Acute Care, Bed Mobility, Sleep Positioning Flashcards
When teaching a patient self care in the initial treatment stages and prior to discharge the goal is to promote:
Self responsibility
The five acute care steps are:
Find a position of comfort Apply Ice Take and Anti-Inflammatory Follow the PUP Principle Avoid Known Aggravating Activities
The Position of Comfort is trained using the principles of positioning to ensure that the patient is ________ appropriately and that all regions of the body have no ___________ which could aggravate symptoms
Supported
Load or Torsional Force
An efficient position of comfort is a position that __________ the pain and allows for a __________ after an upright position is assumed
Decreases or Centralizes Pain
Maintenance of this decrease or centralization of pain
Positions of comfort can include ______, ________, __________, or ___________ positions
Sitting
Supine
Sidelying
Reclined
To position in a position of comfort these three steps must be taken:
Position in a mid range, loose-packed, tissue tension, pain-free position
Support all areas of suspension, or unsupported areas
Support from proximal to distal
This has been shown through clinical studies to be the most effective form of application of a modality if a patient is willing to perform it:
Ice Massage
Heat is used more in cases of __________ Ice is used more in cases of ____________
Stiffness
Pain
Patients should stop taking asprin or motrin if they experience any _________ or ___________
Stomach Discomfort
Ringing in the Ears
Do not recommend asprin or motrin if the patient has any history of _________ or ____________
Ulcers
Bleeding Disorders
A patient needs to be instructed that pain is an indication of ___________
Tissue damage
A ___________ position is necessary in the initial healing stages to reduce the stress on the damaged tissues.
Non-Weight Bearing
A controlled increase of appropriate stress to the damaged tissues can actually _________ healing
Promote
The key to using the PUP principle is to train the patient to __________
Listen to their body and heed the warning of pain
The patient should _______________ whenever the patient feels an onset of the pain related to the damaged tissues
Return to the position of comfort immediately
As ___________ occurs the amount of time one can be upright between rest periods will increase
Healing
The therapist needs to help the patient identify the activities which are a part of their routine and can be directly related to ___________
Increased pain or symptoms
In situations where the activities that the patient do cannot be avoided the goal is to discuss with the patient how to _____________ until the acute phase of their episode is over
Modify the activity
Encourage the patient that it is his/her responsibility to _________. It is the therapist’s responsibility to ________
Get pain free
Facilitate the process.
The patient needs to keep accurate records of ________ and ________ so as to assist the therapist in making the right decisions about the course of treatment.
Aggravating activities
The course of the pain
Sleeping surfaces should offer _______ and be easily ______
Support
Accessible
If it is determined that the patient may need a new mattress, be sure to instruct the patient to:
First sample a firmer surface by making a mat on the floor and sleeping there one or two nights
Sample a softer surface by adding a foam topper to an existing mattress.
Test the mattress at a mattress store once knowing if the mattress needs to be firmer or softer.
The patient should test a new mattress for at least _________ or ____________ on each of several new mattresses before deciding on the right mattress
30-45 minutes
A time equal to the length of the time before pain comes at night
When testing mattresses the patient should take their own _________
Pillow
Down and Down/Feather pillows offer a more ____________ with less _______ allowing the neck to fully relax
Conforming support
Pushing back
Foam pillows offer more ___________ for areas such as the ____________
Support
Legs, hips, and arms or for the broad shouldered patient
If a patient complains that there are too many pillows, they should be encouraged that:
More pillows are needed during the healing phase and most likely only one or two will be needed when the patient is fully recovered.
If a patient complains that they move all night they should be taught how to
Move in bed with the supports and pillows as an exercise, such as log rolling and bed mobility exercise
During training for sleep emphasize the the importance of the principle of ___________ and discuss the difference between a __________
Unloading
Support and a fulcrum
A support is:
A towel, pillow, piece of foam, or any other structure or object which can be placed externally to the body and be used to unload the weight of a particular body part from proximal tissues.
A support should not alter the ___________, just unload the weight of a body part and reduce the stress of associated structures
Alignment.
A fulcrum is:
A pillow, towel, piece of foam, or any other structure which alters the alignment of the body to emphasize a movement in one direction or another.
A fulcrum may be useful if placed on a particular part of the body to __________
Increase range of motion
To make the use of a fulcrum more specific you should consider the _________ and _________ of the fulcrum
Specificity
Placement
For kinesthetic comparative training the patient is put into their existing preferred position ________ and ______
First and after treatment
The patient is placed into a new position and asked to ____________ then they are put into their original position and asked to ____________
Note proprioceptive and kinesthetic changes
Verbally describe the changes
The physiological principle behind KCT technique is _________
Accommodation.
It is more effective to use KCT to teach a new position because the patient will recognize the ______
Differences
The three principles of positioning are:
Position in a mid-range, loose-pack, tissue tension, pain-free position
Support all areas of suspension, or unsupported areas
Support from proximal to distal.
When laying in side-lying a _______ is placed under the waist to keep the __________ in a loose packed position
Folded towel
Lumbar spine
Pillows are used to reduce the force of __________ in the cervical spine
Lateral shear
When positioning in side lying too much weight on the lower shoulder is often a sign that there is insufficient support at the ___________
Head and neck.
When laying in supine pillows should support from the ____________ down to the __________ if possible to support the lumbar spine and pelvis
Ischial Tuberosities
Ankles
A ___________ can be used instead of a pillow when laying in supine to support the head during exercise classes or beach lounging
Scrunched towel.
The 11 acute care exercises and 1 bonus exercise are:
Log rolling Functional Hip Release Diaphragmatic Exercise Hands and Knees Supine over Prop Pelvic clock Lateral shear in side-lying Prone knee bend, unilateral and bilateral Prone press up segmentally Extension in standing Extension with distraction and flexion with distraction Bonus: bracing
__________ is used to train mobility in bed and should be practiced every night before going to sleep to encourage an automatic, appropriate rolling response while sleeping
Functional rolling.
__________ is a feldenkrais based exercise that focuses on motor control and results in increased ROM as well as better awareness of the hip joint
Functional Hip Release
Hands and knees is modified to focus on isolated segments of dysfunction through __________
Weight shift.
These two exercises can be performed over a prop to progress the supine over prop exercise
Diaphragmatic breathing or pelvic clock.
This exercise should be taught very early on in the course of treatment
Basic Bracing
Always reinforce the ________________ of the patient for their home program
Self responsibility role.
The patient should be taught to ___________ to assume hook lying when they are in the acute stage of their condition
Press their feet into the table
Principles of mobility in bed are there to encourage patients to improve their______
ACE
The five activities taught to an acute patient for bed mobility include:
Assisted Rolling Self Assisted Bridging Up From Sidelying Up From Supine Up From Prone
In assisted rolling the leg on the ______ side of the roll is pressed into the mat
same
in assisted rolling the leg on the _______ side of the roll is brought to the chest to push into for the roll
opposite
The hand on the ________ side as the raised leg is used to assist rolling and is placed on the _______ of the raised knee
same, outside
When rolling from sidelying to supine the patient places the ______ hand on the _________ of the knee
upper hand, medial side of the knee
When self assisting bridging the patient _______ his or her thighs and pushes ______ while squeezing the ______
tractions, out, gluts
