PTA 250 Final (Chapters 6, 10, & 12)

ventilator

- keeps pt. alive & breathing

- don't adjust settings, pull tube, or turn machine off, let nurse deal with it

- connects to pt. through nose or mouth

central venous pressure catheter

plastic IV tube used to measure pressure in right atrium or superior vena cava

- gives most accurate blood pressure

- surgically inserted

chest tube drainage system

- surgically inserted into lateral side of ribs

- drains excess fluid, air, blood, drainage

- can operate off of gravity or pump

- don't pull/kink/dislodge tubes, don't kick over collection container

Gastric Tube (G tube)/PEG

- feeding tube surgically inserted into middle of pt.'s stomach

- pt. is not allowed to have any food by mouth

- can administer medications and liquid food through it

- place gait belt above tube

- pt. cannot be in supine, needs to be at least 35-40 degrees elevated

- long term

colostomy bag

- surgical opening created to allow elimination of feces

- external collection bag

- be aware pt. has it and consider gait belt position

nasograstric tube

feeding tube inserted in nose that goes down into pt.'s stomach

- can remove fluid, gas, content from stomach through this tube, can also administer medication

- pt. cannot have anything by mouth

- short term

- pt. should not flex head or bend forward

JP drain

drain inserted into body, soft collection canister where blood/fluid/drainage collect

urinary catheter

inserted into bladder to remove urine from bladder

- be careful not to pull, move, or kink tube

- foley, external, suprapubic

tracheostomy

breathing tube directly inserted into trachea

- be mindful of neck flexion/rotation

intercranial pressure monitor

measures pressure in pt.'s head (pressure against skull and brain tissue)

- normal intercranial pressure: 4-15 mm mercury

- avoid prone position, isometric exercise, head flexion, hip flexion more than 90 degrees and valsalva maneuver

- head of bed should be 15 degrees elevated

benefits of passive exercise

preserves & maintains ROM

minimizes contracture formation

minimizes adhesion formation

maintains mechanical elasticity of muscke

promotes & maintains local circulation

promotes awareness of joint motion

evaluates joint integrity and motion

enhances cartilage nutrition and stimulates movement of synovial fluid

inhibits or reduces pain

PROM

passive range of motion

- taking joint through full range of motion until end feel is met

end feel

the feel of resistance of the tissue at the end of the range

circular bandage pattern

the bandage is applied in a series of overlapping circular turns around a body part to anchor the bandage initially or terminally.

spiral bandage pattern

the bandage is applied in a series of overlapping diagonal turns (up or down) around a body part

open spiral or oblique bandage pattern

series of diagonal turns that do not overlap and have an open space between each turn

recurrent bandage pattern

series of lengthwise layers applied to the anterior-posterior surfaces of an extremity or digit. used to cover the most distal aspect.

figure-of-eight pattern

series of spiral turns applied in alternate directions. the first turn progresses in an inferior-to-superior and the second turn progresses in an superior-to-inferior direction

standard hospital bed

can be adjusted in many ways, has controls and rails

Volume cycled ventilator

long term use

Pressure cycled ventilators

short term use

Vital Signs Monitor

Includes blood pressure, heart rate/cardiac patterns, temperature, respiration rate, oxygen saturation

Nasal Cannula

A common oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostrils

Oronasal mask

Soft plastic mask that goes over the nose and mouth

- Used if pt.'s need more oxygen than nasal cannula can supply

Endotracheal (ETT) Tube

tube in mouth or nose that connects ventilator to patient through their airway

Pulse oximeter

Measures oxygen saturation in blood

Less than 90 is low

pulmonary artery catheter

long plastic IV tube that is inserted into the jugular or femoral vein, measures PAP

- do not allow hip flexion greater than 30 degrees or abduction (if inserted in femoral vein) and shoulder motion (if inserted in subclavian vein)

arterial (A) line

placed in artery (radial, dorsal pedal, axillary, brachial, femoral)

-measures blood pressure, can draw blood

Hickman catheter

inserted in cephalic or internal jugular vein

- measures central venous pressure, can administer medications or remove blood through it

lab values

- levels of troponin/creatine kinase are elevated - heart attack

- 90% of oxygen saturation should be maintained during exercise

- patients with Hgb less than 8 g/dl should not participate in physical activity

- patients who are on anticoagulants:

INR less than 4.0: can participate in therapy

INR between 4.0 and 5.0: light exercise permitted

INR greater than 5.0: no exercise allowed

INR 6.0 or higher: bed rest

intravenous infusion (IV) lines

- used to draw blood, and/or infuse fluids/nutrients/medications

- don't take blood pressure in that arm, make sure infusion bag stays above where IV is placed

- avoid elbow flexion if IV is in elbow

Patient-controlled analgesia (PCA)

delivery system that allows patients to self-administer a predetermined dose of pain medications on demand

dialysis

replaces or assists in normal kidney function

shock symptoms

pale, moist, cool skin

shallow/irregular breathing

dilated pupils

weak/rapid pulse

diaphoresis

dizziness/nausea

syncope

orthostatic hypotension

low blood pressure that occurs upon standing up

allergic reactions

be aware of equipment you are using/anything that can cause a reaction with your patient

- identify what causes the reaction and remove it from patient

falls

common occurrences

- educate patient on how to recover

fracture

swelling, bruising, deformity, pain in bone

- protect site, prevent further injury/infection, never try to realign fracture

burns

red/blistered skin

- prevent wound contamination

seizures

protect the person from injury by moving nearby objects away, protect their modesty/privacy, position person on side/safe area

heat exhaustion

- least threatening

- pt. experiences: profuse sweating, nausea, headache, shallow or rapid breathing, weak or rapid pulse, pale color, elevated temperature, exhaustion, unconsciousness, muscle cramos

heat stroke

- most threatening

- pt. experiences: nausea, headache, dry skin, labored breathing, strong/rapid pulse, flushed/gray color, very elevated temperature, unconsciousness, pupils contracting & dilating

insulin-related illness

objective is to restore the pt. to a normal insulin-glucose state

hypoglycemia - caused by too much insulin, pt. should be treated with sugary substance

hyperglycemia - caused by too little insulin, pt. should be treated with insulin injection, don't give them sugar

stroke

signs: face drooping, arm weakness, speech difficulty,

- time is crucial

- 3rd leading cause of death

- call 911

what does PROM not do

increase ROM

prevent muscle atrophy

reduce adipose tissue

build muscle strength

vertebral artery occlusion test

- performed before cervical PROM to ensure circulation to the brain won't be interrupted

procedure:

- position pt. in supine

- fully extend head, flex head, and laterally flex the neck to the R for 30 seconds then back to neutral

- full extend the head, neck, and laterally flex the neck to the L for 30 seconds then back to neutral

- ask about dizziness/fainting and look at eyes for darting