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PREFERRED PRACTICE PATTERN
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As of July, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology. Therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.
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PATIENT PRESENTATION
A 34-year-old female presents to PT with complaints of general weakness, 2 weeks after being discharged from a 40-day admission to the hospital. She was previously employed as a CAN nurse, but has not worked in the past year since her diagnosis. She went into respiratory failure after her surgery (colon tumor resection, hemidiaphragm hernia repair, and hysterectomy with bilateral salpingo-oophorectomy). She was intubated and still has her feeding tube in, although, she is not using it currently. She expects to get it removed in the next few weeks. She lives in a two-level home with her family. She has difficulty getting up the stairs and has to use both arms to pull herself up them. She is independent with ADLs; however, uses supervision assist during showering for safety. She also uses hand held assist when getting into the shower as it is a step-over tub/shower. She is experiencing daily vomiting, usually in the mornings and constipation from the pain medicines. She has a lot of pain and numbness in her whole body with sleeping at night; however, she feels that the right side of her body is worse than the left. It also feels weaker than the left side. In addition, she has low back pain that started during her hospital admission.
Structural assessment includes: flat lumbar spine with patient maintaining a forward bent torso during standing, walking, and sitting. She is able ...