, pain with breathing.
12
Q
What does pulse oximetry tell us?
A
Arterial blood oxygenation.
13
Q
What are the normal and not normal ranges of SpO2?
A
Normal: 96-100%
Below 90: NEED O2
Below 85: severe hypoxia
14
Q
What is blood pressure?
A
The force blood exerts against a vessel wall.
15
Q
What are 3 things that affect BP?
A
- vessel compliance
- vessel size
- blood volume
16
Q
What happens to the heart in systole and diastole?
A
Systole- ventricular contraction.
Diastole- ventricular relaxation.
17
Q
What are factors that affect BP?
A
Medications, age, substances (food, alcohol, smoking), emotions, pain, exercise, body/arm position, hot or cold exposure.
18
Q
What is something that would be on a Px’s arm to tell you to use their right arm?
A
IV, breast/axillary surgery, lymphedema, increased or decreased muscle tone.
19
Q
What are the BP ranges?
A
Normal: below 120 and below 80
Slightly elevated: 120-129 and below 80
Stage 1 hypertension: 130-139 and 80-89
Stage 2 hypertension: 140 or higher and 90 or higher
Hypertensive crisis: higher than 180 and higher than 120
20
Q
What are the 4 levels of A&O?
A
- A&O x1: person
- A&O x2: person and place
- A&O x3: person, place, time (this is normal)
- A&O x4: person, place, time, event (also normal)
21
Q
What are types of equipment used to take temperatures?
A
Electrical/digital, glass, non-contact infrared, temperature sensitive tape.
22
Q
What are normal temperature ranges?
A
Oral: 98.6 or 97
Axillary: 97.6
Rectal and aural: 99.6
23
Q
If a Px was describing nerve pain, what are some words they would use?
A
Sharp, bright, lightning-like
24
Q
If a Px was describing vasculature pain, what are some words they would use?
A
Throbbing, diffuse, crushing
25
If a Px was describing bone pain, what are some words they would use?
Deep, nagging, dull
25
If a Px was describing sympathetic nervous system pain, what are some words they would use?
Burning, stinging, aching
26
All of the following are factors that affect body temperature except:
- Cardiopulmonary disease
- Time of the day
- Age
- Drinking hot tea 15 minutes before having body temperature measured
- Cardiopulmonary disease
27
Which of the following is true regarding pain assessment in patient care?
- Pain assessment is rarely useful in determining the underlying source of pain.
- Responses to pain are similar across all social and cultural groups.
- Pain assessment is an objective measurement of the patient's experience.
- Pain is always abnormal and can be a valuable indicator of a serious problem.
- Pain is always abnormal and can be a valuable indicator of a serious problem.
28
All of the following are sites for measuring pulse rate except:
Ulnar
Brachial
Radial
Dorsal pedal
Ulnar
29
Which of the following is NOT true about blood pressure?
- Younger patients have lower blood pressure.
- Arm position is not important when measuring blood pressure.
- High stress will increase blood pressure.
- Diastolic pressure may remain unchanged during exercise.
Arm position is not important when measuring blood pressure.
30
Pulse oximetry accuracy can be hampered by all of the following except:
- Diameter of finger.
- Poor circulation
- Carbon monoxide inhalation
- Nail polish
- Diameter of finger.
31
Which of the following would be normal vital sign measurements for an adult?
Pulse 71, BP 117/70, RR 14 Pulse 112, BP 125/96, RR 22
Pulse 65, BP 154/82, RR 10
Pulse 82, BP 148/80, RR 20
Pulse 71, BP 117/70, RR 14
32
What is the cycle of contamination?
1. infectious agent
2. reservoir for organism
3. method of exit
4. method of transmission
5. method of entry into new host
6. susceptible host
33
What would you dress in to follow contact-based protocols?
Gown and gloves
34
What is an example of a contact-based infection?
MRSA, VRE, C-diff, or Hepatitis A
35
What would you dress in to follow droplet-based protocols?
Gown, gloves, N95 mask, and face shield/eye protection.
36
What is an example of a droplet-based infection?
Mumps, meningitis, pneumonia, diphtheria, influenza, or COVID.
