DD Chapter 5

When exercising a client with known anemia, what two measures can be used as guidelines for frequency, intensity, and duration of the program?

(1) Client tolerance (2) Perceived exertion levels

Describe the two tests used to distinguish an iliopsoas bleed from a joint bleed.

(1) Trunk flexion over the hips produces severe pain in the presence of iliopsoas bleeding. Only mild pain occurs on trunk flexion over the hips for a hip hemorrhage. (2) Gently rotating the hip internally or externally causes severe pain in the presence of a hip hemorrhage but only minimal (or no) pain with iliopsoas bleeding.

Under what circumstances would you consider asking a client about a recent change in altitude or elevation?

Living at an elevation of 3500 feet above sea level (or higher) and the client describes symptoms of unknown origin such as: 1) Headache 2) Dizziness 3) Fatigue 4) Changes in sensation of the feet and hands (decreased feeling, burning, numbness, tingling [polycythemia]) 5) Joint pain 6) Swelling 7) Loss of motion [sickle cell disease])

In the case of a client with hemarthrosis associated with hemophilia, what physical therapy intervention would be contraindicated?

Local heat applied to the involved joint(s)

What is the significance of nadir?

Nadir, or the lowest point the white blood count reaches, usually occurs 7 to 14 days after chemotherapy or radiation therapy. At that time, the client is *extremely susceptible to infection*; the therapist must follow all universal precautions, especially those pertaining to good handwashing.

If rapid onset of anemia occurs after major surgery, which of the following symptom patterns might develop?

b. Exertional dyspnea and fatigue with increased heart rate

Chronic GI blood loss sometimes associated with use of NSAIDs can result in which of the following problems?

b. Iron deficiency

Skin color and nail bed changes may be observed in the client with:

b. Pernicious anemia resulting from Vitamin B12 deficiency

Bleeding under the skin, nosebleeds, bleeding gums, and black stools require medical evaluation as these may be indications of:

b. Thrombocytopenia

Preoperatively, clients cannot take aspirin or antiinflammatory medications because these:

c. Decrease platelets