BOOK
Recognizing and Reporting Red Flags for the Physical Therapist Assistant - E-Book
Catherine C. Goodman | Charlene Marshall
(2015)
Additional Information
Book Details
Abstract
Recognizing and Reporting Red Flags for the Physical Therapist Assistant will help you develop skills to recognize signs and symptoms that can compromise patient care, It is the first text to present a consistent, three-step model for monitoring patients for red flags relating to neuromuscular and musculoskeletal problems, medical diseases, side effects of medications, and other co-morbidities that may be unknown to the PT. Combining the insights of physical therapist Catherine Cavallaro Goodman and physical therapist assistant Charlene Marshall, this resource is unmatched in providing clear guidelines for finding and documenting red flags.
- Coverage of warning flags includes red and yellow flags, risk factors, clinical presentation, signs and symptoms, helpful screening clues, and guidelines for communicating with the PT, allowing you as the PTA to quickly recognize the need for any re-evaluation of the patient.
- Three-step approach to formative assessments of physical therapy patients provides a consistent way to watch for and report on adverse changes such as range of motion, strength, pain, balance, coordination, swelling, endurance, or gait deviations.
- PTA Action Plans show the clinical application of text material relating to observing, documenting, and reporting red (or yellow) flags to the physical therapist.
- Clinically relevant information includes the tools that you need to monitor the patient’s response to selected interventions, and accurately and quickly report changes to the supervising PT.
- Picture the Patient sections address what to look for when assessing or working with patients, especially typical red flag signs and symptoms of emerging problems.
- Case examples and critical thinking activities connect theory to practice, showing the role of the PTA and how the PTA can integrate clinical observations with clinical reasoning skills so that they can.
- Cognitive processing-reasoning approach encourages you to learn to gather and analyze data, pose and solve problems, infer, hypothesize, and make clinical judgments, so that you can notify the supervising PT of clients who need further evaluation or may require a referral or consultation with other health care professionals.
- Summary boxes and tables highlight key information for quick reference.
- Key terminology is listed in each chapter, which each term bolded within the chapter and defined in a back-of-book glossary.
- Full-color illustrations and design clearly demonstrate pathologies and processes and make lookup easier in busy clinical settings.
- An Evolve companion website enhances your problem-solving and decision-making skills with additional case studies, problem-solving questions, and activities, as well as screening tools and checklists.
- Combined authorship by a physical therapist and physical therapist assistant provides an authoritative and unique voice in the PTA field.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | Cover | ||
| Front matter | i | ||
| Recognizing & Reporting Red Flags for the\tPhysical Therapist Assistant | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Preface | vii | ||
| Table of contents | ix | ||
| 1 Introduction to recognizing and reporting red flags for the physical therapist assistant | 1 | ||
| Introduction | 1 | ||
| Textbook elements | 1 | ||
| Yellow or red flags | 2 | ||
| Reasons that red flags pop up | 4 | ||
| Quicker and sicker | 4 | ||
| Natural history | 6 | ||
| Signed prescription | 6 | ||
| Medical specialization | 6 | ||
| Progression of time and disease | 6 | ||
| Patient/client disclosure | 6 | ||
| Decision-making process | 7 | ||
| Documentation and liability | 7 | ||
