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Pulmonary Rehab
Case Study
74-year-old female admitted to Oxford Rehabilitation and Healthcare Center from Jefferson Torresdale Hospital with admitting diagnosis of Acute Respiratory Failure and COPD. Patient has a history of AFIB, Hypertension, and wears chronic oxygen at 4lpm prior to hospitalization. She arrives to Oxford newly requiring Trilogy AVAPS-AE Therapy.
Nursing Interventions
Medication Management-Atorvastatin, prednisone, Spiriva, Dulera, Xarelto
Monitor Labs – CBC, BMP, CMP
Respiratory Interventions
Tolerance of AVAPS Therapy – GOAL MET
Maintain Adequate Oxygenation DB&C Exercises – Incentive Spirometry to prevent Atelectasis
Pacing and Endurance Training – RT daily collaboration with Therapy.
Under the Leadership of Oxford Onsite Pulmonologist, Dr. Bruce Dershaw in partnership with Oxford’s Full time Respiratory Therapist, the patient continued to progress, gain strength and tolerance to the use of her AVAP’s Therapy. Patient progressed to ambulating 40 feet with a roller walker and Contact Guard.
This was the patients first experience in short term rehab; she reports feeling much improved and appreciative of the care and education she received. Upon Discharge, She will continue to be followed by PCP, Tricia Loehrig; Pulmonologist, Dr. Steven Geller, Bayada Home Health Services and Community Surgical to supply to AVAP’s Therapy.
Oxford Pulmonary Rehab… Where we set our patients up for continued success! #Trilogy #AVAPS Breathe Easy… Think Oxford.
Rehabbing Care / Ortho
Case Study
64-year-old female admitted to Oxford Healthcare and Rehabilitation Center from Jefferson Bucks Hospital who initially presented after a fall. Pt found to have unstable right trimalleolar fracture. Realignment was unsuccessful in the ER and patient was taken emergently to the OR for external fixation on 7/6, subsequently followed by external fixation removal and ORIF on 7/12 by Dr. Robert Norton. Patient remains NWB on her right lower extremity. PMH includes morbid obesity, HTN, paroxysmal Afib on Eliquis, hyperlipidemia and history of left ankle ORIF. Patient transferred to Oxford Rehab for continued PT/OT.
Nursing Interventions:
Maintain Safety – initially NWB RLE then advanced to WBAT RLE
Maintain Proper Nutrition – dietician following, patient with healthy weight loss
Treat Infection – Macrobid and Pyridium for recurrent UTI and dysuria
Pain Management
Monitor Labs and Vital Signs
Therapy:
Upon admission, patient was Mod A for bed mobility and dependent for transfers. Patient actively participated with PT/OT 5-days week. Patient was followed by PMR physician, Dr. John Furrey for knee paint s/p steroid injection. During her stay at Oxford Rehab, the patient’s weight being status was advanced to weight bearing as tolerated on right LE in ankle boot. Upon discharge, patient was able to ambulate 100ft supervision with SPC.
After a successful stay at Oxford Rehab, the patient discharged safely home with support of family and St. Mary’s Home Care services.
Urgent SNF
Case Study
92-year-old female DIRECTLY admitted to Oxford Rehabilitation and Healthcare Center from Oxford Enhanced Senior Living due to generalized weakness in his bilateral lower extremities. Past medical history significant for CHF, Afib, CKD, hypothyroid, hypertension, and hyperlipidemia. Patient with recent respiratory infection which resulted in decline in his function and ambulation. This rapid decline prompted him to be directly admitted to Oxford Rehab for medical optimization and therapy services.
Nursing Interventions:
CHF Management – torsemide, daily weights
Medication Management – Metoprolol, Eliquis, Levothyroxine, Hydralazine, Atorvastatin
Close Lab Monitoring – twice weekly CBC and CMP
Therapy Interventions
Goals: Prior to admission patient resided in an independent living facility with his spouse. He was modified independent for all mobility and ADLs.
Interventions: Upon admission, patient required Mod A for bed mobility, Min A for transfers and was ambulating Min A 200ft with RW, while requiring Mod A for bathing and LB dressing and Min A for toileting. He actively participated with therapy to regain his independence and strength. Upon discharge, the patient was CGA with bed mobility and transfers. He was able to safely
ambulate CGA 200ft with RW. He was able to advance to Mod I with activities of daily living including bathing, toileting, and LB dressing, while becoming independent with UB dressing.
After a 9-day LOS in short term rehab, the patient returned home with spouse to Oxford Enhanced Senior Living with support from St. Mary’s Home Care. Patient will continue to follow with his cardiologists, Dr. Charles Paraboschi and Dr. Rozengarten and his PCP, Dr. Caroline Murphy-Cook in the community.
