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Intro To PT > PT (CH 6-14) > Flashcards

PT (CH 6-14) Flashcards

1
Q

What are Diagnostic-Related
Groups?

A

a system where a provider is paid a pre-established amount based on the patient’s diagnosis

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2
Q

The ____________ was passed to allow insurance companies to explore new ways to minimize rising health costs

It required employers with more than 25 employees to offer it as an option in order to ______

A

Health Maintenance Organization Act (HMO)

Lower health care costs

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3
Q

A model in which the health insurer or employer negotiates a lower fee with networks or ‘preferred’ health care providers in return for promising a certain volume of patients

A

Preferred Provider Organizations (PPOs)
(less restrictive than HMO)

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4
Q

The 3 types of Manages Care Organizations (MCO’s)

A

HMO, PPO, POS

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5
Q

Which type of MCO only covers in network care unless the care you need is not in network due to speciality or distance

A

HMO

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6
Q

Which type of MCO is very restrictive

A

HMO

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7
Q

Which MCO allows in and out of network care

A

POS

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8
Q

Which MCO prefers in network care

A

PPO

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9
Q

The type of manages care plan determines how consumers access their …

A

Health care

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10
Q

Traditional HMOs require participants to choose a ____ from a panel of providers

A

PCP (Primary Care Provider)

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11
Q

What are Pharmaceutical formularies

A

a list of drugs (usually generic) that limits the number of drugs a practitioner can choose from

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12
Q

Utilization Review

A

the evaluation of medically necessary, appropriate, or efficient use of health care services, procedures, and facilities

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13
Q

a newer managed care model that allows employees to have more choice while taking more responsibility for their health care costs

A

Consumer-driven health plans

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14
Q

The aim of Affordable Care Act / ObamaCare was to

A

increase access, quality, and affordability of health care, lower uninsured rate / provide income based subsidies to assist with affordability

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15
Q

Per Diem rates meaning

A

the company pays a pre negotiated per/day fixed rate which encompasses all included services so, you are not billing for time spent with patient but getting a flat rate for all services provided

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16
Q

PT is often considered a specialty service and is affected by cost control measures of MCOs , so direct access is not enough to overcome ______ deficits

A

Reimbursement

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17
Q

What provides monitoring and coordination of treatments provided to patients to control costs and utilization

A

Case Management

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18
Q

As with PPO plans, choosing to use an out-of-network provider brings higher …

A

higher out of pocket costs (usually there is an annual out of pocket deductible / fixed % co insurance)

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19
Q

PTs have often been considered a specialty service and have been significantly affected by the cost control measures of MCOs so _______ is not enough to overcome these reimbursement deficits

A

Direct Access

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20
Q

“Body language that can affirm/contradict verbal message”
Is which form of communication

A

Nonverbal

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21
Q

“Communication that occurs within an individual. “Self-Talk” “
Is which form of communication

A

Internal

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22
Q

“Reading charts, professional literature”
Is which form of communication

A

Reading

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23
Q

“Active process where re-statement, clarification, Summaries assist”
Is which form of communication

A

Listening

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24
Q

True listening helps build _____ and trust with patients and other professionals

A

Rapport

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25
Q

What are the 3 steps of active listening?

A

Restatement, Reflection, Clarification

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26
Q

What are the 3 domains of learning?

A

Cognitive, Psychomotor, Affective

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27
Q

Verbal components of communication include?

A

Language, speed, intent, tonality, pacing

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28
Q

Non verbal components of communication include?

A

Gesture, posture, touch, personal space, eye contact

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29
Q

What is Rapport?

A

an interaction marked by mutual collaboration and respect but not necessarily indicating agreement

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30
Q

Why is it important to adjust your communication style to each patient?

A

To build rapport, so that patients do not have to adjust to you, to match a patients vocal tone, pace and intent and build comfort

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31
Q

What are the 3 types of rapport?

A

Cultural, verbal, behavioral

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32
Q

What does cultural rapport involve?

