Equipment Contraindications - National Physical Therapy Examination NPTE
- Identify the required safety action before any modality use when skin integrity is compromised.
- Inspect skin and sensation; avoid modality if burn or breakdown risk is high. Compromised skin is prone to further injury from thermal or electrical modalities.
- What is the key safety rule for therapeutic ultrasound over an epiphyseal plate in a growing child?
- Avoid ultrasound over active epiphyseal plates (growth plates). Ultrasound may interfere with normal bone growth in pediatric patients.
- What is the contraindication for superficial heat over an area with absent protective sensation?
- Avoid heat when protective sensation is absent or markedly reduced. Lack of sensation prevents detection of overheating, leading to potential burns.
- What is the key safety precaution for shortwave or microwave diathermy near metal implants?
- Avoid diathermy over or near metal due to excessive heating risk. Electromagnetic fields cause metal to absorb and radiate heat, risking burns.
- What is the key safety concern that makes whirlpool generally inappropriate for most open wounds?
- High risk of wound maceration and bacterial cross-contamination. Immersion promotes excessive moisture and pathogen transfer between patients.
- What is the contraindication for therapeutic ultrasound over the spinal cord after laminectomy?
- Do not apply ultrasound over exposed spinal cord tissue post-laminectomy. Direct ultrasound application risks neural tissue damage due to thermal effects.
- What is the contraindication for electrical stimulation over an active thrombosis (DVT) site?
- Do not apply e-stim over suspected or confirmed thrombophlebitis/DVT. Stimulation may cause clot mobilization, increasing the risk of pulmonary embolism.
- What is the absolute contraindication for therapeutic ultrasound over suspected malignancy?
- Do not apply ultrasound over suspected or known malignancy. Ultrasound may promote tumor growth or metastasis in malignant tissues.
- What is the contraindication for therapeutic ultrasound over an active deep vein thrombosis site?
- Do not apply ultrasound over suspected or confirmed thrombophlebitis/DVT. Thermal effects from ultrasound could dislodge the clot, leading to embolism.
- What is the contraindication for cryotherapy in a patient with cryoglobulinemia?
- Do not use cold with cryoglobulinemia. Cold causes proteins to aggregate, leading to vessel occlusion or tissue damage.
- What is the absolute contraindication for electrical stimulation in a patient with a demand-type pacemaker?
- Do not use e-stim with a demand-type pacemaker. Electrical signals may interfere with pacemaker function, risking cardiac arrhythmias.
- What is the primary contraindication for using a whirlpool on an open wound with fecal contamination risk?
- Avoid whirlpool due to high cross-contamination/infection risk. Whirlpools facilitate bacterial spread, especially with fecal matter present.
- What is the contraindication for electrical stimulation applied through the anterior neck (carotid sinus)?
- Do not apply e-stim over carotid sinus/anterior neck. Stimulation can alter baroreceptor activity, causing hypotension or bradycardia.
- What is the contraindication for therapeutic ultrasound directly over the eyes or gonads?
- Do not apply ultrasound directly over eyes or testes/ovaries. These sensitive organs are at high risk for thermal damage from ultrasound energy.
- What is the contraindication for electrical stimulation over known or suspected malignancy?
- Avoid e-stim directly over known or suspected malignancy. Electrical stimulation could enhance tumor cell proliferation or spread.
- What is the contraindication for superficial heat over an area of active bleeding or acute hemorrhage?
- Do not apply heat over active bleeding/acute hemorrhage. Heat causes vasodilation, which can exacerbate or prolong hemorrhage.
- What is the contraindication for cryotherapy in a patient with cold urticaria?
- Do not use cold; cold urticaria is a contraindication. Cold triggers histamine release, causing hives or anaphylaxis in susceptible individuals.
- What is the contraindication for cryotherapy in a patient with Raynaud disease or phenomenon?
- Avoid cold application with Raynaud disease/phenomenon. Cold exacerbates vasospasm, potentially leading to ischemia in affected extremities.
- What is the contraindication for therapeutic ultrasound over areas with impaired sensation or cognition?
- Avoid ultrasound when the patient cannot report heat/pain accurately. Impaired feedback prevents detection of excessive heating, increasing burn risk.
- What is the absolute contraindication for therapeutic ultrasound over a pregnant abdomen or low back?
- Do not apply ultrasound over the pregnant uterus (abdomen/low back). Ultrasound can cause thermal effects potentially harmful to the developing fetus.
- What is the contraindication for electrical stimulation over the pregnant uterus?
- Do not apply e-stim over the abdomen/low back during pregnancy. Electrical currents may adversely affect fetal development or induce contractions.
- What is the contraindication for cryotherapy in a patient with paroxysmal cold hemoglobinuria?
- Do not use cold with paroxysmal cold hemoglobinuria. Cold exposure induces red blood cell destruction and hemoglobin release in urine.
- What is the contraindication for diathermy in a patient with an implanted electronic device?
- Do not use diathermy with pacemakers, neurostimulators, or pumps. Diathermy fields can disrupt device function or cause overheating and failure.
- What is the contraindication for superficial heat over a region with severe peripheral vascular disease?
- Avoid heat when circulation is severely impaired (PVD/ischemia). Poor blood flow impairs heat dissipation, heightening the risk of thermal injury.