Chest Assessment课件.PPT

Does the patient have pitting edema in the lower extremities ? 1+, 2+, 3+, 4+ CHF renal failure metastatic cancer 精品文档 Patient Case Study # 1 82 y/o Caucasian female Admitted for observation to EROU (23-hour stay): falling c/o of pain in chest and hip PT consult : evaluation for level of medical care 精品文档 Social History Living alone in a rented apt. at Meridian Point - minor assisted living contract Because of falling hx., Meridian Point would take her into their full assisted living units if she was admitted for 3 days at FMC 精品文档 Family lives in Flagstaff, Az. Family expressing reluctance about having her move in with them for companion care 精品文档 Medical History Fractured radius in Jan, 1999 Fractured right femur in August, 1994 Bilateral mastectomy - Cancer - 1980 Pneumonia - 1980, 1990, 1996 Negative for diabetes 精品文档 Medical Findings CT scan of thorax, pelvis WNL CT scan of brain showed atrophy - WNL X-Ray of chest showed some diffuse cloudiness in L R - no masses 精品文档 Physical Therapy Exam ROM - WNL for all extremities Strength - 4/5 for age Gait - 125 ft without LOB w/ FWW Transfers - SBA --- min assist Orientation - 3/3 精品文档 Oximetry - SaO2 - 86% on 2 L/min as per nasal cannula Blood Pressure - 156/88 Heart Rate - 98 bpm 精品文档 Chest Assessment 精品文档 Read through the chart for past medical history and reasons for the present admission. 精品文档 Is the present admission for some other cause other than cardiopulmonary or is this a re-admission for a long standing chronic condition ? 精品文档 Read the psychosocial history patient’s age marital status supportive family (SW’s report) will there be at-home care or will it involve some level of post-acute institutional care ? 精品文档 Look at the x-ray results : Diffuse spider webbing ? Egg-shell calcifications present ? Is the cardiac image obscured ? Are there spots on the lungs ? Are fractures present ? Fluid lines present ? 精品文档 Left Pneumothorax 精品文档 CWP - Black Lung 精品文档 Flail Chest 精品文档 Cancer - Tumor In Right Lung 精品