| Goodman model for the PTA | 8 | ||
| Past medical history | 10 | ||
| Risk factor assessment | 10 | ||
| Clinical presentation | 10 | ||
| Associated signs and symptoms of systemic diseases | 10 | ||
| Summary | 11 | ||
| References | 13 | ||
| 2 Pain types and viscerogenic pain patterns | 15 | ||
| Introduction | 15 | ||
| Mechanisms of referred visceral pain | 15 | ||
| Embryologic development | 15 | ||
| Multisegmental innervation | 17 | ||
| Direct pressure and shared pathways | 18 | ||
| Understanding pain and other symptoms | 19 | ||
| Pain in the older adult | 20 | ||
| Characteristics of pain | 21 | ||
| Location of pain | 21 | ||
| Description of pain | 22 | ||
| Intensity of pain | 22 | ||
| Frequency and duration of pain | 22 | ||
| Pattern of pain | 23 | ||
| Aggravating and relieving factors | 23 | ||
| Associated symptoms | 24 | ||
| Sources of pain | 26 | ||
| Cutaneous sources of pain | 26 | ||
| Somatic sources of pain | 26 | ||
| Visceral sources of pain | 27 | ||
| Neuropathic pain | 27 | ||
| Referred pain | 28 | ||
| Differentiating sources of pain | 28 | ||
| Types of pain | 29 | ||
| Tension pain | 29 | ||
| Inflammatory pain | 30 | ||
| Ischemic pain | 30 | ||
| Myofascial pain | 30 | ||
| Muscle tension | 30 | ||
| Muscle spasm | 30 | ||
| Muscle trauma | 31 | ||
| Muscle deficiency | 31 | ||
| Trigger points | 31 | ||
| Joint pain | 32 | ||
| Drug-induced pain | 34 | ||
| Radicular pain | 34 | ||
| Arterial, pleural, and tracheal pain | 34 | ||
| Gastrointestinal pain | 35 | ||
| Inflammatory bowel disease | 35 | ||
| Pain at rest | 35 | ||
| Night pain | 35 | ||
| Night pain and cancer | 36 | ||
| Pain with activity | 36 | ||
| Chronic pain | 37 | ||
| Catastrophizing and fear avoidance | 37 | ||
| Fear-avoidance behavior | 37 | ||
| Comparison of systemic versus musculoskeletal pain patterns | 38 | ||
| Characteristics of viscerogenic pain | 39 | ||
| Recognizing emotional and psychological symptoms | 39 | ||
| Anxiety | 40 | ||
| Depression | 40 | ||
| Drugs, depression, or dementia? | 42 | ||
| Panic disorders | 42 | ||
| References | 45 | ||
| 3 Recognizing, documenting, and reporting red flags | 49 | ||
| General survey | 49 | ||
| Mental status | 50 | ||
| Risk factors for delirium | 50 | ||
| Nutritional status | 51 | ||
| Body and breath odors | 52 | ||
| Vital signs | 53 | ||
| Pulse rate | 54 | ||
| Respiration | 55 | ||
| Pulse oximetry | 55 | ||
| Blood pressure | 57 | ||
| Assessing blood pressure | 57 | ||
| Pulse pressure | 58 | ||
| Variations in blood pressure. | 58 | ||
| Hypertension | 59 | ||
| Hypertension in african americans.  | 59 | ||
| Hypertension in hispanics.  | 59 | ||
| Hypotension | 59 | ||
| Postural orthostatic hypotension. | 61 | ||
| Core body temperature | 62 | ||
| Recognizing and reporting neurologic red flags | 63 | ||
| Major areas to observe | 63 | ||
| Reflexes | 64 | ||
| Neural tension | 65 | ||
| Falls and fall prevention | 65 | ||
| Risk factors for falls | 66 | ||
| Recognizing and reporting red flag clinical presentations | 68 | ||
| The integumentary system: Skin and nail beds | 68 | ||
| Responding to skin lesions | 71 | ||
| Palpation | 72 | ||
| Change in skin temperature | 72 | ||
| Change in skin color | 72 | ||
| Assessing dark skin | 74 | ||
| Red flags for skin cancer | 74 | ||
| Observing surgical scars | 76 | ||
| Common skin lesions | 77 | ||
| Vitiligo | 77 | ||
| Café-au-lait | 77 | ||
| Skin rash | 77 | ||
| Hemorrhagic rash | 78 | ||
| Dermatitis | 78 | ||
| Rosacea | 78 | ||
| Thrombocytopenia | 79 | ||
| Xanthomas | 79 | ||
| Rheumatologic diseases | 80 | ||
| Steroid skin and steroid rosacea | 81 | ||
| Erythema chronicum migrans | 81 | ||
| Effects of radiation | 81 | ||
| Sexually transmitted diseases/infections | 82 | ||
| Herpes virus | 83 | ||
| Herpetic whitlow.  | 83 | ||
| Herpes zoster.  | 83 | ||
