Patient Exam + Eval

What do we want to gather in the subjective or prior to appointment?

Reason for admission, Dx, PMH, reason for PT consult, family support, living arrangements, environment/work/home barriers and demands, fall history, PLOF, key events at hospital, labs, meds, imaging/tests, precautions, code status, case management

What are the different WB statuses?

NWB, TTWB/TDWB, PWB, WBAT, WB

Move in the tube?

Keep arms in for WB exercise, arms anywhere for NWB, no lifting 10+ lbs

Strict Sternal?

Keep arms in (not behind back either), no pushing/pulling, no lifting over 5-10lbs

Total hip precautions (posterior)

No flexion beyond 90 degrees, No IR, No ADD

• Turn towards non-operative side while walking

Total hip precautions (anterior)

No extension, No ER, No ABD

Spinal precautions

No bending at the waist greater than 90 degrees, no lifting >10 lbs, no twisting/SB trunk, do not cross knees or ankles

• Always log roll into/out of bed

Abdominal precautions

No lift/pull/push >10 lbs, don’t engage abdominals, do not hold breath/strain, use pillow to brace

• Log rolling

Hip, Spine, Abdominal precautions all share one thing in common. What is it?

They last 6 weeks post-op

How do you survey lines and leads?

360 degree scan

What positioning is necessary for enteral nutrition/tube feed?

HOB elevated 30 degrees, 30-60 mins

What is TPN and its main risk?

Ful nutrition through IV, risk of blood infection

NG tube for what?

Delivery of substances to stomach and withdrawal

Ostomy bag?

Urine/poo post-op colon or bladder

Dialysis for messed up -. - - put in place if long-term.

Kidneys, AV Fistula

What is an SCD?

Sequential compression device, prevent VTE, take off for mobility

Systems Review:

• Mental Function- _

• Integument- _

• CP-_

• MSK- _

• Neuro- _

• AXO (place, time, situation, self)

• Edema (pitting, circumference, F8), visual inspection

• HR, SpO2, BP, RR, Peripheral pulses

• Gross ROM (start AROM), Gross Strength

• Light touch, myotomes, proprioception, DTR, coordination, pathological reflex, CN screen

Weakness of myotome= _, Gross weakness= _, _, _

LMN/radiculopathy; deconditioning, illness, UMN/myelopathy

Quick CN screen, go!

CN II: read nametag or clock

CN III, IV, VI: H test

CN VII: smile, frown, puff cheeks, raise eyebrows, close eyes

CN VIII: rubbing near ear

CN XII: Stick out tongue

Functional mobility important, protect - and -

yourself and patient

What is the egress test?

• Tells us if we need to use a lift

Supine→ sit, Sit→stand, Stand and march (3), step and return

Balance assessment always -, also please document - - used

important, mobility device

Levels of assist

Independent (I), Modified Independent (ModI), Supervision (S), Contact Guard Assistance (CGA), MinA (75+), ModA (50-75), MaxA (25-49), TotalA (<25)

STG and LTG time frame

STG: 1-2 d

LTG: 1-2 w max