Flashcards in Rehab Medicine: Renal Rehabilitation Deck (38)
What does a Physiatrist or Rehab physician 'specialize' in ?
Function (Practical approach to patient care and activities of daily living)
Kidney damage with normal or increased GFR
Kindey damage with a mild decrease in GFR
Kidney damage with Moderate decrease in GFG
Kidney damage with severe decrease in GFR
Less than 15 mL/min
Stage 6 real failure
What is the major etiology of Chronic Renal Failure ?
Diabete mellitus (50%)
What is the second most prevalent etiology of CRF ?
What is the major manifestation seen in CRF ?
What is uremic frost ?
In Chronic renal failure, BUN is so high that urea is crystalizing in the head !
What are other manifestation of CRF ?
Fatigue, dyspnea, headache, pruritus, peripheral edema, hyperpigmentation, neuropathy, altered mental status, auscultory rales, “uremic frost”
Is the treatment for Stages I-IV CRF medical or Surgical ?
DM, HTN, Diet Modification (adequate protein intake, restricting fluid/Na and possible K/P)
What kind of surgical options are available to those with Stage V or higher CRF ?
Dialysis (Hemo or Peritoneal)
What must be made in the arm of a person who is to undergo heomdialysis ?
(Use neck while fistula is 'maturing')
Why would someone choose peritoneal dialysis over hemodialysis ?
More lifestyle freedom, more pt responsibility,
(Must be done 4x daily)
What does peritoneal dialysis increase risk for ?
List the complications associated with renal transplantation
rejection (Signs of Graft Rejection: Anorexia, malaise, fever, HTN, leukocytosis, BUN elevation, kidney enlargement with localized tenderness, graft site tenderness, reduced UO, edema)
What is the major "frontline" drug used for immunosupression ?
Cylosporine is another drug used as an immunosuprressant after kidney transplant. What mineral deficiency is often seen with long term use of this drug ?
Hypomangnsemia (Must replace Mg+)
what other SE are seen in patients on Cyclosporine ?
Heart Attack, Hypertension, Seizures.
Besides immunosuppression for transplant patients, what other condition is Azothiopine used for ?
What are the three goal of Rehab
1. Function (FIM)
2. Independence (Owestry Disability Index)
3.QUality of life (SF-36)
What professions are part of a Rehabilitation Team ?
Patient Social Reports
What is the role of the physiatrist ?
Provides primary medical care, while coordinating interdisciplinary team and medical specialists
What is the role of the Physical Therapist
LE strengthening, transfers, gait, balance, endurance, energy conservation techniques
What is the role of the Occupational Therapist
UE strengthening, transfers, fine motor tasks with hands, self care ADLs Home assessments adequate DME/home modifications
What is the Role of the Speech Therapist
Speech, language, cognitive assessments, swallow evaluation
What is the Role of the Neuropsychologist.
Emotional, behavioral adjustment, higher cognitive and psychological evaluations related to current admission
What is the role of the Rehab Nurse
skin care, bowel/bladder management, pain control, preventative / coping education, medication administration
What is the Role of Social workers
disposition planning with family and insurance companies
Why do 83% of transplant patients not return to work ?
They are afraid their condition will worsen (may not like job,also)
What is the main purpose of the Pre-Transplant exercise program ?
To limit the amount of complications that may be seen during or directly after the surgery
Skeletal Muscle Atrophy
What do post transplant exercise programs consists of ?
Aerobic and Resistive
Regimens focus of lifestyle: stretching, repetitive low level resistence, aerobic exercise x 30mins daily
What SE does the post-transplant workout try to counteract ?
Counteracts SEs of immunosuppressive regimen (muscle wasting, weight gain, fatigue)
In terms of cognitive function, what is often seen in post-transplant patients ?
Improved attention, memory, reasoning
What does rehabilitation seek to improve in patients who are in ESRD or post-transplant ?
Rehabilitation improves overall physical function, mood, and quality of life.