Chapter 17

1

Chapter 17Chapter 17

Treatment OrdersTreatment Orders

Slide 2Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

ObjectivesObjectivesObjectivesObjectives

• Identify two procedures performed to Identify two procedures performed to repair obstructed coronary blood vessels.repair obstructed coronary blood vessels.

• State the purpose of the cardiopulmonary State the purpose of the cardiopulmonary (respiratory care) department.(respiratory care) department.

• Explain the purpose of hyperbaric oxygen Explain the purpose of hyperbaric oxygen therapy.therapy.

• Identify two basic types of traction.Identify two basic types of traction.• Name the traction setup used by patients Name the traction setup used by patients

to assist them to move in bed.to assist them to move in bed.

• Identify two procedures performed to Identify two procedures performed to repair obstructed coronary blood vessels.repair obstructed coronary blood vessels.

• State the purpose of the cardiopulmonary State the purpose of the cardiopulmonary (respiratory care) department.(respiratory care) department.

• Explain the purpose of hyperbaric oxygen Explain the purpose of hyperbaric oxygen therapy.therapy.

• Identify two basic types of traction.Identify two basic types of traction.• Name the traction setup used by patients Name the traction setup used by patients

to assist them to move in bed.to assist them to move in bed.

Slide 3Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Objectives, continuedObjectives, continuedObjectives, continuedObjectives, continued

• Given a list of treatments, identify Given a list of treatments, identify which department would perform which department would perform them.them.

• State the purpose of the physical State the purpose of the physical therapy department.therapy department.

• State the purpose of the State the purpose of the occupational therapy department.occupational therapy department.

• List the two main types of dialysis.List the two main types of dialysis.

• Given a list of treatments, identify Given a list of treatments, identify which department would perform which department would perform them.them.

• State the purpose of the physical State the purpose of the physical therapy department.therapy department.

• State the purpose of the State the purpose of the occupational therapy department.occupational therapy department.

• List the two main types of dialysis.List the two main types of dialysis.

Slide 4Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Lesson 17.1Lesson 17.1

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• Cardiovascular treatments are often Cardiovascular treatments are often invasive, and may be performed in the invasive, and may be performed in the cardiac catheterization lab or in the cardiac catheterization lab or in the operating room by an interventional operating room by an interventional cardiologist cardiologist

• The HUC may have to coordinate and The HUC may have to coordinate and schedule invasive cardiovascular treatments schedule invasive cardiovascular treatments

• Consent forms are required and special diets Consent forms are required and special diets and medications may be necessaryand medications may be necessary

• Cardiovascular treatments are often Cardiovascular treatments are often invasive, and may be performed in the invasive, and may be performed in the cardiac catheterization lab or in the cardiac catheterization lab or in the operating room by an interventional operating room by an interventional cardiologist cardiologist

• The HUC may have to coordinate and The HUC may have to coordinate and schedule invasive cardiovascular treatments schedule invasive cardiovascular treatments

• Consent forms are required and special diets Consent forms are required and special diets and medications may be necessaryand medications may be necessary

Cardiovascular TherapiesCardiovascular TherapiesCardiovascular TherapiesCardiovascular Therapies

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• Cardiovascular treatments are often Cardiovascular treatments are often performed directly following invasive performed directly following invasive cardiovascular diagnostic tests done in the cardiovascular diagnostic tests done in the cardiac cath lab (as discussed in Chapter cardiac cath lab (as discussed in Chapter 16)16)• Angioplasty may follow coronary angiographyAngioplasty may follow coronary angiography• Insertion of a pacemaker may follow Insertion of a pacemaker may follow

electrophysiology studieselectrophysiology studies

• Cardiovascular treatments are often Cardiovascular treatments are often performed directly following invasive performed directly following invasive cardiovascular diagnostic tests done in the cardiovascular diagnostic tests done in the cardiac cath lab (as discussed in Chapter cardiac cath lab (as discussed in Chapter 16)16)• Angioplasty may follow coronary angiographyAngioplasty may follow coronary angiography• Insertion of a pacemaker may follow Insertion of a pacemaker may follow

electrophysiology studieselectrophysiology studies

Cardiovascular Therapies, continuedCardiovascular Therapies, continuedCardiovascular Therapies, continuedCardiovascular Therapies, continued

