Physio Initial Inpatient

Reason for referral: Functional decline post viral illness HOPC: - Patient admitted due to severe respiratory distress following a viral infection. - Requires physiotherapy for mobility improvement and respiratory function enhancement. - Complains of worsening leg pain and persistent headache. Medications: See med chart PMHx: - History of chronic obstructive pulmonary disease (COPD) - Previous episodes of pneumonia SH: - Lives in a single-story house with spouse - Previously independent in mobility and daily activities - Exercise tolerance was moderate, could walk 500 meters without rest - Receives cleaning services twice a week and meals on wheels five times a week - No falls in the past 12 months Objective: - Found resting in bed, alert and oriented, saturating comfortably on 2L O2 via nasal prongs - Vitals observations: Between the flags (BTF) - Attachments: IV line in situ - Auscultation: Decreased breath sounds in lower left zone, with inspiratory crackles and expiratory wheeze - Lateral Basal Expansion (LBE): Reduced on the left side - Cough: Strong, dry, non-productive, and effective - CXR: Bilateral infiltrates consistent with viral pneumonia Mobility: - Supine: Independent - Sit Bal: 1x assist with strong lean to right - STS: Independent with use of rail - Stand Bal: 1x moderate assist (MA) - Transfer: 2x moderate assist (MA) with roller frame (RF) - Walking: 1x light assist (LA) 10m limited by shortness of breath (SOB) Treatment: - Education on risks of prolonged bed rest - Active Cycle of Breathing Techniques (ACBT) x2 rounds - Mobilized 2x8m with assistance Assessment: - Nurses should assist patient with transfers and mobilization on the ward - Patient is not at baseline function - Patient is not safe for discharge from physiotherapy due to limited mobility and respiratory issues - Barriers: 12 stairs at home with no rails and minimal support to assist Plan: - Recommend continued respiratory physiotherapy and mobility exercises - Next physiotherapy review in 2 days - Goal: Improve walking distance and respiratory function