Study Guide For Ch. 2.pdf

2.3 PICCfor regular IV more durable; for things like feeding tubes “we don’t want PICC bc its more serious” Peripheral IV (PIV)gets inserted into PICC line for antibiotics and fluids like diluted formulas Foley Catheter pee bag and inserted in the bladder prevents infection and exacerbating of bed s...

2.3 PICCfor regular IV more durable; for things like feeding tubes “we don’t want PICC bc its more serious” Peripheral IV (PIV)gets inserted into PICC line for antibiotics and fluids like diluted formulas Foley Catheter pee bag and inserted in the bladder prevents infection and exacerbating of bed sores prolonged use could lead to infection Sequential Compression Devices wrap around ankles and calfs (squeezing and releasing) prevents deep vein thombosis people out of surgery, no muscle pump action, lower edema, not walking around as often 2.4 sign: objective/observable, can be quantified with measurement instruments ex: swollen finger symptom: subjective ex: I feel dizzy HR Know how to do age, gender, level of PA, history of problems kids: higher HR men: lower HR Blood Pressure: force exerted by the blood against vessel wall • helps w/ parameter for activity intensity • diagnostic info/prognostic info • key indication of health of CV system * tells us about hearts ability to respond to metabolic demand Know how to do extreme BP = possible stroke, faint, MI Respiratory Rate count pulse, mental predicts: shock, sepsis, inflammation note responsive to internal/external stimuli alterations in thoracic cavity, • count respiratory muscle activity can rise change and fall in Know how to do same pulse ox why do we take body temp determine if inflammation/infection • least accurate: forehead • most accurate: under tongue normal: >90% for most pt • tells us about physiologic tolerance of activity • can be don on finger, earlobe, toe arterial blood= saO2 peripheral = SpO2 positio n, can put hand on them if breath shallow 2.5 Hand washing one minute hand washing 1 in 31 Healthcare professionals fall ill bc they don’t wash their hands best tool against Healthcare Associated infections HAI Donning and Doffing PPE Mode of Pathogen Transmission Direct Contact involves physical transfer to pathogens directly from one person to another ex: bathing or transferring patient Indirect Contact involves an intermediate step begins when a contaminated person touches an object or an infected person then touches someone else ex: infected gloves touching someone else Droplet Transmission involves large pathogenic particle droplets coming in contact the host mucous membrane of nose or mouth generated by coughing, sneezing or simply talking Airborne Transmission dissemination of small particles containing infectious agents that are inhaled by a susceptible host remains in the air longer than droplets Environment of care Clean technique efforts to reduce the number of infectious organisms in the clinical setting Sterile technique specialized process deigned to eliminate pathogens from medical equipment, surfaces and environments commonly used in operating rooms, requires high technology and specialized training Standard Precautions standardized infection control practices quirked when working with all clients and patients in any setting based on the need to protect the patient and healthcare worker 2.6 Orientation, Cognition, and communication Alert & Oriented (A&O): document communication, pt demeanor, affect/mood in objective portion of SOAP A&O X4 1. Person: alert to own name, date of birth (A&OX1) 2. Place: location, city, state, building, general area (A&OX2) 3. Time: Know what day it is? Month? Year (A&OX3) 4. Situation: know why here, recall info (A&OX4) ex: A&OX1, pt unable to correctly verbalize day of the week. where at & name cognition • record emotion: irritated, annoyed, flat affect, lethargic etc 2.7 Movement Precautions/Contraindications precautions: PT can work, just modify or be cautious ex: low hemoglobin but no symptoms contraindication: PT should not proceed ex: extremely low THR/THA Precautions Hemiarthroplasty: no precautions Anterior Approach: fast healing but more risk bc femoral n ant precautions: no abd, ext past neutral, ER Posterior Approach: more common post precautions: no add, flexion >90, IR median sternotomy precautions 1. Avoid shoulder flex/abd >90 2. Avoid lifting >10 lbs 3. Avoid UE WB 4. Avoid unilateral reaching OH 5. Avoid extreme scap retraction 6. Cough.sneeze w/ pillow pressed on chest spinal precautions LOG ROLLLLLLLLLL NO BLTs 1. Bending (do @ hips/knees) 2. Lifting (nothing > 5-8lbs depending on surgeon) 3. abdominal precautions 1. Practice good mechanics/posture! Twisting LOG ROLLLLL Abdominal Binder PRN 2. Log roll transition from supine to sit • liver transplants 3. • small & large bowel resections 4. No valsalva (holding breath & bearing down, • surgeries inferior to diaphragm want to decrease amt of intrabdominal • used for pt comfort NO BLTS pressure) WB Precautions contraindications 1. Uncontrolled DVT 2. Uncontrolled PE (pu;m emb) 3. Resting Tahcycardia > 100 BPM 4. Fever 5. Systolic BP >180 mmHG and diastolic > or less than 100 mmHG (except for permissive HTN) 6. Unstable Angina 2.8 Outcome Measures objective tests that allow a clinician to assess a patient using evidence based methods to assist in clinical decision making -provide numerical values and usually add up to a certain score Dimension refers to the focus of the measure which can be looked at according to the ICF model -format of a tool is either performance based or conducted via self report -reliability of a tool is the ability to which the test is reproducible, or the consistency with which the tool is utilized by either the same or different clinicians -validity is the extend to which the tool measures which it is support to measure -responsiveness of a test measures the ability to detect change -minimal detectable change is the smallest amount of change and an outcome measure that is not attributable to error perceived as beneficial to the patient or clinician Feasibility a fairly self explanatory attribute what you want to choose a test that is not time consuming, that is easy to score and that uses the least amount of or easiest equipment to use *Shirly Ryan Ability Lab- representation of outcome measures for you*