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NCS Prep > 14 Special Topics > Flashcards

14 Special Topics Flashcards

1
Q

Goals of wheelchair evaluation

A

Assess pelvic alignment
Identify possible ROM limitations
Determine visual field available
Note anatomical deformities

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2
Q

Seat depth of wheelchair

A

Subtract 2 inches

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3
Q

Proper wheelchair fitting

A

Start at pelvis
Use 3 points of control
Increase surface area to disperse pressures
Accommodate to fixed deformities and correct flexible deformities

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4
Q

Flexible posterior pelvic tilt

A

Pommel
Lumbar support
Anterior/posterior trunk supports

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5
Q

Fixed posterior pelvic tilt

A

Open seat to back angle to match pelvis angle
Contoured back
Tilt in space to allow upright head

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6
Q

Flexible pelvic obliquity

A

Firm foam on low side and soft foam on high side

Build up low side and grid/waffle on high side

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7
Q

Fixed pelvic obliquity

A

Build up to meet high side, cut down to match low side

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8
Q

Flexible windswept legs

A 
Proper width seat
Contoured seat
Pommel
Lateral pelvic/thigh supports
Leg harness or troughs
Foot straps
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9
Q

Fixed windswept legs

A

Foot plate that fits both feet
Ensure contact of back and seat with cushion
Measure true point of maximum for seat width

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10
Q

Flexible kyphosis

A

Anterior chest/shoulder support
Mid-thoracic/lumbosacral support
Tilt in space frame

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11
Q

Fixed kyphosis

A

Custom molded back
Grid seating
Open back seating
Tilt frame

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12
Q

Flexible scoliosis

A

Generic contoured back
Lateral trunk supports (3-point pad system)
Anterior trunk supports

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13
Q

Fixed scoliosis

A

Custom molded seating
Grid back
Lateral tilt under seat to fix head position

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14
Q

Insurance coverage for manual wheelchairs

A

Must be used inside home
Sufficient UE and cognitive function
Caregiver available to provide assistance when necessary

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15
Q

Insurance coverage for power wheelchairs

A

Unable to self-propel manual wheelchair

Home has adequate space

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16
Q

Positioning seat cushion

A

For postural deformities
Trunk weakness
Spasticity
Orthopedic deformities

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17
Q

Stage I pressure injury

A

Non-blanchable erythema
Intact skin
Usually over bony prominence

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18
Q

Stage II pressure injury

A

Partial thickness
Shallow open wound with red/pink wound bed
No slough present

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19
Q

Stage III pressure injury

A 
Full thickness skin loss
Bone, tendon, muscle NOT visible
Subcutaneous fat may be visible
Slough may be present
May have undermining and/or tunneling
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20
Q

Stage IV pressure injury

A

Full thickness skin loss
Exposed bone, tendon, or muscle
Slough or eschar present
Often includes tunneling and undermining

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21
Q

Unstageable pressure injury

A

Full thickness skin loss- depth unknown
Depth obscured by slough or eschar
Dry, intact eschar should not be removed

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22
Q

Suspected deep tissue injury

A

Depth unknown

Discolored, intact skin or blood-filled blister from pressure or shear

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23
Q

Gait speed for ADL independence

A 
>= 1.0 m/s independent
<= 0.6 m/s dependent
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24
Q

Gait speed more likely to be hospitalized

A 
<= 0.6 m/s more likely
>= 1.0 m/s less likely
25
Q

Gait speed necessity of fall risk intervention

A

<=1.0 m/s

26
Q

Gait speed for discharge location

A

<=0.1 m/s for SNF

>=0.1 m/s home more likely

27
Q

Gait speed ambulation status

A

<=0.4 m/s household walker
0.4-0.8 m/s limited community ambulator
0.8-1.2 m/s community ambulator
>= 1.2 m/s cross street and normal walking speed

28
Q

Most common primary brain tumor in adults

A

Meningiomas (36%)

29
Q

Most common malignant brain tumors in adults

A

Gliomas (80%)

30
Q

Most common pediatric CNS tumors

A 
Pilocytic astrocytoma
Malignant glioma
Medulloblastoma
Neuronal and mixed neuronal-glial tumors
Ependymoma
31
Q

Meningiomas

A

Benign from meninges

Grow slow, large size before affecting function

32
Q

Astrocytoma

A

Glioma
Low grade- slow, likely in children
High grade- fast, likely in adults
Glioblastoma multiforme- most common and deadliest primary brain tumor