A

Following the standard protocol for a given environment (dress, greetings, touch)

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33
Q

What does verbal rapport include?

A

Using similar phrases and conversational styles as the person you are talking to

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34
Q

What does behavioral rapport include?

A

Postural and body movements (hand gestures, standing or sitting posture)

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35
Q

True or False
There are times when breaking rapport is appropriate.

A

True
Occasionally patients may be inappropriate, so PTs can break rapport to become assertive or withdraw touch

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36
Q

What are the 6 levels of cultural understanding?

A

Destructiveness
Incapacity
Neutral
Pre-competence
Competence
proficiency

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37
Q

(Levels of cultural understanding)
Dehumanizing, denying services due to culture

A

Destructiveness

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38
Q

(Levels of cultural understanding)
patient is treated with bias and stereotypes

A

Incapacity

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39
Q

(Levels of cultural understanding)
assumption that all cultures are the same, services are ethnocentric

A

blindness

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40
Q

(Levels of cultural understanding)
use of appropriate response to cultural differences

A

Pre-competence

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41
Q

(Levels of cultural understanding)
Differences are accepted and respected. Knowledge, resources and services are continually adapted

A

competence

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42
Q

(Levels of cultural understanding)
differences are highly regarded, new approaches are developed to promote competence practice

A

Proficiency

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43
Q

Acknowledges differences, limited behavior change

A

Cultural Awareness

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44
Q

Lifelong commitment to change, gains respect and trust

A

Cultural Humility

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45
Q

Implicit Bias

A

Attitudes or Stereotypes that impact our understanding in an unconscious manner.

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46
Q

In communication, you can’t react comfortably to something different if you …..

A

Don’t fully understand yourself

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47
Q

Context in a conversation refers to ….

A

what gives meaning during communication

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48
Q

High context assumptions assume that the group is….

A

the group is more important than the individual

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49
Q

People who follow high context assumptions generally use:

A
  1. Indirect communication
  2. Circular logic
  3. Nuance is important – eye gaze, gestures, etc.
  4. Communication is influenced by the listeners knowledge and less by what the speaker is saying
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50
Q

Low context assumptions assume that …

A

the individual is more important than the group.

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51
Q

People who use low context assumptions generally use …

A
  1. Direct communication
  2. Linear, logical thinking
  3. Influenced by the words of the speaker not the listener
  4. Less nuanced
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52
Q

Western medicine generally follows the ___ Context assumptions

A

Low

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53
Q

What are the 4 LAMP Skills in communication?

A

Leadership, Administration, Management, Professionalism

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54
Q

“Spoken/Signed that is usually perceived via auditory canals”
Is which form of communication

A

Verbal

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55
Q

A PT must adjust to every patient’s cultural need in order to …

A

Avoid stereotypes and treat each person as an individual

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55
Q

When a patient speaks little to no English, it is always best to use a qualified medical interpreter when at all possible because …

A

This helps to avoid miscommunication and reduces the chance of offending someone

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56
Q

Though it is important to include family in decision making for a patient, due to HIPPA laws a PT must make sure family member is …

A

the Power or Attorney and is legally allowed to make decisions regarding the patient and their care

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57
Q

The 5 primary generations

A

Traditionalists - Before 1946

Baby boomers - 1946 to 1964

Generations X - 1965 to 1980

Millennials -1981 to 1996

Generation Z - 1997 to 2012

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58
Q

Over __ million people in the US have visual impairments

These impairments can include?

What questions should you ask patients who are visually impaired?

A

26

Cataracts, Glaucoma, Macular Degeneration

How much assistance do they need when moving around & how visual material can be presented so that they can read it appropriately

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59
Q

__% of people in the U.S. have some form of auditory impairment.

What questions should you ask a patient that has an auditory impairment?

What may help improve their understanding?