| Cutaneous manifestations of abuse | 85 | ||
| Mongolian spots | 85 | ||
| Cancer-related skin lesions | 85 | ||
| Kaposi’s sarcoma | 86 | ||
| Lymphomas | 86 | ||
| Observing the nail beds | 87 | ||
| Nail bed changes | 88 | ||
| Precautions/contraindications to therapy | 91 | ||
| Guidelines for immediate communication with the physical therapist | 91 | ||
| References | 92 | ||
| 4 Review of systems for the physical therapist assistant | 97 | ||
| Recognizing and reporting hematologic red flags | 97 | ||
| Platelet disorders | 97 | ||
| Recognizing and reporting cardiovascular red flags | 101 | ||
| Chest pain or discomfort | 101 | ||
| Palpitation | 102 | ||
| Dyspnea | 102 | ||
| Cardiac syncope | 103 | ||
| Fatigue | 103 | ||
| Cough | 103 | ||
| Cyanosis | 103 | ||
| Edema | 103 | ||
| Claudication | 103 | ||
| Recognizing and reporting pulmonary red flags | 104 | ||
| Signs and symptoms of pulmonary disorders | 105 | ||
| Cough | 105 | ||
| Dyspnea | 105 | ||
| Cyanosis | 105 | ||
| Clubbing | 105 | ||
| Altered breathing patterns17 | 105 | ||
| Pulmonary pain patterns14 | 106 | ||
| Tracheobronchial pain | 107 | ||
| Pleural pain | 107 | ||
| Diaphragmatic pleural pain | 107 | ||
| Pulmonary embolism and deep venous thrombosis | 108 | ||
| Risk factors | 108 | ||
| Pulmonary embolism | 108 | ||
| Deep venous thrombosis | 109 | ||
| Recognizing and reporting gastrointestinal red flags | 110 | ||
| Signs and symptoms of gastrointestinal disorders | 110 | ||
| Abdominal pain | 110 | ||
| Dysphagia | 111 | ||
| Odynophagia | 111 | ||
| Gastrointestinal bleeding | 111 | ||
| Epigastric pain with radiation | 112 | ||
| Symptoms affected by food | 112 | ||
| Early satiety | 113 | ||
| Constipation | 113 | ||
| Diarrhea | 114 | ||
| Fecal incontinence | 115 | ||
| Arthralgia | 115 | ||
| Shoulder pain | 115 | ||
| Neuropathy | 116 | ||
| Recognizing and reporting hepatic red flags | 116 | ||
| Hepatic and biliary signs and symptoms | 116 | ||
| Skin and nail bed changes | 117 | ||
| Musculoskeletal pain | 118 | ||
| Neurologic symptoms | 119 | ||
| Recognizing and reporting urologic red flags | 121 | ||
| Urinary tract infections | 121 | ||
| Urinary incontinence | 122 | ||
| Risk factors | 123 | ||
| Kidney stones | 124 | ||
| Tumors of the kidney or bladder | 125 | ||
| Renal and urologic pain | 125 | ||
| Recognizing and reporting endocrine red flags | 127 | ||
| Muscle weakness, myalgia, and fatigue | 127 | ||
| Bilateral carpal tunnel syndrome | 127 | ||
| Periarthritis and calcific tendinitis | 128 | ||
| Spondyloarthropathy and osteoarthritis | 128 | ||
| Neuromuscular symptoms | 128 | ||
| Diabetes mellitus | 129 | ||
| Diabetic neuropathy | 130 | ||
| Peripheral (motor and sensory) | 130 | ||
| Autonomic | 130 | ||
| Exercise-related complications | 130 | ||
| Insulin pump during exercise | 131 | ||
| Recognizing and reporting metabolic disturbance red flags | 131 | ||
| Dehydration | 131 | ||
| Recognizing and reporting red flags of cancer | 132 | ||
| Early warning signs | 132 | ||
| Lumps, lesions, and lymph nodes | 132 | ||
| Proximal muscle weakness | 133 | ||
| Pain | 133 | ||
| Change in one or more deep tendon reflexes | 134 | ||
| Clinical manifestations of cancer recurrence or metastases | 134 | ||
| Pulmonary | 134 | ||
| Neurologic | 135 | ||
| Musculoskeletal | 136 | ||
| Hepatic | 136 | ||
| Recognizing when to consult with the physical therapist | 137 | ||
| References | 137 | ||
| 5 Recognizing and reporting red flags in the head, neck, and back | 141 | ||
| Goodman model for the physical therapist assistant (see box 1-2) | 141 | ||
| Past medical history | 141 | ||
| Risk factor assessment | 143 | ||
| Clinical presentation | 144 | ||
| Effect of position | 144 | ||
| Night pain | 145 | ||
| Associated signs and symptoms | 146 | ||
| Review of systems | 146 | ||
| Yellow-flag findings | 146 | ||
