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Aute Care PT (BLOOD PRESSURE (Systolic (increases linearly at rate of 8-12…
Aute Care PT
BLOOD PRESSURE
BP
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increases during dynamic resistance exercise, higher during concentric phase or valsalva
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Systolic
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10-20% legs > arms, if arms < legs indicates PVD
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LINES, TUBES, EQUIPMENT
Equipment
Mechanical Ventiliation
alarm may indicate coughing/change in respiratory pattern, or disconnection
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increased risk for contracture, skin breakdown, and deconditioning
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Tubes
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Urinary Catheters
avoid snagging, disconnecting, or occluding
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Nasogastric (NG)
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avoid head & neck mvmt, forward bending
Chest tubes
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alarm may indicate coughing/change in respiratory pattern, or disconnection
Lines
Swan-Ganz (Pulmonary Artery Cath), Central Venous Cath, Indwelling Right Atrial Cath
exercise possible, restricted mobility near catheter insertion site
Total Parenteral Nutrition, Hyperalimentation Device (IV feeding)
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exercise possible, restricted mobility near catheter insertion site
Arterial Lines
exercise possible, but avoid disturbing apparatus
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Intracranial Monitoring
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avoid neck flx, hip flx > 90 degrees, and prone posn
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report sustained increases of intracranial pressure, short-term elevation OK
EMERGENT CONDITIONS
Hypovolemic Shock
risk factors: severe trauma, hemorrhage, or burn
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presents with hypotension, anxiety, altered mentation, cool/clammy skin, rapid & thready pulse, thirst, and fatigue
treated by activating emergency med system, posn in supine with legs elevated12" if possible, control bleeding
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other forms of shock: cardiogenic, septic, anaphylactic
Autonomic Dysreflexia
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presents as sweating & skin flushing above level of lesion, elevated BP, blurred vision
treated via ID and termination of noxious stimuli, posn pt upright to lower BP, remove tight clothing; if not able to ID stimuli vasodilators may assist with sympotmatic relief
massive sympathetic discharge associated with SCI triggered by noxious stimuli e.g., bladder distention, UTI, skin ulcers, bowel impaction
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Pulmonary Embolism
presents with difficulty breathing, chest pain, rapid pulse
risk factors: surgery, prolonged inactivity, increased clotting factors, abnormal vasculature
typically, dislodged venous thrombosis travels to and blocks PA
dx via pulmonary angiogram, chest x-ray, lung scan, or spiral CT
treated with anticoagulants e.g., Warfarin, Heparin
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