A

15%

How best to assist them in hearing or understanding you

Good articulation and lower tones will help to improve understanding
Having the patient repeat your instructions will help to ensure your instructions

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60
Q

When first meeting family members make sure to introduce yourself and …

A

explain your roll in the healthcare team

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61
Q

When working with a team as a PT, what is the SBAR technique ?

A

Situation
(Concise statement of the problem)

Background
(Brief summary of pertinent information)

Assessment
(Analysis and Considerations of Options)

Recommendation
(Actions you recommend)

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62
Q

For student communication, It is important to begin modeling the professional behaviors you will be expected to demonstrate. Professional interactions should be ______ and ______.

A

respectful and positive

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63
Q

When trying to create a good first impression remember ….

A

Your appearance speaks volumes

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64
Q

Communication is …

A

is the transference, transmission or exchange of ideas and information

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65
Q

What are the 3 prevention categories and their definitions

A

Primary - Preventing injury/illness/disease before they start
Weightbearing exercise to prevent osteoporosis

Secondary - Interventions provided after the onset of pathology with the intention of minimizing progression/severity
Exercise for those with high blood pressure and high cholesterol to prevent heart attack

Tertiary - Slow the progression and increase quality of life
Patient who had a stroke rehabbing to regain function

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66
Q

Balance and growth across physical, spiritual, emotional, intellectual, social, and psychological domains

A

Wellness

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67
Q

A resource leading to well-being physically, mentally, and emotionally

A

Health

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68
Q

Enabling people to increase control and improvement over their health

A

Health Promotion

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69
Q

An action or activity taken on for the purpose of promoting, protecting, or maintaining health without objective metrics regarding effectiveness

A

Health Behavior

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70
Q

Health Related Quality of Life (HRQOL)

A

An individual or groups perceived physical and mental health over time

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71
Q

Which form of nutritional advice can PTs give to patients?

Which form of nutritional advice cannot be given by PTs to patients?

Who should a PT refer to regarding nutrition if needed?

A

Generalities of healthy eating and weight management

Specific diets or specific nutrients

A dietitian

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72
Q

5 As Framework (addressing health behaviors with patients)

A

Ask-Advise-Assess-Assist-Arrange

73
Q

Tobacco Use Can impair …

A

Impair tissue healing and injury recovery

74
Q

Good stress is also known as

A

Eustress

75
Q

Bad stress is also known as

A

Distress

76
Q

What can reduce stress ?

A

exercise, sleep, relaxation, deep breathing etc.

77
Q

(Behavioral Change Theories)
Trans Theoretical Model includes 3 constructs which are:

The 5 stages of change in this theory are:

A

Decisional Balance – pros and cons
Self-Efficacy – confidence
Process of Change – stages

Precontemplation – unaware or past failures
Contemplation – pros and cons-deciding
Preparation – making plans to change
Action/Change – engaging in new behaviors
Maintenance – continue new behavior for 6 months

78
Q

(Behavioral Change Theories)
The Social Cognitive Theory includes (4):

A

Behaviors are interactions between environment, personal factors, and behaviors

Self-efficacy or confidence that change can be successful in many situations impacts effort and determination

Need to set folks up for success by addressing barriers proactively

Self-efficacy assessments are crucial

79
Q

(Behavioral Change Theories)
The Social Determination Theory includes:

A

Supportive environment is crucial for folks to thrive

Behavior change is sustainable when motivating factors are for intrinsic reasons

Motivation must be assessed and supported

Rationales for change by PT’s must support intrinsic value for behavior change

Must address patients competence, autonomy, and relatedness to the things you are asking them to do so patients feel respected, heard, and well cared for

80
Q

In order to assess health or health behaviors a PT can ask questions about:

A

Activity level
Healthy eating
Smoking
Sleep
Stress

81
Q

In the intervention process goal setting is important, what does SMART stand for in regards to this process

Goals should be challenging but _______

A

specific, measurable, action-based, realistic, time-referenced

realistic

82
Q

True or False
Behavioral change is impossible.

A

False.
It is difficult but not impossible.