| Work | 146 | ||
| Beliefs | 146 | ||
| Behaviors | 146 | ||
| Affective presentation | 146 | ||
| Red-flag signs and symptoms | 147 | ||
| Pediatric red flags | 148 | ||
| Location of pain and symptoms | 149 | ||
| Headache | 149 | ||
| Cancer | 151 | ||
| Migraines | 151 | ||
| Cervical spine | 152 | ||
| Thoracic spine | 152 | ||
| Scapula | 154 | ||
| Lumbar spine | 154 | ||
| Sacrum/sacroiliac | 154 | ||
| Sources of pain and symptoms | 154 | ||
| Viscerogenic | 154 | ||
| Neurogenic | 156 | ||
| Vasculogenic | 158 | ||
| Spondylogenic | 158 | ||
| Psychogenic | 158 | ||
| Recognizing and reporting red flags of cancer | 159 | ||
| Past medical history | 159 | ||
| Red flags and risk factors | 160 | ||
| Clinical presentation | 160 | ||
| Associated signs and symptoms | 160 | ||
| Recognizing and reporting cardiac red flags | 161 | ||
| Angina | 161 | ||
| Myocardial ischemia | 161 | ||
| Abdominal aortic aneurysm | 161 | ||
| Risk factors | 161 | ||
| Clinical presentation | 161 | ||
| Recognizing and reporting peripheral vascular red flags | 163 | ||
| Back pain: Vascular or neurogenic? | 164 | ||
| Recognizing and reporting pulmonary red flags | 165 | ||
| Past medical history | 165 | ||
| Clinical presentation | 165 | ||
| Associated signs and symptoms | 166 | ||
| Recognizing and reporting renal and urologic red flags | 166 | ||
| Origin of pain patterns | 166 | ||
| Past medical history | 167 | ||
| Clinical presentation | 167 | ||
| Recognizing and reporting gastrointestinal red flags | 167 | ||
| Past medical history and risk factors | 168 | ||
| Signs and symptoms of gastrointestinal dysfunction | 168 | ||
| Esophagus | 170 | ||
| Stomach and duodenum | 170 | ||
| Small intestine | 171 | ||
| Recognizing and reporting hepatic red flags | 171 | ||
| The pancreas | 172 | ||
| Recognizing and reporting red flags of infection | 172 | ||
| Vertebral osteomyelitis | 172 | ||
| Disk space infection | 173 | ||
| Bacterial endocarditis | 173 | ||
| References | 174 | ||
| 6 Recognizing and reporting red flags in the upper extremity | 179 | ||
| Recognizing and reporting red flags in the shoulder | 179 | ||
| Past medical history | 179 | ||
| Risk factors | 183 | ||
| Clinical presentation | 183 | ||
| Associated signs and symptoms | 186 | ||
| Recognizing and reporting pulmonary red flags | 186 | ||
| Recognizing and reporting cardiovascular red flags | 187 | ||
| Angina or myocardial infarction | 188 | ||
| Clinical signs and symptoms | 188 | ||
| Bacterial endocarditis | 188 | ||
| Pericarditis | 188 | ||
| Aortic aneurysm | 190 | ||
| Deep venous thrombosis of the upper extremity | 190 | ||
| Recognizing and reporting urologic red flags | 191 | ||
| Recognizing and reporting gastrointestinal red flags | 192 | ||
| Recognizing and reporting liver and biliary red flags | 193 | ||
| Recognizing and reporting red flags of infection | 194 | ||
| Recognizing and reporting red flags of cancer | 195 | ||
| Primary bone neoplasm | 195 | ||
| Pulmonary (secondary) neoplasm | 196 | ||
| Pancoast’s tumor | 197 | ||
| Recognizing and reporting gynecologic red flags | 198 | ||
| References | 198 | ||
| 7 Recognizing and reporting red flags in the lower extremity | 201 | ||
| Past medical history | 201 | ||
| Risk factors | 202 | ||
| Hip and buttock | 203 | ||
| Pain pattern | 203 | ||
| Neuromusculoskeletal presentation | 203 | ||
| Systemic presentation | 205 | ||
| Groin | 206 | ||
| Neuromusculoskeletal presentation | 207 | ||
| Index | 227 | ||
| A | 227 | ||
| B | 227 | ||
| C | 227 | ||
| D | 228 | ||
| E | 228 | ||
| F | 228 | ||
| G | 228 | ||
| H | 228 | ||
| I | 229 | ||
| J | 229 | ||
| K | 229 | ||
| L | 229 | ||
| M | 229 | ||
| N | 229 | ||
| O | 230 | ||
| P | 230 | ||
| Q | 231 | ||
| R | 231 | ||
| S | 231 | ||
| T | 232 | ||
| U | 232 | ||
| V | 232 | ||
| W | 233 | ||
| X | 233 | ||
| Y | 233 |