37
What is an example of an airborne-based infection?
COVID, TB, measles.
37
What would you dress in to follow airborne-based protocols?
N95 mask, and patient has to have negative air pressure room.
38
What would you dress in to follow airborne&contact-based protocols?
Gown, gloves, and mask.
39
What is an example of an airborne&contact-based infection?
Chickenpox
40
What is universal design?
Concept of designing building that is usable by all
without the need for adaptation.
41
What is the required width for accessibility?
36"
42
What is the required turning diameter for accessibility?
60"
43
What is the required forward reach length for accessibility?
15"-48"
44
What is the required side reach length for accessibility?
9"-54"
45
What is the required height for high tables and countertops for accessibility?
28"-34"
46
What is the required width for doorways for accessibility?
32"-34"
47
What is the required height for handrails for accessibility?
34"-38"
48
What is the required height for grab bars for accessibility?
33"-36"
49
What is the required thickness for carpeting for accessibility?
No more than 1/2"
50
What are the stair height and depth requirements for accessibility?
No taller than 7" and at least 11" deep
51
What is the minimum width for a sidewalk to be accessible?
36"
52
The Americans with Disabilities Act is designed to do all of the following, except:
- Ban discrimination based on disability
- Designate transportation access to limited modes of transportation
- Improve opportunities for employment
- Remove employment and access barriers
Designate transportation access to limited modes of transportation
53
"Universal design" means...
- Using the same floor plans for all buildings with similar purposes
- All existing buildings should be barrier free
- Creating a building accessible and free of barriers for people of all ages
- Creating environments without barriers for the elderly
Creating a building accessible and free of barriers for people of all ages
54
When completing a home visit, considerations in the bathroom should include all of the following, except...
- Height of toilet seat
- Toilet grab bars placed horizontally at least 50 inches from the floor
- Width of door frame
- Non-skid surfaces in tub or shower
Toilet grab bars placed horizontally at least 50 inches from the floor
55
To determine the most accessible exterior entrance, important factors to consider include all of the following, except...
- Most level surface
- Closest to where car will be parked
- Availability to neighbor's house
- Fewest number of stairs
Availability to neighbor's house
56
When presenting Mrs. Jones at a team meeting, it would NOT be acceptable to say...
-"She transfers from bed to wheelchair with max assist of 2."
- "She is 6 days post total hip replacement."
- "She requires mod assist with bed mobility activities."
- "She is wheelchair bound at this time."
"She is wheelchair bound at this time."
57
Define body mechanics.
Refers to the way we move our bodies.
58
What percentage of the population reports back pain or back injuries?
30%-70%
59
What affects alignment?
Postural curve, pelvic position, musculature, etc.
60
What does a posterior tilt of the pelvis look like?
Less thoracic curve looks like flat back.
61
What does an anterior tilt of the pelvis look like?
More lumbar curve, called lordosis.
62
What affects poor posture?
-Habit
-Genetic predisposition
-Muscular imbalances
-Structural abnormalities
-Any combination of the above
63
What does a kyphotic-lordotic back look like?
Kind of like the letter S.
64
What does a flat back look like?
Spine is almost even with ideal posture line drawn.
65
What does sway back look like?
Most of spine is straight except for thoracic spine which is a little more curved.
66
What does internal and external force mean?
Internal- muscles
External- gravity, weight, or resistance applied to the body
67
What does friction mean?
Created by two contacting surfaces.
68
What is base of support (BoS)?
Contact area of an object with its support surface.
69
What is line of gravity?
Gravity's line of action (the area between the legs of a cane or the area between your feet when you're standing with them apart). The greater the distance between said bases, the better.
70
Know the difference between mobility and stability.
Stability;
-BoS is greater in area
-LoG acting on CoM is near center of BoS
-Distance between CoM is lower and closer to CoM
Mobility:
-BoS is smaller in area
-LoG is allowed to move beyond the center of the Bos
-The distance of CoM above the BoS is greater
71
Which of the following is NOT a general body mechanics guideline?
- Position yourself close to the load.
- When possible, push rather than pull.
- Bend the hips and knees.
- Inhale during exertion.