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Examples of cardiovascular therapiesExamples of cardiovascular therapies: : • Insertion of a cardiac pacemakerInsertion of a cardiac pacemaker• Insertion of an implantable cardioverter-Insertion of an implantable cardioverter-

defibrillator (ICD)defibrillator (ICD)• AngioplastyAngioplasty

Examples of cardiovascular therapiesExamples of cardiovascular therapies: : • Insertion of a cardiac pacemakerInsertion of a cardiac pacemaker• Insertion of an implantable cardioverter-Insertion of an implantable cardioverter-

defibrillator (ICD)defibrillator (ICD)• AngioplastyAngioplasty

Cardiovascular Therapies, continuedCardiovascular Therapies, continuedCardiovascular Therapies, continuedCardiovascular Therapies, continued

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Cardiac PacemakerCardiac PacemakerCardiac PacemakerCardiac Pacemaker

From Thibodeau GA, Patton KT: Anatomy and physiology, ed 6, St. Louis, 2007, Mosby.

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Implantable Cardioverter-Implantable Cardioverter-DefibrillatorDefibrillatorImplantable Cardioverter-Implantable Cardioverter-DefibrillatorDefibrillator

From Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing, ed 6, St. Louis, 2004, Mosby.

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Coronary StentCoronary StentCoronary StentCoronary Stent

From LaFleur Brooks M: Exploring medical language: a student-directed approach, ed 6, St. Louis, 2005, Mosby.

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Coronary Artery Bypass Graft Coronary Artery Bypass Graft (CABG)(CABG)Coronary Artery Bypass Graft Coronary Artery Bypass Graft (CABG)(CABG)

From Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment and management of clinical problems, ed 5, St. Louis, 2000, Mosby.

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Cardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) Downtime RequisitionDowntime RequisitionCardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) Downtime RequisitionDowntime Requisition

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Examples of angioplasty ordersExamples of angioplasty orders: : • Percutaneous transluminal coronary Percutaneous transluminal coronary

angioplasty (PTCA)angioplasty (PTCA)• Balloon angioplastyBalloon angioplasty• Heart artery dilatationHeart artery dilatation• Stent placementStent placement

Examples of angioplasty ordersExamples of angioplasty orders: : • Percutaneous transluminal coronary Percutaneous transluminal coronary

angioplasty (PTCA)angioplasty (PTCA)• Balloon angioplastyBalloon angioplasty• Heart artery dilatationHeart artery dilatation• Stent placementStent placement

Cardiovascular TherapiesCardiovascular TherapiesCardiovascular TherapiesCardiovascular Therapies

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Surgical intervention:Surgical intervention: • Coronary artery bypass graft (CABG)Coronary artery bypass graft (CABG)• Off-pump coronary artery bypass graft Off-pump coronary artery bypass graft

(OPCAB)(OPCAB)• Minimally invasive direct coronary artery Minimally invasive direct coronary artery

bypass (MIDCAB)bypass (MIDCAB)• Performed with the aid of a robot (e.g., Performed with the aid of a robot (e.g.,

daVinci)daVinci)

Surgical intervention:Surgical intervention: • Coronary artery bypass graft (CABG)Coronary artery bypass graft (CABG)• Off-pump coronary artery bypass graft Off-pump coronary artery bypass graft

(OPCAB)(OPCAB)• Minimally invasive direct coronary artery Minimally invasive direct coronary artery

bypass (MIDCAB)bypass (MIDCAB)• Performed with the aid of a robot (e.g., Performed with the aid of a robot (e.g.,

daVinci)daVinci)

Cardiovascular Therapies, Cardiovascular Therapies, continuedcontinuedCardiovascular Therapies, Cardiovascular Therapies, continuedcontinued

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• Respiratory treatments are performed at Respiratory treatments are performed at the patient’s bedside by a respiratory the patient’s bedside by a respiratory therapisttherapist

• It is important that the health unit It is important that the health unit coordinator enter all of the information coordinator enter all of the information given in the doctor’s order when ordering given in the doctor’s order when ordering a respiratory treatment a respiratory treatment

• The respiratory therapist will read the The respiratory therapist will read the doctor’s order before performing the doctor’s order before performing the treatmenttreatment

• Respiratory treatments are performed at Respiratory treatments are performed at the patient’s bedside by a respiratory the patient’s bedside by a respiratory therapisttherapist

• It is important that the health unit It is important that the health unit coordinator enter all of the information coordinator enter all of the information given in the doctor’s order when ordering given in the doctor’s order when ordering a respiratory treatment a respiratory treatment

