Rehab 1.1 - medical management

x ray

you should wait for a ___________ before mobilizing a patient with a PICC line

• EKG

• BP cuff

• pulse ox

if someone is on tele, what does the tele provide

• brachial

• radial

• femoral

which arterys can an arterial line be placed

no (mobility is limited by the length of the a-line cord)

is it possible to disconnect an arterial line

arterial line

the ___________ is an advanced IV that measures arterial BP, obtain arterial blood samples, and delivers medicine

70 - 110 mmHg

what is the mean arterial pressure

systolic = 100 -140

diastolic = 60-90

what is the normal Arterial BP for systolic and diastolic

yes

can you mobilize patients with upper extremity a-lines

no (they are on bedrest)

can you mobilize patients with a femoral a-line

60-80

someone with a femoral a-line have a ____-____ degree limit for hip flexion

PA line

another name for the Swan-Ganz

subclavian; right atrium; pulmonary

the pulmonary artery catheter (Swan-Ganz) is inserted through a large vein, usually the __________, through the ____(chamber of the heart)____ and into the __________ artery

• pulmonary arterial pressure = 10-20

• right atrial pressure = 2-8

• cardiac output = 4-6 L/min

what does the pulmonary artery catheter (Swan-Ganz) measure (3)

what are their mean values?

typically bedrest (but if they can mobilize avoid movements that would disrupt the PA line)

can you mobilize someone with a PA line

central venous line (CVL)

the _____________ advanced IV goes through the subclavian, basilic, jugular, or femoral vein and to the superior vena cava

• subclavian

• jugular

• basilic

• femoral

what veins can the central venous line (CVL) be inserted?

0-8

when someone has a central venous line, you need to monitor their central venous pressure which is ____-____ mmHg

jugular

patients that have their central venous line inserted into their _______ vein need to limit cervical ROM

CVL

which is closer to the heart, the PICC or CVL

yes

can you do blood draws with a central venous line

no

can you do blood draws with a PICC line

no

can you do blood draws with a PIV line

• subclavian

• internal jugular

• femoral

what veins can the port-a-cath be inserted

port-a-cath

the ___________ advanced IV would be used to deliver chemo, TPN, adn infusion therapy

yes (no restrictions as long as it’s healed)

can you mobilize someone with a port-a-cath

yes (just be careful)

can you exercise and do manual therapy in the area of a port-a-cath

30-60

if the temporary pacemaker of patient’s is pulled/discontinued, they must go on bedrest for _____-____ minutes

60-90

once a femoral a-line is removed, the patient must be on a strict bedrest for _____-_____ minutes

endotracheal

endotracheal or tracheostomy:

temporary

endotracheal

endotracheal or tracheostomy:

through the mouth

tracheostomy

endotracheal or tracheostomy:

directly into trachea

tracheostomy

endotracheal or tracheostomy:

long term

one manages the ventilator while one guards the patient

why would you need another person to mobilize a patient on a mechanical ventilator

sedation

a patient on a mechanical ventilatory can be mobilized but it depends on their ________

chest tube

the __________ advanced IV is used when a patient needs excess fluids drained and/or need to maintain pulmonary inflation

either

is a chest tube with or without a suction device

below

the chest tube’s drainage system should be ________ the level of insertion

sit them up

if the chest tube becomes dislodged, how should you position the patient

ask the nurse (if yes, you as the PT do not clamp it shut)

can you mobilize a patient with a suction on their chest tube

ICP

which ones monitors, ICP or external ventricular drain

ICP

the ____________ advanced IV is a catheter placed in the anterior horn of the lateral ventricle that monitors the intracranial pressure

< 20 mmHg

what is the normal value of the intracranial pressure (ICP)

ICP

Intracranial pressure (ICP) or external ventricular drain (EVD):

intermittent or continuous drainage

EVP

Intracranial pressure (ICP) or external ventricular drain (EVD):

continuous drainage

external ventricular drain (EVD)

the ___________ advanced IV is a catheter placed in the anterior horn of the lateral ventricle or epidural space that continuously drains CSF

both

Intracranial pressure (ICP) or external ventricular drain (EVD):

temporary

up

if the transducer in a intraventricular catheter goes (up or down) it could cause the CSF to go back into the brain causing it to swell, push downwards, compress the brain stem, and cause death

down

if the transducer in a intraventricular catheter goes (up or down) it could cause all the CSF to be sucked out causing the brain to go downwards and compress the brain stem and then death

yes (just need the nurse to clamp it and monitor the transducer)

can you mobilize someone with an intraventricular catheter

no (get the nurse)

can you as the PT clamp the intraventricular catheter for mobility purposes

VP or VA

the ___________ advanced IV drains extra CSF from the brain to abdominal cavity or heart

24 hours

a patient needs to be on bedrest for __________ after a VP/VA shunt is placed

NG tube

a __________ goes through the nostril and esophagus to the stomach to administer feedings/meds, can also do gastric emptying via continuous suction

yes but ask the nurse

can you take a patient off NG tube suction

aspiration

patients with an NG tube have ________ precautions

bed elevated 30 degrees (or higher)

position of the patient for feeding with an NG tube

PEG tube

a ____________ is placed through the abdominal wall and into the stomach

NPO (nothing by mouth) or aspiration

a patient with a PEG tube is on __________ or _________ precaution

bed elevated 30 degrees or more

how should the patient with a PEG tube be positioned when the feeding pump is on

yes with nurses permission

can you stop the pump on the PEG tube

yes with the nurses permission

can you as the PT unhook a patient off their PEG tube

fecal management system

the ____________ is a rectal tube/pouch that collects bowel drainage

pad/chuck/sheet

what should you use with a patient with a fecal management system to help mobilize