33
Q

Oligodendrocytoma

A

Glioma

Slow growing- years before symptoms

34
Q

Ependymomas

A

Glioma

Rare in adults

35
Q

Grade I tumor

A

Benign
Slow-growing
Usually associated with long-term survival
Rare in adults

36
Q

Grade II tumor

A

Relatively slow growing
May spread to nearby healthy tissue
May be recurring as grade II or higher grade tumor

37
Q

Grade III tumor

A

Malignant
Actively reproduces abnormal cells
Spreads to nearby tissues
Often returns as higher grade tumor

38
Q

Grade IV tumor

A

Most malignant
Fast growing
Easily spreads to normal tissue
Tumor forms new blood vessels to maintain rapid growth
Tumor has areas of dead cells in the center

39
Q

Signs of increased intracranial pressure

A 
Headache
Nausea/vomiting
Blurred vision
Balance problems
Personality changes
Seizures
Drowsiness
40
Q

Spinal cord tumor presentation

A

UMN and LMN signs
Nerve root pain
Bowel/bladder changes

41
Q

Birth to 3 month milestones

A

Alternate kicking legs on back
Hold head 45 degrees in prone by 2 months
Begins to hold head midline and track objects with eyes
Reflexes- step, moro, Babinski, ATNR, flexor posture, grasp, root, suck
Cooing sounds and develops smile/imitates faces

42
Q

4 to 6 month milestones

A 
Able to lift and hold head in all positions
Plays with hands near face and chest
Palmar grasp 4 months, raking 6 months
Roll to side and tummy to back 4-5 months
Roll back to tummy 6 months
Bears weight on elbows/hands on tummy
Sit without arms for brief periods
Postural reflexes develop
43
Q

7 to 9 month milestones

A 
Able to sit independently
Begins to creep
Pull to stand with arms, uncontrolled drop stand to sit
Drop objects on purpose
Inferior pincer grasp, thumb more active
Cruise along furniture 9 months
44
Q

10 to 12 month milestones

A 
Lower self from standing with legs
Play in squat position
May take first steps with wide base
Kneels independently
Use objects appropriately
Fine pincer grasp, finger-feeds self
45
Q

13 to 15 month milestones

A

Begins walking
Can stack 2 objects
Begins using spoon
Scribbles

46
Q

16 to 19 month milestones

A 
Walks up steps with HHA and 2 feet
Walks backwards
Stacks 4 objects
Kick stationary ball
Hold toys while walking
Removed clothing, drink from cup
47
Q

20 to 23 month milestones

A

Walk down steps with HHA and 2 feet
Jump in place
Imitates domestic tasks, shows independence
Stacks 6 objects

48
Q

2 year milestones

A 
Jumps on 2 feet
Handedness established
Uses fork
Follows 2-step commands
2-word phrases
49
Q

3 year milestones

A

Ascends stairs alternating feet
Pedals tricycle
Turns pages of books
Toilet trained

50
Q

4 year milestones

A

Hops on one foot
Descends stairs alternating feet
Able to do buttons
Tells stories

51
Q

5 year milestones

A 
Skips
Balance on one foot 10 seconds
Draw person
Tripod pencil grasp
Independent ADLs
52
Q

Down syndrome complications

A 
Deafness
Visual impairments
Heart defects
Sleep apnea
Ear infections
53
Q

Norm-referenced outcome measure

A

Compares performance of and individual to a representative group

54
Q

Criterion-referenced outcome measure

A

Document performance in relation to domain of information or specific skill set
Measures changes in performances of individual

55
Q

PDMS-2

A

Assesses fine and gross motor skills
Birth to 7 years
Norm and criterion referenced

56
Q

GMFM

A 
Assess gross motor skills
5 months to 16 years
Change over time in CP
Also validated for Down syndrome
Criterion-referenced
57
Q

BOT

A

Assess fine and gross motor skills
4.5-14.5 years
Norm-referenced

58
Q

ICP monitor

A

Measures ICP, some allow CSF drainage
Most need to stay at level of external auditory meatus
If therapy performed, device needs to be recalibrated by RN after

59
Q

NG tubes, Gastrostomy, J tubes

A

HOB should not be below 30 degrees after feeding

NCS Prep (19 decks)

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