Inhale during exertion.
72
Lumbar lordosis is caused by which of the following?
- Anterior pelvic tilt
- Posterior pelvic tilt
- Lateral pelvic tilt
- Flexion of the lumbar spine
Anterior pelvic tilt
73
Which of the following statements is NOT true about the center of mass (CoM)?
- The CoM is often referred to as the "center of gravity" (CoG).
- The CoM never changes position.
- The CoM is generally slightly higher in men than in women.
- In the standing position, the CoM is located slightly anterior to S2.
The CoM never changes position.
74
Common causes of back problems or discomfort include all of the following, except...
- Episode(s) of trauma
- Faulty posture
- Poor body mechanics
- Normal flexibility
Normal flexibility
75
Which of the following is an example of an internal force commonly used when assisting patients with movement?
- Gravity
- Muscular tension
- Ankle weights
- Friction
Muscular tension
76
What are some reasons behind immobilization?
◦ extreme weakness
◦ disease
◦ depression
◦ mechanical factor (cast, traction)
77
What are some complications of immobilization for the CNS?
◦ Altered sensation
◦ Decreased motor activity
◦ Emotional state - anxiety, boredom, frustration
◦ After 4 weeks can have decrease in intellect
78
What are some complications of immobilization for the skeletal system?
◦ Loss of bone mass
◦ Joint stiffness (contracture)
79
What are some complications of immobilization for the respiratory system?
◦ Impairment of coughing
◦ Risk of pneumonia
80
What are some complications of immobilization for the muscular system?
◦ Decrease in muscle strength (1 wk. bedrest = 20% decrease in strength)
◦ Decreased endurance
◦ Poor coordination
81
What are some complications of immobilization for the CV system?
◦ Orthostatic hypotension
◦ Blood clots can form due to blood pooling
◦ Decrease in circulation to periphery
◦ Aerobic deconditioning
82
What are some other complications because of immobilization?
◦ Depression
◦ UTI (Urinary tract infection)
◦ Constipation
83
Where are the areas you get pressure ulcers when laying on your side?
- Ear
- Shoulder
- Elbow
- Hip
- Thigh
- Leg
- Heel
84
Where are the areas you get pressure ulcers when laying on your back?
-Back of head
- Shoulder
- Elbow
- Butt
- Heel
85
Where are the areas you get pressure ulcers when laying on your stomach?
- Elbow
-Rib cage
- Thigh
- Knees
- Toes
86
What is another name for pressure ulcer?
Decubitus ulcer
87
What are the 4 stages of a pressure ulcer?
1. Persistent redness
2. Formation of bubbles
3. Damage to skin
4. Skin necrosis
88
Where are the areas on the hips and knees that you can get ulcers?
* Greater trochanter
* Medial & lateral femoral
epicondyles
* Head of fibula
* Patella
* Tibial tuberosity
* Tibial condyles
89
Where are the areas on the pelvis that you can get ulcers?
* Sacrum
* Posterior Superior Iliac
Spine (PSIS)
* Ischial Tuberosity
* Anterior Superior Iliac
Spine (ASIS)
90
Where are the areas on the elbow that you can get ulcers?
* Olecranon process
* Medial epicondyle
* Lateral epicondyle
91
Where are the areas on the shoulder that you can get ulcers?
* Spine of scapula
* Acromion process
92
How often should you change a patient's position?
Every 2 hours.
93
What is a restraint?
a device that restricts patients mobility (can be chemical)
94
What is the order of transfer skills?
◦ Bed mobility
◦ Sitting skills
◦ Transfer skills
◦ Standing skills
◦ Walking
◦ Stair climbing
95
What is the functional mobility progression?
1. Mobility
2. Stability
3. Functional (controlled) Mobility
4. Skill
96
What is the developmental sequence?
1. fetal position
2. lift neck
3. lift neck and chest
4. sit with help
5. sit alone
6. stand with help
7. crawl
8. walk with help
9. stands alone
10. walk alone
97
What do you have to avoid when a total hip is done?
◦ 60º to 90º hip flexion
◦ 0º hip internal rotation
◦ 0º hip adduction
98
What is hemiplegia?