• The respiratory therapist will read the The respiratory therapist will read the doctor’s order before performing the doctor’s order before performing the treatmenttreatment

Cardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) DepartmentDepartmentCardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) DepartmentDepartment

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Examples of respiratory treatmentsExamples of respiratory treatments: : • Oxygen (OOxygen (O22) per NP (NC), mask, nasal ) per NP (NC), mask, nasal

cath, tent, or ventilatorcath, tent, or ventilator• Intermittent positive pressure breathing Intermittent positive pressure breathing

(IPPB)(IPPB)• Small volume nebulizer (SVN)Small volume nebulizer (SVN)• Ultrasonic nebulizerUltrasonic nebulizer

Examples of respiratory treatmentsExamples of respiratory treatments: : • Oxygen (OOxygen (O22) per NP (NC), mask, nasal ) per NP (NC), mask, nasal

cath, tent, or ventilatorcath, tent, or ventilator• Intermittent positive pressure breathing Intermittent positive pressure breathing

(IPPB)(IPPB)• Small volume nebulizer (SVN)Small volume nebulizer (SVN)• Ultrasonic nebulizerUltrasonic nebulizer

Cardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) Department, continuedDepartment, continuedCardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) Department, continuedDepartment, continued

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Wall Outlet for OxygenWall Outlet for OxygenWall Outlet for OxygenWall Outlet for Oxygen

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• Chest percussion therapy (CPT)Chest percussion therapy (CPT)• Heated aerosol (HA) Heated aerosol (HA) • Incentive spirometry (IS) Incentive spirometry (IS) • Biphasic positive airway pressure (BiPAP)Biphasic positive airway pressure (BiPAP)• Continuous positive airway pressure Continuous positive airway pressure

(CPAP)(CPAP)• Metered dose inhaler (MDI)Metered dose inhaler (MDI)

• Chest percussion therapy (CPT)Chest percussion therapy (CPT)• Heated aerosol (HA) Heated aerosol (HA) • Incentive spirometry (IS) Incentive spirometry (IS) • Biphasic positive airway pressure (BiPAP)Biphasic positive airway pressure (BiPAP)• Continuous positive airway pressure Continuous positive airway pressure

(CPAP)(CPAP)• Metered dose inhaler (MDI)Metered dose inhaler (MDI)

Cardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) DepartmentDepartmentCardiopulmonary (Respiratory Care) Cardiopulmonary (Respiratory Care) DepartmentDepartment

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The ventilator assists or replaces respiration The ventilator assists or replaces respiration of the patient.of the patient.Settings:Settings:• IMV mode: intermittent mechanical IMV mode: intermittent mechanical

ventilationventilation• TV: tidal volumeTV: tidal volume• FiOFiO22: fraction of inspired oxygen: fraction of inspired oxygen• PEEP: positive end-expiratory pressurePEEP: positive end-expiratory pressure• PS: pressure supportPS: pressure support

The ventilator assists or replaces respiration The ventilator assists or replaces respiration of the patient.of the patient.Settings:Settings:• IMV mode: intermittent mechanical IMV mode: intermittent mechanical

ventilationventilation• TV: tidal volumeTV: tidal volume• FiOFiO22: fraction of inspired oxygen: fraction of inspired oxygen• PEEP: positive end-expiratory pressurePEEP: positive end-expiratory pressure• PS: pressure supportPS: pressure support

Cardiopulmonary (Respiratory Care)Cardiopulmonary (Respiratory Care)Mechanical VentilatorMechanical VentilatorCardiopulmonary (Respiratory Care)Cardiopulmonary (Respiratory Care)Mechanical VentilatorMechanical Ventilator

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• IntubationIntubation Insertion of an endotracheal tubeInsertion of an endotracheal tube

• ExtubationExtubation Removal of an endotracheal tubeRemoval of an endotracheal tube

• Pre-op teachingPre-op teaching

• IntubationIntubation Insertion of an endotracheal tubeInsertion of an endotracheal tube

• ExtubationExtubation Removal of an endotracheal tubeRemoval of an endotracheal tube

• Pre-op teachingPre-op teaching

Other Respiratory OrdersOther Respiratory OrdersOther Respiratory OrdersOther Respiratory Orders

