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3 key factors that create a need for screening:
- side effects of medications
- comorbidites
- visceral pain mechanisms
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Reasons for Medical Screening
- Direct access: Therapist has primary responsibility or first contact.
- Quicker and sicker patient/client base.
- Signed prescription: Clients may obtain a signed prescription for physical/occupational therapy based on similar past complaints of musculoskeletal symptoms without direct physician contact.
- Medical specialization: Medical specialists may fail to recognize underlying systemic disease.
- Disease progression: Early signs and sxs are difficult to recognize, or sxs may not be present at the time of medical examination.
- Patient/client disclosure: Client discloses information previously unknown or undisclosed to the physician.
- Client does not report sxs or concerns to the physician because of forgetfullness, fear, or embarrassment.
- Presence of one or more yellow (caution) or red (warning) flags.
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Constitutional Symptoms
- fever
- diaphoresis (unexplained perspiration)
- night sweats (can occur during the day)
- nausea
- vomiting
- diarrhea
- pallor (paleness)
- dizziness/syncope (fainting)
- fatigue
- weight loss
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Physical Therapist Role in Disease Prevention
- Primary Prevention: stopping the process(es) that lead to the development of disease(s), illness(es), and other pathologic health conditions through education, risk-factor reduction, and general health promotion
- Secondary Prevention: early detection of disease(s), illness(es), and other pathologic health conditions through regular screening: this does not prevent the condition but may decrease duration and/or severity of disease and thereby improve the outcome, including improved quality of life
- Tertiary Prevention: providing ways to limit the degree of disability while improving function in patients/clients with chronic and/or irreversible diseases
- Health Promotion and Wellness: providing education and support to help patients/clients make choices that will promote health or improved health. The goal of wellness is to give people greater awareness and control in making choices about their own health.
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Elements of Patient/Client Management
- Examination: history, systems review, and tests and measures
- Evaluation: assessment or judgment of the data
- Diagnosis: determined within the scope of practice
- Prognosis: projected outcome
- Intervention: coordination, communication, and documentation of an appropriate treatment plan for the diagnosis based on the previous four elements
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