Weakness on one side
99
Your patient is a 14 year-old girl who was in a motor vehicle accident (MVA) and is now comatose in the ICU. You are working with the patient's family regarding appropriate positioning for this patient. Which of the following would be most appropriate to tell them?
- "Her inability to move independently makes her more vulnerable to skin breakdown."
- "You can add more pillows if you think she is uncomfortable."
- "The patient needs to be repositioned every 3 hours when she is lying in bed."
- "She should have a pillow under her heels while she is in supine."
"Her inability to move independently makes her more vulnerable to skin breakdown."
100
Inattentiveness to proper positioning and position changes can lead to contracture. What is a contracture?
- Morphological changes indicative of cellular death
- Shortening or tightening of soft tissue that prevents normal movement
- A deficiency of blood in a body part due to functional constriction
- Softening of a solid region by soaking
Shortening or tightening of soft tissue that prevents normal movement
101
Pressure injuries are often caused by bony prominences. All of the following are bony prominences that need to be monitored while a patient is positioned in supine, except...
- Spine of scapula
- Great trochanter
- Sacrum
- Posterior calcaneus
Greater trochanter
102
Draping is used to allow exposure of a body area to be treated. Which of the following is true about draping?
-A patient may help adjust drape material.
- All of the above.
- Draping protects a patient's privacy during treatment.
- Drape material should not restrict movement or access to the area to be treated
All of the above
103
Some individuals require special care when positioning, and may not be able to remain in positions for more than a few minutes. Indicators that someone may be one of these patients include all of the following, except...
- Difficulty complying with instructions to remain in a particular position
- Circulation or respiratory impairments
- Frequent phone calls from family and friends
- Inability to sense the need for a position change
Frequent phone calls from family and friends
104
Bridging is completed in the __________________ position.
Supine
Prone
Hooklying
Quadruped
Hooklying
105
Which position is typical for guarding an unstable patient during bed mobility tasks in sitting?
Behind the patient
To the left side of the patient
To the right side of the patient
In front of the patient
In front of the patient
106
Bed mobility is a critical component of functional mobility. Which of the following statements regarding bed mobility is true?
Normal movement patterns are not generally considered.
Soft pliable surfaces are easier for patients to move on.
Patients should be encouraged to relax and allow the therapist to do all of the work.
Patient's movements are best controlled by applying forces centrally.
Patient's movements are best controlled by applying forces centrally.
107
Weight bearing in modified plantigrade is shared by...
Both feet
Both knees and both hands
Both feet and both hands
One foot and one hand
Both feet and both hands
108
All of the following determine standards and criteria for documentation except:
The individual therapist
Health care facilities
Accrediting bodies
The federal government
The individual therapist
109
The ICF Model has two main components: Functioning & Disability and Contextual Factors. Which of the following is NOT considered a "Functioning & Disability" factor?
Participation
Activities
Body Function
Personal Factors
Personal Factors
110
Match the item on the left to its category of "Medical Diagnosis," "Impairment," or "Functional Limitation."
1. Cerebral palsy
2. Inability to walk one block
3. Decreased hamstring strength, measuring 3/5
Diagnosis-1
Impairment- 3
Functional Limitation- 2
111
How long should it take to confirm the fit of a wheelchair?
1-2 minutes
5-10 minutes
15-20 minutes
45-50 minutes
1-2 minutes
112
The postural support system of the wheelchair includes: (check all that apply)
Seat surface
Back surface
Upper extremity supports
Lower extremity supports
Pelvic belt
All
113
If the seat of the wheelchair is too wide, the user may experience...
Difficulty propelling the wheelchair
Excessive pressure on the greater trochanters
Excessive forward trunk inclination
All of the above
Difficulty propelling forward
114
When educating a patient about reaching forward towards the floor while sitting in a wheelchair, you should instruct them to...
Unlock their wheels
Make sure their anti-tip extensions are in place
Turn castor wheels forward
Not lean forward when in a wheelchair
Turn castor wheels forward
115
Most wheelchair users benefit from a seating system that is...
Soft
Firm
A sling
Triangular
Firm