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• Hyperbaric oxygen therapy (HBOT)Hyperbaric oxygen therapy (HBOT)• 100% oxygen under high pressure in a 100% oxygen under high pressure in a

hyperbaric chamberhyperbaric chamber• Improves healing and stimulates growth of Improves healing and stimulates growth of

blood vesselsblood vessels

• Hyperbaric oxygen therapy (HBOT)Hyperbaric oxygen therapy (HBOT)• 100% oxygen under high pressure in a 100% oxygen under high pressure in a

hyperbaric chamberhyperbaric chamber• Improves healing and stimulates growth of Improves healing and stimulates growth of

blood vesselsblood vessels

Wound Care Department/ClinicWound Care Department/ClinicWound Care Department/ClinicWound Care Department/Clinic

Slide 22Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

• Traction is the mechanical pull applied to part Traction is the mechanical pull applied to part of the bodyof the body

• The pull is achieved by connecting an The pull is achieved by connecting an apparatus attached to a bed to an apparatus apparatus attached to a bed to an apparatus attached to the patientattached to the patient

• Traction may be applied to the legs, arms, Traction may be applied to the legs, arms, neck, back, or pelvis to treat fractures, neck, back, or pelvis to treat fractures, dislocations, and long-duration muscle dislocations, and long-duration muscle spasms, and to prevent or correct deformitiesspasms, and to prevent or correct deformities

• Traction is the mechanical pull applied to part Traction is the mechanical pull applied to part of the bodyof the body

• The pull is achieved by connecting an The pull is achieved by connecting an apparatus attached to a bed to an apparatus apparatus attached to a bed to an apparatus attached to the patientattached to the patient

• Traction may be applied to the legs, arms, Traction may be applied to the legs, arms, neck, back, or pelvis to treat fractures, neck, back, or pelvis to treat fractures, dislocations, and long-duration muscle dislocations, and long-duration muscle spasms, and to prevent or correct deformitiesspasms, and to prevent or correct deformities

Traction OrdersTraction OrdersTraction OrdersTraction Orders

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Two main types of tractionTwo main types of traction::• Skeletal tractionSkeletal traction• Skin tractionSkin traction

Two main types of tractionTwo main types of traction::• Skeletal tractionSkeletal traction• Skin tractionSkin traction

Traction Orders, continuedTraction Orders, continuedTraction Orders, continuedTraction Orders, continued

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Examples of skin traction ordersExamples of skin traction orders::• Skin traction 5# to left armSkin traction 5# to left arm• Skin traction 7# to pelvisSkin traction 7# to pelvis• Left unilateral Buck’s tractionLeft unilateral Buck’s traction

Examples of skin traction ordersExamples of skin traction orders::• Skin traction 5# to left armSkin traction 5# to left arm• Skin traction 7# to pelvisSkin traction 7# to pelvis• Left unilateral Buck’s tractionLeft unilateral Buck’s traction

Traction Orders, continuedTraction Orders, continuedTraction Orders, continuedTraction Orders, continued

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Examples of skeletal traction ordersExamples of skeletal traction orders::• Cervical traction with Crutchfield Cervical traction with Crutchfield

tongstongs• Thomas leg splint with Steinmann pin Thomas leg splint with Steinmann pin

with 20# of tractionwith 20# of traction• Traction by gravity left armTraction by gravity left arm

Examples of skeletal traction ordersExamples of skeletal traction orders::• Cervical traction with Crutchfield Cervical traction with Crutchfield

tongstongs• Thomas leg splint with Steinmann pin Thomas leg splint with Steinmann pin

with 20# of tractionwith 20# of traction• Traction by gravity left armTraction by gravity left arm

Traction Orders, continuedTraction Orders, continuedTraction Orders, continuedTraction Orders, continued

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Unilateral Buck’s tractionUnilateral Buck’s tractionUnilateral Buck’s tractionUnilateral Buck’s traction

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Crutchfield TongsCrutchfield TongsCrutchfield TongsCrutchfield Tongs

From Phipps WJ, Monahan FD, Sands JK, et al: Medical-surgical nursing, ed 7, St. Louis, 2003, Mosby.

