By Tiffany Lai September 1, 2023
The range of diagnoses you see on these floors is enormous. Here are examples of some common ones:
Abdominal surgeries
Method could be laparoscopic or open abdomen.
- Abdominal precautions for open abdomen surgeries. If you visualize the incision, you will see a vertical or horizontal cut on the belly.
- No bending, lifting, twisting, or lifting >5 lbs.
- Teach adaptive technique for lower body dressing, toileting, and bed mobility (logroll).
Lung diseases (COPD, bronchiestasis)
- Check the doctors orders for SPO2 parameters.
- Check with RT or nursing about how much you can increase supplemental O2 to stay within those parameters during your session.
- Compare prior level of Home O2 use vs current hospital O2 use
Diabetes (DKA)
It is important to assess pt’s ability to provide skincare to lower extremities, especially in patients with neuropathy.
Cognitive tests to determine ability to manage medications and check blood glucose.
Falls
Check the chart for possible fractures and weightbearing precautions.
Ask the patient about the circumstances surrounding the fall.
Was it happenstance? Poor environmental setup? Balance issues? Poor safety awareness?
Assess sitting and standing balance and determine what might help mitigate the situation. Will DME or continued therapy services help?
Failure to thrive
Interview family or patient for caregiver assistance available at home.
Perform a cognitive assessment.
Altered mental status/dementia/alzheimers
Caregiver assistance available at home Cognition Abnormal lab values vs. dementia diagnosis Home safety risk assessment Fall risk assessment
Kidneys (renal failure)
Energy conservation Cognition
UTI
Cognition Fall risk assessment
Parkinsons
Sitting and standing balance ROM joints - particularly hip flexion Speed of movement
Liver disease
CIWA Sitting and standing balance
GI bleed
Hgb and hematocrit levels Abdominal precautions
Frozen shoulder, Carpal tunnel, dequervain
Need for resting hand splint ROM functional strength
Back pain
Logroll to get out of bed ROM of spinal extensors and piriformis