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list at least two questions that the PTA needs to be thinking about to gather enough information to write a comprehensive daily note.

list at least two questions that the PTA needs to be thinking about to gather enough information to write a comprehensive daily note.

Has demonstrated improvement in transfer ability, as amount of assistance needed has decreased.

Ambulated 75’ x 2 using wheeled walker, required minimal assistance for advancing walker and verbal cueing for proper pattern.

Patient reports pain in R knee @ 5/10 at rest, 8/10 with activity.

Nursing reports patient performed independent transfer in bathroom last night.

Has met weekly goal of independent bed mobility.

Patient says pain relief lasted for 4 hours after application of electrical stimulation at last intervention session.

Will ask wife to attend next intervention session to observe and assist with patient’s transfers.

Patient able to go up/down 3 steps w/ use of cane and 1 rail; independent with procedure after initial instruction in correct technique.

Performed AAROM x 10 to L knee flexion/extension; patient required total assistance for completing last 10 degrees of motion during final 3 repetitions of extension

May not be ready for d/c to lesser level of care as goal of independent transfer has not been met.

Will ask PT to assess need to joint mobilization techniques to L shoulder.

1. Based on the topics listed below, list at least two questions that the PTA needs to be thinking about to gather enough information to write a comprehensive daily note.

a. Pain:

b. Gait Training:

c. Ice Packs:

d. Transfers / bed mobility training:

e. Exercises:

f. Patient instructions:

3. Imagine that you have obtained “answers” to each of the questions you listed previously. Choose 2 of the above interventions and organize the answers into a Subjective (S) and Objective (O) section of a daily progress note:

(S)

(O)

(S)

(O)

4. From the listed S and O above, write how you could reflect upon in the assessment section to demonstrate whether or not the patient is making improvements in his mobility.