Non Systems 2

hickman catheter

central line tunneled under skin

provides antibiotics, nutritional solutions and blood samples

swanz ganz catheter

balloon flotation device inserted through the internal jugular vein or femoral vein into the pulmonary artery

montiors blood flow and function of the heart

colostomy bag

exits the colon to the abdomen when a part of the colon or large intestine has been removed

focus on early mobility and beware height of gait belt (goes above)

central venous pressure catheter

measures blood directly from right atrium and superior vena cava

arterial line

monitor arterial blood gases

chest tube drainage

inserted through incision in chest and may be connected to a mechanical or gravity based suction system

used to remove air, purulent matter from the patient’s chest or pleural cavity

a clinician is preparing to ambulate a patient with pleural effusion and a chest tube. which of the following procedures is MOST IMPORTANT to consider?

a. collection bottle kept below level of inserted tube

b. collection bottle kep at level of inserted tube

c. collection bottle should be removed before ambulating patient

d. collection bottle should be held by PT while patient ambulates

a. collection bottle kept below level of inserted tube

chest tube dislodge

patient exhale

place gauze or gloved hand over area

call nursing staff

keep collection bottle below tube

IV line

do not hold above head for extended periods

alert staff if fluid is low due to air bubbles

arterial line dislodged

apply firm pressure

alert staff immediately

femoral line

avoid repetitive hip flexion and hip flexion >45 degreees

catheters

hang below level of bladder

do not empty if output being monitored

empty or alert staff if overfilled

a clinican is measuring a patient with a T12 spinal cord injury for a custom wheelchair. the patient will be using a 1in seat cushion for pressure relief. which of the following considerations is most appropriate?

a. 1in added to back height of chair

b. 1in subtracted from back height of chair

c. the patient sohuld be instructed in learning for pressure relief at a minumum of every 60 minutes

d. 1 in should be added to the seat height of chair

a. 1in added to back height of chair

wheelchair seat height

heel to popliteal fold +2 in

avg 19.5-20

seat depth

posterior buttock along lateral thigh to politeal fold

-2 in

avg 16 in

seat width

widest aspect of buttock or thights

+1.5-2in

avg 18 in

back seat

chair seat to axilla

-4 inches

consider any seat cushion and add thickness to final value

avg 16 in

armrest height

seat of chair to olecranon

+1 in (consider cushions)

avg 9 in

a patient uses a wheelcahir to commute from the parking lot to the physical therapy clinic. while performing a wheelchair transfer to treatment table, which of the following is most important consideration?

a. patient use shoulder muscles to support upper body

b. therapist should assist the patient’s lower extremities onto table

c. wheelchair should be locked prior to transferring

d. patient should use slideboard to transfer

c. wheelchair should be locked prior to transferring

wheelchair axle positioning normal

in line with shoulder or slightly posterior

wheelchair axle positioning bariatric

move rear wheel axle forward

wheelchair axle positioning transfemoral amputation

move rear axle wheel behind patient’s shoulder

which of the following is MOST LIKELY to be included while educating the patient on prevention of hip dislocation

a. transfer to the affected side from chair to bed

b. when donning/doffing shoes, rest the left ankle on top of the right knee sitting

c. keep knees higher than hips when sitting

d. avoid standing activities that involve rotating the body away from the operated extremity

d. avoid standing activities that involve rotating the body away from the operated extremity

which of the following initial gait patterns is most appropriate for this patient

a. bilateral axillary crutches and four point gait pattern

b. single cane and modified four point gait pattern

c. front wheeled walked and step to gait pattern

d. front wheeled walking and step through gait pattern

c. front wheeled walked and step to gait pattern

patient has progressed to a single cane and clinican is now instructing the patient in ascending stairs. the maximize safety during stair training which of the following positions is most appropriate for clincian?

a. in front of the patient, facing them, holding onto their cane

b. behind and to the patient’s left side, with one hand on gait belt

c. behind and to patient’s right side, one hand on gait belt

d. in front and to patient’s left side, maintaining contact with patient’s shoulder

b. behind and to the patient’s left side, with one hand on gait belt

standard crutches

axillary crutches

axilla space of approx. 2”

crutch is approx. 2” and 4-6 anterior to patient’s toe of the shoe

forearm crutches

lofstrand crutches

top of forearm cuff distal to elbow approx 1-1.5” below olecranon proccess

crutch is approx 2” lateral 4-6” anterior to patient’s toe of the shoe

cane

always held on unaffected side

is approx 2” lateral 4-6” anterior to patient’s toe of the shoe

ascending = good foot up first, followed by bad foot and cane

descending = bad foot and cane first followed by good foot

handpiece height

always 20-25 degrees elbow flexion

hand piece at level of wrist crease, ulnar styloid process

greater trochanter

position during ambulation on level ground

stand behind and slightly toward the patient’s involved LE

grab gait belt with supinated forearm

move forward in step with patient

longitudinal arch foot orthosis

scaphoid pad

pes planus

flat foot

UCBL

controls hindfoot valgus

reduces subtalar motion

three point counterforces - control calcaneal eversion, forefoot abduction

a clinican examines a patient who reports foot pain while running. the examination shows the patient has excessive pronation. which of the following would be most appropriate orthotic insert?

a. lateral post under 5th met head

b. a lateral post under calcaneus placing it in everted postion

c. middle post proximal to third met head

d. a medial post proximal to first met head

d. a medial post proximal to first met head

dorsiflexion assist AFO

DF weakness

posterior leaf spring

klenzak joint

posterior leaf spring

DF assist

recoils during swing phase to produce dorsiflexion

klenzak joint

DF assist

incorporated into stirrup

plantarflexion stop/resistance

PF tightness

plastic hinged AFO with posterior stop

which of the following combinations of orthotic and anatomical causes will most likely lead to same gait deviation

a. excessive height of medial upright KAFO and glute max weakness

b. excessive height of lateral upright KAFO and glute max contracture

c. inadequate DF stop and pes equinus deformity

d. inadequate DF assist and weak hip flexors

d. inadequate DF assist and weak hip flexors