Slide 28Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Other traction-related ordersOther traction-related orders::• Overhead frame and trapeze: used to Overhead frame and trapeze: used to

assist the patient to move about in bedassist the patient to move about in bed• Braun frame: a cradle for the limbBraun frame: a cradle for the limb

Other traction-related ordersOther traction-related orders::• Overhead frame and trapeze: used to Overhead frame and trapeze: used to

assist the patient to move about in bedassist the patient to move about in bed• Braun frame: a cradle for the limbBraun frame: a cradle for the limb

Traction OrdersTraction OrdersTraction OrdersTraction Orders

Slide 29Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Lesson 17.2Lesson 17.2

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• Physical therapy: treats patients to improve and Physical therapy: treats patients to improve and restore their functional mobilityrestore their functional mobility

• Occupational therapy: works toward Occupational therapy: works toward rehabilitation of patients, in conjunction with rehabilitation of patients, in conjunction with other health team members, to return patients other health team members, to return patients to the greatest possible functional independenceto the greatest possible functional independence

• Physical therapy: treats patients to improve and Physical therapy: treats patients to improve and restore their functional mobilityrestore their functional mobility

• Occupational therapy: works toward Occupational therapy: works toward rehabilitation of patients, in conjunction with rehabilitation of patients, in conjunction with other health team members, to return patients other health team members, to return patients to the greatest possible functional independenceto the greatest possible functional independence

Physical Medicine and RehabilitationPhysical Medicine and RehabilitationPhysical Medicine and RehabilitationPhysical Medicine and Rehabilitation

Slide 31Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Types of physical therapy ordersTypes of physical therapy orders::• Hydrotherapy:Hydrotherapy:

Hubbard tankHubbard tank WhirlpoolWhirlpool

• Exercises:Exercises: Passive, active, resistive, reeducation, Passive, active, resistive, reeducation,

coordination, and relaxationcoordination, and relaxation

Types of physical therapy ordersTypes of physical therapy orders::• Hydrotherapy:Hydrotherapy:

Hubbard tankHubbard tank WhirlpoolWhirlpool

• Exercises:Exercises: Passive, active, resistive, reeducation, Passive, active, resistive, reeducation,

coordination, and relaxationcoordination, and relaxation

Physical Therapy (PT)Physical Therapy (PT)Physical Therapy (PT)Physical Therapy (PT)

Slide 32Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

A Hubbard TankA Hubbard TankA Hubbard TankA Hubbard Tank

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• Walker train: gait trainWalker train: gait train• Crutch trainCrutch train• Transfer trainTransfer train• Wheelchair mobilityWheelchair mobility• Anterior cruciate ligament repair (ACL) Anterior cruciate ligament repair (ACL)

protocolprotocol• Total hip arthroplasty (THA) protocolTotal hip arthroplasty (THA) protocol

• Walker train: gait trainWalker train: gait train• Crutch trainCrutch train• Transfer trainTransfer train• Wheelchair mobilityWheelchair mobility• Anterior cruciate ligament repair (ACL) Anterior cruciate ligament repair (ACL)

protocolprotocol• Total hip arthroplasty (THA) protocolTotal hip arthroplasty (THA) protocol

Physical Therapy (PT)Physical Therapy (PT)Physical Therapy (PT)Physical Therapy (PT)

Slide 34Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

• Total knee arthroplasty (TKA) protocolTotal knee arthroplasty (TKA) protocol• Continuous passive motion (CPM)Continuous passive motion (CPM)• Heat and cold application orders:Heat and cold application orders:

Ultrasound Ultrasound Hydrocollator packsHydrocollator packs Ice or cold packsIce or cold packs

• Total knee arthroplasty (TKA) protocolTotal knee arthroplasty (TKA) protocol• Continuous passive motion (CPM)Continuous passive motion (CPM)• Heat and cold application orders:Heat and cold application orders:

Ultrasound Ultrasound Hydrocollator packsHydrocollator packs Ice or cold packsIce or cold packs

Physical Therapy (PT), continuedPhysical Therapy (PT), continuedPhysical Therapy (PT), continuedPhysical Therapy (PT), continued

Slide 35Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Continuous Passive MotionContinuous Passive MotionContinuous Passive MotionContinuous Passive Motion

From Elkin MK, Perry AG, Potter PA: Nursing interventions and clinical skills, ed 2, St. Louis, 2000, Mosby.

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• Pain relief ordersPain relief orders:: Transcutaneous electrical nerve Transcutaneous electrical nerve

stimulation (TENS)stimulation (TENS) Functional electrical stimulation or Functional electrical stimulation or

electrical stimulation (FES or ES)electrical stimulation (FES or ES)

• Pain relief ordersPain relief orders:: Transcutaneous electrical nerve Transcutaneous electrical nerve

stimulation (TENS)stimulation (TENS) Functional electrical stimulation or Functional electrical stimulation or

electrical stimulation (FES or ES)electrical stimulation (FES or ES)

Physical Therapy (PT), continuedPhysical Therapy (PT), continuedPhysical Therapy (PT), continuedPhysical Therapy (PT), continued

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Transcutaneous Electric Nerve Stimulation Transcutaneous Electric Nerve Stimulation (TENS)(TENS)Transcutaneous Electric Nerve Stimulation Transcutaneous Electric Nerve Stimulation (TENS)(TENS)

From Ignatavicius DD, Workman ML, Mishler MA: Medical-surgical nursing, ed 2, Philadelphia, 1995, Saunders.