83
Q

The largest practice area in PT

A

Musculoskeletal

84
Q

Dysfunction

A

The loss of functional abilities

85
Q

Damage to MSK system can result in changes in the body which include

A

ROM, pain, edema (swelling), muscle weakness, fatigue

86
Q

Overuse injuries are caused by …

Examples?

A

Repeated stresses to the same body part

Running, repetitive work activities, throwing, overhead sports

87
Q

(Common overuse injury)
inflammation of bursae, bursae often get pinched or rubbed by repetitive motion

A

Bursitis

88
Q

Runners often get ____ of the hip when running with overly tightened tensor fasciae latae muscles

A

Bursitis

89
Q

(Common overuse injury)
What is tendinopathy?

Tendon injuries can be due to what 2 factors

A

Repeated overuse or overstretching of muscles that can cause stress and injury to tendons

inflammation (tendonitis)
Degenerative changes due to overuse (tendinosis)

90
Q

(Common overuse injury)
What is nerve entrapment?

A

Pressure on a nerve from the neighboring structure

91
Q

(Common Traumatic Injuries)
What is a ligament sprain?

A

over stretching a ligament that can cause pain and instability of a joint

92
Q

(Common Traumatic Injuries)
Direct trauma, rotational force or sheer forces that can cause a bone to break is?

Who is at increased risk of this?

A

Fracture

The elderly

93
Q

(Common Traumatic Injuries)
A sudden muscle contraction or a sever stretch that can cause tearing of muscle fibers is?

A

Muscle Strain

94
Q

(Common surgical Injuries)
____ ____ ___________ are used to put in new joint surfaces and decrease pain caused by degenerative changes

A

total joint arthroplasties

95
Q

When a patient’s own tissue can not be repaired so tissue from a different area of the body or a cadaver is used

A

Reconstruction

96
Q

Transplanting living tissue from one site to another

A

Graft

97
Q

the patient’s ability to move their limb independently

A

AROM

98
Q

the therapist moving a patient joint through a range of motion without help from the patient

A

PROM

99
Q

When a joint has less motion than it should

When a joint has more motion than it should

What is used to measure a patient’s ROM

A

Hypomobile

Hypermobile

Goniometer

100
Q

The amount of force produced during a voluntary contraction

A

Strength

101
Q

Testing a specific muscle to look for weakness

A

MMT

102
Q

The ability of a limb to move through a range of motion

A

flexibility

103
Q

Therapists use _____ of the skin to determine what is occurring in MSK system

A

palpation

104
Q

(physical agent of intervention)
Thermal Agent?

Examples?

A

What is used to alter the temperature of a specific body part to assist with tissue healing

Hydrotherapy, Hot/Cold pack, parafin treatment

105
Q

(physical agent of intervention)
electrical stimulation is?

why is it used

A

Uses electrodes to stimulate nerves, muscles, and other soft tissue

Improve ROM, reduce swelling

106
Q

What is manual therapy?

A

hands on treatment and manipulation of a given body part or joint

107
Q

The 3 forms of resisted exercise

A

Isometric
Isotonic
Isokinetic

108
Q

Muscle contraction without visible movement

A

isometric

109
Q

Muscle contraction that controls joint and causes shortening OR lengthening

A

isotonic

110
Q

Concentric or eccentric muscle contraction that occurs at a constant speed

A

isokinetic

111
Q

What activities do PTs use for endurance training?

A

cycling, swimming, running, climbing etc.

112
Q

True or False?
PTs almost always assign a home exercise program to a patient at the initiation of therapy

A

True

113
Q

Injury resulting from the disruption of blood flow

A

CVA (aka stroke)

114
Q

What % of patients die within a month of having a stroke?

A

30

115
Q

What causes a TBI?

Methods of TBI?

A

a significant external trauma to the brain and its surrounding structures

accidents, falls, violence

116
Q

What is the leading cause of death and disability in children and young adults?

