Lab values EOP

normal wbc

4,500-11,000

< 1,000 wbc

protective isolation

Normal platelet count

150,000-300,000

considered low number platelet count

<20,000

if platelet count is <10,000

hold PT

normal hemoglobin level

12.2-16.6

normal hematocrit

38-49%

normal blood glucose

60-110

normal PT time

12-15s

normal INR values`

.9-1.1

Normal PTT range

25-41 seconds

chemical waste product produced by muscle metabolism (measures kidney function)

creatinine

Normal Creatinine

.5-1.2

increases if kidneys cant filter /remove urea from blood

blood urea nitrogen (BUN)

Normal Blood Urea Nitrogen (BUN)

10-20 mg/dL

if hemoglobin is less than 8

adls only, no exercise

if hemoglobin is greater than 10

resistance and aerobic exercises

if hematocrit is <25%

adls only

if hematocrit is >35%

resistance and aerobic exercise

if WBC is <5,000 w. fever

no exercise

if WBC is >5,000

light exercise and progress

x-ray pending to rule out fracture

do not proceed

mri to rule out cord compression

do not proceed

ct scan to rule out bleed

do not proceed

no spine clearance by MD with trauma pt

do not proceed

imaging still pending

do not proceed

if systolic BP is decreasing with exercise

stop therapy and do not proceed

with cardiac, abdominal surgery, spine surgery, when resistance causes fatigue, marked osteoporosis when fracture may happen

use no resistance

two ways we classify pain

duration and type

categories for duration of pain

acute, persistent, recurrent, chronic

three types of pain

nociceptive, inflammatory, neuropathic

A-alpha nociceptors

proprioception

very fast

a beta nociceptors

touch fast

a delta nociceptors

mechanical and thermal pain

C Fibers (Nociceptors)

mechanical, thermal, chemical pain, slow/unrelated inflammation

Which of the following signals travels faster to the brain?

A. inflammatory pain

B. receiving a massage

C. closing your eye and standing on a foam surface

D) bumping your elbow on a doorknob

E) none

C. a-aplha

absence of pain to a stimulus which would normally be painful

analgesia

complex regional pain syndrome

causalgia

collective term used to include allodynia and hyperalgesia

Dysesthesia

Pain due to a stimulus that does not normally provoke pain

Allodynia

an abnormal sensation which may be described as "pins and needles"

paresthesia

pain that is felt at a site distant from the cause or location of an injury

referred pain

receive secondary gain (monetary) and are conscious of their efforts

malingerer

exhibit pain which is out of proprotion to objective findings. they are not conscious of their efforts which is seen as an illness behavior or an underlying psych problem

symptom magnifier

self administered

measures sensory, affective pain intensity

questions of usefulness of descriptive terms to determine different causes of pain because of too much overlap

short form mcgill

self-administered for chronic LBP

measures somatic and autonomic impact

modified somatic perception questionnaire

self administered

helps to determine the type of pain, somatic, neuropathic, inflammatory

Pain quality assessment scale (PQAS)

observation by clinican

for pt's with alzheimers disease, measures intensity

discomfort scale for dementia

clinician completes observation of pt at rest and with movement

used for cognitively impaired pt

CNPI: checklist of nonverbal pain indicators

self administered, self-report

measures intensity

uses a color chart, number or facial expression

visual analog scale

demonstrated strong agreement in rank of ordering pain

can be self administered (older than 4) or administered by others

faces pain scale

child is given four red poker chips and the child indicates how many pieces of pain they have

hester poker chip tool

SOAP

subjective, objective, assessment, plan

Your patient reports right lateral knee pain that has been "on and off" for the last 3 weeks. he has warmth and swelling in the area. how would ylou classify the pain

recurrent, inflammatory

normal HR adults

60-100 bpm

normal hr in children 1-10

70-130

HR for newborn (0-3months

100-150

HR for infants 3-6months

90-120

HR for infants 6-12 months

100-160

well conditioned athletes HR

40-60

Fast heart rate (HR greater than 100bpm)

Tachycardia

slow heart rate (less than 60 bpm)

bradycardia

Pulse rate should ________ with exercise

increase

it is abnormal for pulse rate to slowly ________ after exercise stops

decrease

T/f It is abnormal for your pulse to be ________ during or after exercise

irregular

t/f: it is abnormal for your pulse rate to _________ above what is expected for the exercise

increase

for a blood pressure cuff, the bladder width should be _____ limb circumference and the bladder length should be______.

40%, 80%

Normal BP for infants (0-3months)

Systolic: 85-90

diastolic: 35-65

normal bp for infants (3-12months)

Systolic: 90-100

diastolic: 60-67

normal BP for children 1-4 years old

Systolic: 100-108

diastolic: 80

normal BP for children 4-12 years old

Systolic: +2 per year

diastolic: 60-70

normal bp for adolescents

Systolic: 100-120

diastolic: 65-75

normal bp

120/80

normal bp for elderly

Systolic: 120-140

diastolic: 80-90

prehypertension

Systolic: 120-130

diastolic: 80-89

Hypertension Stage 1

Systolic: 140-159

diastolic: 90-99

stage 2 hypertension

>160/>100

hypertensive crisis

systolic >180, diastolic >110

t/f it is abnormal for systolic bp to not increase with exercise

true

t/f it is normal that someone's systolic bp does not decrease once exercise stops

false, this is abnormal

t/f is it abnormal if the diastole BP increases more than 10-15mmhg during exercise

true

if MAP is less than 60, then?

no exercise

Adult RR

12-18

children RR

30-50

abnormal rr

>20 < 10

a heightened response to pain from a stimulus that normally causes pain

Hyperalgesia

location of venous problem

medial malleoli

how to determine venous problem

dark pigmentation, swelling, enlarged superficial veins

tests for venous problems

venous filling time, homans sign, cuff test,

if you had a venous problem and you had a venous filling time test done, what would it do

decrease

if you had a venous problem and got a claudication test done, what would it be

negative

are venous wounds painful?

no

Arterial Location of Ulcers

lateral foot, toes, ischemic areas, dead/necrotic tissue, hair loss, tight skin

are arterial wounds painful?

pain w walking

what might someone with an arterial wound have a history of?

diabetes, HTN, CHF

Venous filling time test >15s

arterial dysfunction

venous filling time <15s

venous dysfunction

Rubor of dependency results show >15-30s and not the previous color

arterial dysfunction

three tests for arterial dysfunction

capillary repillary, claudication, rubor of dependancy

three tests for venous dysfunction

venous filling time

homan's sign

cuff test