1
2
3
4
Pulmonary Rehab
Case Study
75-Year-old female admitted to Capitol Rehabilitation and Healthcare Center from Penn State Holy Spirit Hospital with admitting diagnosis of Severe COPD, UTI and Anemia. Patient has a history of CVA, Hypertension and Lung Cancer.
Nursing Interventions
Treat Infection – Ceftriaxone 1 gram IV for UTI
Monitor Labs and Vitals
Medication Management – Antibiotic, Amlodipine
Respiratory Interventions – Capitol’s Onsite Respiratory Therapist
Maintain Adequate Oxygenation – wean oxygen as tolerated
Bronchodilation – Budesonide, Incruse Ellipta
DB&C Exercises
Therapy
Upon admission, Patient required minimal assistance with all self-care tasks and was able to ambulate 15 feet with roller walker and minimal assist. She was receiving occupational and physical therapy for 5 times a week. Upon discharge, she was able to ambulate 30 feet w roller walker and contact guard.
Patient was discharged to the Terrace’s Assisted Living after 14 days LOS in short team rehab. She continued to follow w Bayada Home Health Services and is new to Oxygen therapy. Oxygen therapy secured on Discharge at 2 lpm via nasal cannula.
Cardiopulmonary Rehab
Case Study
83-Year-old male admitted to Capitol Rehabilitation and Healthcare Center from UPMC Community General Osteopathic Hospital with admitting diagnosis of Acute on Chronic Respiratory Failure, Sepsis Pneumonia and Hypotension. Patient has a history of HFpEF and COPD.
Nursing and Respiratory Interventions
Monitor Labs and Vitals
Monitor Fluid Balance – 1500ml fluid restriction
Medication Management – Midodrine and Lasix
Maintain Adequate Oxygenation – Chronic regimen 3 lpm via nasal cannula
Bronchodilation – Albuterol, Anoro Elipta
Pacing and Endurance Training
DB&C Exercises
Physiatry Led Rehabilitation under the direction of Physiatrist, Dr. Morganstein
Upon admission, Patient required maximum assistance to take 2-3 steps and with all self-care tasks. He was receiving occupational and physical therapy for 5 times a week. Upon discharge, he was able to ambulate 160 feet with supervision and no adaptive equipment.
Patient discharged to home independently after his short team rehab stay. He continued his oxygen therapy and to follow with PCP Dr. David Knorek, Cardiologist Dr. William Apollo and the UPMC Advanced Heart Failure Center in Harrisburg.
Neuro Rehabbing Care
Case Study
78-Year-old male admitted to Capitol Rehabilitation and Healthcare Center from Hershey Medical Center with admitting diagnosis TBI with a history of Parkinson’s, Diabetes, Dysphagia and Treatment of Sacral Wounds.
Nursing Interventions
Maintain Safety
Provide Peritoneal Nutrition- Wean PEG tube/ advance diet – GOAL MET
Wound Healing – Sacral Stage 4 wound – GOAL MET
Monitor Labs and Vitals
Medication Management – Lovenox
Capitol’s Onsite Physiatrist led Team Collaboration allowed the Therapy and Nursing team to routinely collaborate and advance patient along the care continuum.
- Advance Patient Diet; Peritoneal Nutrition to regular Diet – GOAL MET.
- Improve Strength: Dependent to self-propel in WC and participate in self care – GOAL MET.
The Patient resided 45 miles from and decided on a Center closer to home for continued LTC after his short team rehab stay to continue his Rehab Recovery.
Pulmonary Rehab
Case Study
75-Year-old female admitted to Capitol Rehabilitation and Healthcare Center from Penn State Holy Spirit Hospital with admitting diagnosis of S/P Fall, COPD and Chronic Respiratory Failure w hypoxia. Patient has a history of Hypertension, PVD and Dysphagia.
Nursing Interventions
Maintain Safety – Recent Fall
Maintain Adequate Nutrition
Monitor Labs and Diagnostics: CXR, CBC, BMP and Magnesium
Medication Management – Z-Pak, Xarelto, Metoprolol, Aspirin,
Breo
Respiratory Interventions – Capitol’s Onsite Respiratory Therapist
Maintain Adequate Oxygenation -3 lpm on admission; wean
oxygen as tolerated
Aspiration Precautions – Downgraded Mechanical Soft Diet
Therapy
Upon admission, Patient required moderate assistance with all selfcare tasks and was able to ambulate 20 feet with roller walker and moderate assist. She gained the strength necessary to ambulate 150 feet w roller walker supervised assist.
Her oxygen requirements were decreased, currently requiring only 2 lpm of Oxygen therapy. Patient and Family decided on the continued care with the team at Capitol Rehabilitation and Healthcare Center.