A

TBI

117
Q

___ is usually the result of a motor vehicle accident, falls, and sports

A

SCI

118
Q

The job of the _______ ______ is to detect head position and movement

A

Vestibular system

119
Q

Patches of demyelination of the CNS which causes disturbances in the conduction from the CNS to PNS

A

MS

120
Q

3 primary symptoms of Parkinson’s disease

A

Tremors- alternating contratcion of muscle groups
Rigidity - resistance when limb are passively moved
Bradykinesia - slowness of movement

121
Q

True or False
There is a cure for Parkinson’s Disease.

A

False

122
Q

ALS is also known as

ALS is caused by

A

Lou Gehrig’s disease

Degeneration of motor nerve cells

123
Q

True or False
There is a cure for ALS.

A

False

124
Q

The largest organ in the body

A

Skin (integument)

125
Q

The 3 phases of wound healing

A

inflammatory, proliferative, remodeling

126
Q

Treatment of the inflammatory phase of wound healing include

These activities should only be performed if …

A

wound care, active ROM exercises, positioning etc.

they do not cause pain

127
Q

Factors that influence wound healing

A

Wound depth - size - location
Healing time
Reason for wound

128
Q

Common integument conditions

A

dermatitis, skin cancers, shingles, burns, pressure ulcers

129
Q

Bluish skin may indicate
Red skin may indicate
Lack of hair growth may indicate

A

poor circulation
inflammation
poor circulation

130
Q

Arterial Wounds are usually on ….
The pain is usually severe with an ______ shape and pale base

A

the lower leg

irregular

131
Q

Venous Ulcers are usually on ….
The pain is usually mild with a ___ base and irregular shape

A

on leg
pink

132
Q

Neuropathic Ulcers usually are on …..
they are often painless but may ____ easily

A

bottom of foot, heel or bony prominences
bleed

133
Q

Pressure Ulcers are usually on …. but can occur anywhere there is excessive prolonged pressure

A

bony prominences

134
Q

superficial wounds are painful and ___

A

red

135
Q

partial thickness injuries are painful, ___, and blistering
there is significant _____

A

red, drainage

136
Q

Full thickness ____ are not usually painful

A

burns

137
Q

The 2 layers of integument

A

epidermis, dermis

138
Q

A lot of pediatric therapy revolves around play in the natural environment such as:

A

home, school, daycare, community centers, parks

139
Q

EHCA became IDEA, which is

A

Education of All Handicapped Children
Individuals with Disabilities Act -
law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

140
Q

Examples of Neuromuscular conditions in pediatrics

A

autism, CP, spina bifida

141
Q

examples of MSK conditions in pediatrics

A

scoliosis, club foot, osteogenesis imperfecta

142
Q

examples of cardiovascular conditions in pediatrics

A

asthma, cystic fibrosis

143
Q

Examples of systemic/metabolic health conditions in pediatrics

A

diabetes type 1 and 2, fetal alcohol syndrome, obesity

144
Q

the __ model helps look at the child globally and holistically and within the situational context

A

ICF

145
Q

5 questions that should be asked when evaluating interventions for pediatrics

A

Does the intervention encourage the child to initiate a program of lifelong fitness activities, including proper nutrition, exercise, weight control, and stress management?

Does the intervention encourage the child to assume responsibility for personal health, including knowledge of the condition?

Is the child encouraged to become personally involved in decisions on rehabilitation?

Does the intervention motivate the child to foster self esteem?

Does the intervention promote meaningful pursuits that will foster the prevention of secondary conditions?

