4.25 TBI 2 Flashcards
You can have a severe TBI without having this
severe symptomology
TBI pts and inhibition
- act out much more on their thoughts
- speaking, acting, etc.
What do TBI pts need for therapy?
- make sure not to reinforce unacceptable behaviors
- Watch what you say - shouldn’t be making jokes because they will too
- don’t want them to become too dependent on you
- put them in safe environments so they can struggle
Why should you not laugh?
- must address the problem, say it’s wrong, and constantly reinforce
- It’s the only way their brain might rewire correctly so they don’t do inappropriate things out in public
If a pt was disinhibited before their TBI, what are they more likely to be?
much more disinhibited after
Why is it important for TBI pts to struggle?
If they don’t struggle and learn, they won’t get better
Dealing with frustration
- Once they have some insight into their injury, they’ll get frustrated
- they’ll have motor impairments and be frustrated with how other people see them differently
lowest response you can get on Glasgow coma scale
3 (adding up each part)
What are the 3 categories of Glasgow coma scale?
- eye opening
- best motor response
- verbal response
decerebrate posturing
- full extensor posturing (rigid extension)
- not a great prognosis usually
decorticate posturing
- flex UE
- ext LE
RLA
Ranchos Los Amigos
What does RLA classify?
cognitive function
What are the RLA categories?
- no response
- generalized
- localized
- confused-agitated
- confused-inappropriate
- confused-appropriate
- automatic-appropriate
- purposeful-appropriate
RLA: no response
nothing happening
RLA: generalized
inconsistent rxns
RLA: localized
react specifically, but may not always be consistent
RLA: confused-agitated
- nonpurposeful behavior
- odd/weird acting
- easily agitated
- probably don’t want to participate much in therapy
- memory issues
cannot correct agitation in this stage
RLA: confused-inappropriate
- pretty well with response to stimuli
- not as easily agitated as 4
- not a great attn span
- memory issues
- easier to work with them because they aren’t as angry/agitated
RLA: confused-appropriate
- trying to do things now
- confused about what’s going on, but attempt to do what is asked of them
- start seeing carryover from tx to tx
RLA: automatic-appropriate
- oriented to where they are
- appropriate
- normal ADLs, but more robot-like
- typically have a hard time coping with adapting to a changing environment
RLA: purposeful-appropriate
- carryover
- can move between multiple activities
- once relearned, don’t need supervision
- appear typically normal to outsiders, possibly back to premorbid levels
If low on the cognitive fxn scale, this does not necessarily mean they’re low on ____
motor function
