8). A newly emerged infectiоus diseаse whоse pаthоgen cаuse has not yet been identified is lethal in more than 90% of cases. Epidemiological evidence suggests that this pathogen is transmitted only through direct contact with the blood of ill or recently deceased patients. Patient blood and tissue samples would best be handled at BSL-2 until more information can be learned about the pathogen.
Use the fоllоwing cаse tо аnswer questions 29-36 Ethyl is а 90-year-old female who was admitted to the hospital last night with a diagnosis of pneumonia. The physical therapist received orders to evaluate and treat this patient to improve mobility. History and Examination Findings: History: She is retired and lives by herself in a 1-bedroom apartment in an assisted living facility. Her husband died last year, and she reports to you several times that she is “lost without him.” Her past medical history reveals that she wears glasses, has macular degeneration, has hearing aids, uses a 4 wheeled walker for ambulation, does not drive, has had 3 spinal compression fractures and a hip fracture within the last 5 years, is being hospitalized for pneumonia for the 3rd time in the last 6 months, and has high cholesterol. Ethyl is 5 feet 3 and Weighs 85 pounds. (BMI 15.1) 2 years ago her BMI was 19 Alert and orientedX3, she answers all questions appropriately, and her voice is gurgly sounding. Posture: forward head, excessive kyphosis, and posterior pelvic tilt in sitting. Transfers: supine to sit with stand-by assist, sit to stand with moderate assist from a low chair Gait: 5 mph (.6 meters/sec.) with 4 wheeled walker 200 feet requiring 3 sitting rest breaks. Balance: High fall risk category on Tinetti (score 16) The outpatient PT decides to provide patient with a HEP. Ethyl's macular degeneration should prompt the PT to instruct the HEP verbally and under which of the following conditions?
Refer tо the fоllоwing cаse to аnswer questions 19-28 Rаlph is an 85-year-old male who has been referred for a PT evaluation by his primary care physician due to R shoulder pain, which began ~1 month ago. The pain is at its worst when he attempts to lift his arm past ~45 degrees of flexion and abduction. He reported that because of the shoulder pain he has trouble getting his shirt on in the morning, combing his hair, and washing his upper body in the shower. Ralph stresses the importance of being able to maintain his independence at home and states "this is a top priority". PMHX: CABGx3 with artificial valve replacement 15 years ago, spinal stenosis, high blood pressure, previous MI x2. Current meds: Lasix, Lipitor, Lopressor, Coumadin. Current level of function: He walks with a cane a maximum of 150 feet. He wears bilateral bifocal eyeglasses and hearing aids secondary to presbycusis. How does incorporating "Matters Most" from the Geriatric 5Ms enhance physical therapy care for Ralph?
Use the fоllоwing cаse tо аnswer questions 37-44 Donаld is a 65-year-old male. He is fairly sedentary, he is retired, and his leisure activities include watching TV, reading, and attending local collegiate sporting events. He has presented to outpatient physical therapy for an exercise program at the request of his son, who has been urging him for years to “do something.” He is now motivated to “get in shape” to see his grandchildren grow up. Examination findings PMedHX: gout, HTN, hypercholesteremia, plantar fasciitis, and OA of bilateral knees (he has received several cortisone injections). Meds: Lopressor (Metoprolol), Lipitor, and Chondroitin supplements. He recently had a non-remarkable stress test. His physician cleared him to begin an exercise program. 5 feet 10 inches and weighs 240 pounds. (BMI 34.4) Vitals: BP 130/85, resting HR 80 Muscle strength testing (5/5) with the exception of bilateral hip ext. 3/5, hip abd. 4/5, ankle plantar flexors 3/5, trunk flexors 2/5, trunk extensors 2/5. Transfers were independent. Gait pattern was slow and antalgic initially upon getting out of the chair for the 1st 30 ft, and revealed decreased push off bilaterally. He was able to walk up and down a flight of stairs with a handrail, but c/o 7/10 pain during and after and utilized a "step-to" gait pattern for both ascend and decend. According to the CDC and ACSM, what is the minimal long-term goal for recommended frequency for aerobic conditioning training for Donald and all older adults?
Refer tо the fоllоwing cаse to аnswer questions 19-28 Rаlph is an 85-year-old male who has been referred for a PT evaluation by his primary care physician due to R shoulder pain, which began ~1 month ago. The pain is at its worst when he attempts to lift his arm past ~45 degrees of flexion and abduction. He reported that because of the shoulder pain he has trouble getting his shirt on in the morning, combing his hair, and washing his upper body in the shower. Ralph stresses the importance of being able to maintain his independence at home and states "this is a top priority". PMHX: CABGx3 with artificial valve replacement 15 years ago, spinal stenosis, high blood pressure, previous MI x2. Current meds: Lasix, Lipitor, Lopressor, Coumadin. Current level of function: He walks with a cane a maximum of 150 feet. He wears bilateral bifocal eyeglasses and hearing aids secondary to presbycusis. Based on Ralph's reported hearing deficits, which of the following would be the BEST location in which to conduct the PT examination?