146
Q

The ability to receive and interpret input through peripheral sensory nerves

A

Sensation

147
Q

Perception

A

the ability to integrate and respond to sensory input appropriately

148
Q

Functional Recovery

A

Accomplish tasks in the same manner they were performed previously

149
Q

Accomplish tasks through alternative means using strategies or substitutions

A

Compensation

150
Q

Using both functional recovery methods and compensation methods for BEST outcomes

A

Blended

151
Q

The Brain and Spinal Cords ability to adapt and remodel themselves as they learn new behaviors and skills

A

Neuroplasticity

152
Q

Physical agents might be incorporated to improve flexibility and strength. Examples include:

A

Biofeedback
Neuromuscular electrical stimulation (NMES)
Functional electrical stimulation (FES)

153
Q

Older adults need help staying independent with _____ and _____

A

Activities of Daily Living (ADL’S) and Instrumental Activities of Daily Living (IADL’S)

154
Q

Some changes associated with aging are now thought to be associated with

A

Inactivity and sedentary lifestyle

155
Q

_______ ________ does not decline with normal aging but memory and conceptualization can be reduced.

A

Cognitive function

156
Q

True or False
Psychosocial changes are not common in older adults.

A

False

157
Q

Common conditions in older adults include

A

arthritis, osteoporosis, hip fractures, diabetes

158
Q

______ can have an influence on interventions with older adults

A

Medications

159
Q

What should always be incorporated in prevention for older adults

A

balance and fall prevention

160
Q

1 in __ adults have diabetes

A

5

161
Q

The number 1 cause of death in the US

A

CVD

162
Q

The 3rd leading cause of death in the US
(more woman and non hispanic blacks have this disease)

symptoms include

A

COPD

shortness of breath (dyspnea), and productive cough

163
Q

a process of inspiration drawing air in and expiration which is pushing air out

A

ventilation, or breathing

164
Q

the process of exchanging oxygen and carrying carbon dioxide between the air we breathe and the blood passing through the lungs

A

respiration

165
Q

Congestive Heart Failure (CHF) is

the onset can be ___ or ___

it can cause problems in the body such as

A

when the heart is damaged to the point that it can not move blood effectively

chronic or acute

fatigue, decreased breathing

166
Q

a result of the trapping of air in the lungs which causes hyperinflation

A

COPD

167
Q

What is caused by the decreased ability of the lungs to expand which results in a decrease in air volume in the lungs

A

Restrictive Lung Diseases

168
Q

Cardiac Catheterization is a ________ _________ that requires passing a flexible catheter into an artery of the leg and guiding it up to the heart to the coronary arteries or veins

A

Invasive procedure

169
Q

Examples of Noninvasive Procedures

A

Echocardiography (ECHO) (ultrasound to asses heart chambers, walls, valves)
Electrocardiogram (ECG)
exercise stress testing (determine how cardiov and pulm system respond under increased stress loads)

170
Q

One of the most commonly used noninvasive tests

A

ECG

171
Q

Diseases affecting the lungs can limit….

A

limit the amount of oxygen available for consumption

172
Q

Ischemia is…
It can result in…

A

Ischemia is the loss of blood flow and results in decreased oxygenation due to arteriosclerosis

173
Q

Heart failure is …

A

Heart failure is when there is a decrease in the pumping function of the heart

174
Q

Exercise stress tests can be performed using …

A

treadmills or stationary bikes

175
Q

Non-invasive procedure that examines the lung structures

A

X-ray, CT, and MRI

176
Q

MRI uses ____ waves while CT uses ___ waves

A

magnetic, radio

177
Q

Tests the effectiveness of the respiratory system and respiratory musculature. The test helps to classify the lung disease pattern and seriousness

A

Pulmonary Function Tests (PFTs)

178
Q

An electronic device is inserted near the clavicle and wires are attached to the heart to control the pulse of the heart

This is used for patients with chronic arrhythmia

A

Cardiac Pacemaker

179
Q

Heart Transplantation
is performed when

generally the patient must be ….

A

when the heart does not respond to any other treatments

younger than 60, free of other health issues and is emotionally stable

180
Q

FITT parameters are sometimes used to determine exercise guidelines. This stands for?

A

F - Frequency - How Often
I - Intensity - How Hard - Use target HR or rate of perceived exertion
T - Time - How Much
T - Type - What type of activities

181
Q

removal of excess mucus created by an obstructive pulmonary disease

A

Secretion Removal

Intro To PT (1 decks)

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