Slide 38Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

• Types of occupational therapy orders:Types of occupational therapy orders: Activities of daily living (ADL)Activities of daily living (ADL) Evaluation and treatmentEvaluation and treatment Supply and train in adaptive equipment Supply and train in adaptive equipment Increase mobilityIncrease mobility Fabricate cock-up splint for extremityFabricate cock-up splint for extremity

• Types of occupational therapy orders:Types of occupational therapy orders: Activities of daily living (ADL)Activities of daily living (ADL) Evaluation and treatmentEvaluation and treatment Supply and train in adaptive equipment Supply and train in adaptive equipment Increase mobilityIncrease mobility Fabricate cock-up splint for extremityFabricate cock-up splint for extremity

Occupational Therapy (OT)Occupational Therapy (OT)Occupational Therapy (OT)Occupational Therapy (OT)

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• When the kidneys fail to remove wastes, When the kidneys fail to remove wastes, medical intervention is necessary to sustain medical intervention is necessary to sustain lifelife

• The kidneys may fail temporarily (acute renal The kidneys may fail temporarily (acute renal failure) or they may be permanently failure) or they may be permanently damaged and become nonfunctional (chronic damaged and become nonfunctional (chronic renal failure and end-stage renal disease renal failure and end-stage renal disease [ESRD])[ESRD])

• Two types of dialysis: Two types of dialysis: HemodialysisHemodialysis Peritoneal dialysisPeritoneal dialysis

• When the kidneys fail to remove wastes, When the kidneys fail to remove wastes, medical intervention is necessary to sustain medical intervention is necessary to sustain lifelife

• The kidneys may fail temporarily (acute renal The kidneys may fail temporarily (acute renal failure) or they may be permanently failure) or they may be permanently damaged and become nonfunctional (chronic damaged and become nonfunctional (chronic renal failure and end-stage renal disease renal failure and end-stage renal disease [ESRD])[ESRD])

• Two types of dialysis: Two types of dialysis: HemodialysisHemodialysis Peritoneal dialysisPeritoneal dialysis

DialysisDialysisDialysisDialysis

Slide 40Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

• Hemodialysis:Hemodialysis: Removal of waste products from the blood Removal of waste products from the blood

by utilization of a machine through which by utilization of a machine through which the blood flowsthe blood flows

• Peritoneal dialysis: Peritoneal dialysis: Fluid is introduced into the abdominal Fluid is introduced into the abdominal

cavity that absorbs wastes from the blood cavity that absorbs wastes from the blood through the lining of the abdominal cavity through the lining of the abdominal cavity or peritoneumor peritoneum

• Hemodialysis:Hemodialysis: Removal of waste products from the blood Removal of waste products from the blood

by utilization of a machine through which by utilization of a machine through which the blood flowsthe blood flows

• Peritoneal dialysis: Peritoneal dialysis: Fluid is introduced into the abdominal Fluid is introduced into the abdominal

cavity that absorbs wastes from the blood cavity that absorbs wastes from the blood through the lining of the abdominal cavity through the lining of the abdominal cavity or peritoneumor peritoneum

Dialysis, continuedDialysis, continuedDialysis, continuedDialysis, continued

Slide 41Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.

• Performed either in a division of Performed either in a division of diagnostic imaging or in a separate diagnostic imaging or in a separate departmentdepartment

• Most patients have radiation therapy on Most patients have radiation therapy on an outpatient basisan outpatient basis

• The HUC may be asked to set up the The HUC may be asked to set up the patient’s first appointment upon patient patient’s first appointment upon patient dischargedischarge

• Performed either in a division of Performed either in a division of diagnostic imaging or in a separate diagnostic imaging or in a separate departmentdepartment

• Most patients have radiation therapy on Most patients have radiation therapy on an outpatient basisan outpatient basis

• The HUC may be asked to set up the The HUC may be asked to set up the patient’s first appointment upon patient patient’s first appointment upon patient dischargedischarge

Radiation TreatmentsRadiation TreatmentsRadiation TreatmentsRadiation Treatments