BagofDoughnutsTutoring
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I was hired to write this, but didn't get paid so I am sharing it as a free study resource. Maybe it will help.
PL# 1) Based on the information you have so far, prepare a prioritized problem list for the patient, include all issues. Please list in bullet format (6 points) Minus 1 points for each missing key problem/ inappropriate problem
PL# 2) A. Document 2 objective physical therapy assessments ( not classification systems) specifically for the integumentary system that would be appropriate for this patient. List (4 points) (* if you document more then 2 then only first 2 listed will count)
B. Document 3 test and measures (assessments) that would be appropriate to examine from the pt’s other systems (one assessment from each system: musculoskeletal, neuromuscular, cardio-pulmonary)? (should be different assessments from #2 question) List (3 points)
PL# 3) Reference (AMA) a reading (specific page number required) or a journal article (do not use lecture info) for your rationale (this is your “why”) for both questions 3.A & B (see below). (minus 5 points for no reference if missing)
Based on the picture and the information you have so far, anticipate the physical therapy needs of this patient. Briefly describe the components of a physical therapy plan of care for management of this patient. i.e. interventions/ treatment-include off loading device, debridement, dressings and assistive devices if appropriate.
A. For the wound? Why/rationale?
B Other Physical Therapy interventions? Why/rationale?
(12 points total= 6 points for wound, 6 points for other interventions)
PL# 4) SPECIFIC Patient Education: This person has been dx with DM approx 2 months ago he needs education for managing their new DX. Provide 5 specific education points to keep this patient healthy and be able to
Question 1
The related problems to the case include:
· The patient has a non-healing ulcer, preventing her to be able to place her weight on her right foot
· The ulcer has worsened over the past two weeks
· The patient is presently unable to stand without assistance
· The patient is obese and therefore places a lot of weight on the ulcers
· Osteoarthritis in hips/knees
· Needs support from objects to walk
Question 2
· Damage to epidermal tissue
· Damage to dermal tissue
To test musculoskeletal symptoms, the strength of the muscles could be measured by testing resistance to force. For neuromuscular, it is reasonable to test the patellar reflex. For cardiopulmonary, heart rate during exercise.
Question 3
The epidermal tissue is the outer layer of the skin, and the ulcer is present in this layer as well as the dermal layer.1 The dermal layer has the blood vessels and glands, and this could be seen in the image of the patient’s foot. Testing resistance to force determines strength. The reflex test determines if there is nerve damage.2 The heart rate determines if the patient is at risk for a heart condition. The patient should be shown how to cushion the ulcer, and then focus should be on developing strength and muscle memory to help her walk normally. It is also worthwhile to consider massage because the muscle tissue might be tight.
Question 4
To help the patient improve the DM symptoms, it is important for the patient to diet and exercise. This involves restricting sugar intake and exercising about 30 minutes per day four times a week once the wound heals. This shouldn’t be too strenuous at first. The patient should also learn how to measure his glucose, take insulin, and take the other medications he is given at the appropriate times. Following up with doctors if the symptoms change is also helpful.
References
1. Hong J, Jung H, Kim Y. Recombinant Human Epidermal Growth Factor (EGF) to Enhance Healing for Diabetic Foot Ulcers. Ann Plast Surg. 2006;56(4):394-398. doi:10.1097/01.sap.0000198731.12407.0c
2. Yao S, Zhu Y. Wearable multifunctional sensors using printed stretchable conductors made of silver nanowires. Nanoscale. 2014;6(4):2345. doi:10.1039/c3nr05496a
PL# 1) Based on the information you have so far, prepare a prioritized problem list for the patient, include all issues. Please list in bullet format (6 points) Minus 1 points for each missing key problem/ inappropriate problem
PL# 2) A. Document 2 objective physical therapy assessments ( not classification systems) specifically for the integumentary system that would be appropriate for this patient. List (4 points) (* if you document more then 2 then only first 2 listed will count)
B. Document 3 test and measures (assessments) that would be appropriate to examine from the pt’s other systems (one assessment from each system: musculoskeletal, neuromuscular, cardio-pulmonary)? (should be different assessments from #2 question) List (3 points)
PL# 3) Reference (AMA) a reading (specific page number required) or a journal article (do not use lecture info) for your rationale (this is your “why”) for both questions 3.A & B (see below). (minus 5 points for no reference if missing)
Based on the picture and the information you have so far, anticipate the physical therapy needs of this patient. Briefly describe the components of a physical therapy plan of care for management of this patient. i.e. interventions/ treatment-include off loading device, debridement, dressings and assistive devices if appropriate.
A. For the wound? Why/rationale?
B Other Physical Therapy interventions? Why/rationale?
(12 points total= 6 points for wound, 6 points for other interventions)
PL# 4) SPECIFIC Patient Education: This person has been dx with DM approx 2 months ago he needs education for managing their new DX. Provide 5 specific education points to keep this patient healthy and be able to
Question 1
The related problems to the case include:
· The patient has a non-healing ulcer, preventing her to be able to place her weight on her right foot
· The ulcer has worsened over the past two weeks
· The patient is presently unable to stand without assistance
· The patient is obese and therefore places a lot of weight on the ulcers
· Osteoarthritis in hips/knees
· Needs support from objects to walk
Question 2
· Damage to epidermal tissue
· Damage to dermal tissue
To test musculoskeletal symptoms, the strength of the muscles could be measured by testing resistance to force. For neuromuscular, it is reasonable to test the patellar reflex. For cardiopulmonary, heart rate during exercise.
Question 3
The epidermal tissue is the outer layer of the skin, and the ulcer is present in this layer as well as the dermal layer.1 The dermal layer has the blood vessels and glands, and this could be seen in the image of the patient’s foot. Testing resistance to force determines strength. The reflex test determines if there is nerve damage.2 The heart rate determines if the patient is at risk for a heart condition. The patient should be shown how to cushion the ulcer, and then focus should be on developing strength and muscle memory to help her walk normally. It is also worthwhile to consider massage because the muscle tissue might be tight.
Question 4
To help the patient improve the DM symptoms, it is important for the patient to diet and exercise. This involves restricting sugar intake and exercising about 30 minutes per day four times a week once the wound heals. This shouldn’t be too strenuous at first. The patient should also learn how to measure his glucose, take insulin, and take the other medications he is given at the appropriate times. Following up with doctors if the symptoms change is also helpful.
References
1. Hong J, Jung H, Kim Y. Recombinant Human Epidermal Growth Factor (EGF) to Enhance Healing for Diabetic Foot Ulcers. Ann Plast Surg. 2006;56(4):394-398. doi:10.1097/01.sap.0000198731.12407.0c
2. Yao S, Zhu Y. Wearable multifunctional sensors using printed stretchable conductors made of silver nanowires. Nanoscale. 2014;6(4):2345. doi:10.1039/c3nr05496a
