Acute Care Worksheet (precautions, WB, Positions)

Question 1

Independent (I)
Define, staff effort, pt effort

Answer 1

-pt requires no assistance or supervision from PT or device and is safe and secure to ambulate and/or complete tasks
-0% staff efforts
-100% pt effort

Question 2

Modified independence (Mod I)
Define, staff effort, pt effort

Answer 2

-pt completes task using assisted devices (walker, cane grab bar etc.) and/or requires extra time to complete a tasks
-0% staff effort
-100% pt effort

Question 3

Supervision (S)
Define, staff effort, pt effort

Answer 3

-no physical contact from PT or assistant; assistant stands next to pt and gives verbal cues
-0% staff effort
-100% pt effort

Question 4

Standby assist (SBA)
Define, staff effort, pt effort

Answer 4

-have to be in pt’s bubble ready to catch pt if needed, but don’t put hands on pt
-5 to 10% staff effort
-90 to 95% pt effort

Question 5

Contact guarding (CGA)
Define, staff effort, pt effort

Answer 5

-pt requires light physical contact from PT or assistant (ex. Hand placed on pt’s back to steady pt w/o physical support)
<5% staff effort
>95% pt effort

Question 6

Minimum assistance (Min A)
Define, staff effort, pt effort

Answer 6

-pt requires 25% or less physical support or assistance to safely complete task/transfer/ambulation

25% staff effort
At least 75% pt effort

Question 7

Moderate assistance (Mod A)
Define, staff effort, pt effort

Answer 7

-pt requires 50% assistance from PT or assistant to safely complete task/transfer/ambulation

50% staff effort
26-74% pt effort

Question 8

Maximal assistance (Max A)
Define, staff effort, pt effort

Answer 8

-pt requires 75% assistance or support from staff member to safely complete task/transfer/ambulation

75% staff effort
25% pt effort

Question 9

Dependent (D)
Total assistance (Total A)
Define, staff effort, pt effort

Answer 9

-pt requires 100% assistance or support from staff members to complete task/transfer/ambulation

100% staff effort
0% pt effort

Question 10

WB-ing level: FWB

Answer 10

Full BW through extremity

Question 11

WB-ing level: WBAT

Answer 11

Weight bearing as tolerated - as much BW as pt can tolerate through extremity usually limited by pain or ability

Question 12

WB-ing level: PWB

Answer 12

Partial weight bearing - 50% of BW through extremity

Question 13

WB-ing level: TTWB

Answer 13

Toe touch weight bearing - only toes allowed to touch ground; primarily use limb for balance ~25% BW

Question 14

WB-ing level: heel touch weight bearing

Answer 14

Only heel allowed to touch ground; primarily use heel for balance, ~25% of BW

Question 15

WB-ing level: NWB

Answer 15

-no weight at all is allowed through the extremity and do not allow extremity to touch support surface

Question 16

TKA precautions

Answer 16

-if there is WB restriction it would be WBAT initially moving towards FWB
-precautions given by Dr/surgeon

Question 17

General THA WB
precautions

Answer 17

-if there is a WB restriction it would be WBAT initially moving toward FW

Question 18

Anterior approach THA precautions

Answer 18

-minimally invasive approach
-NO ext past neutral, ER and ADD

Question 19

Posterior approach THA precautions

Answer 19

NO IR, flexion >90 degrees, ADD past midline

Question 20

ORIF (open reduction internal fixation) precautions

Answer 20

-precautions set by surgeon
-typically NWB or PWB
-ask nurse or dr if precautions are not stated

Question 21

What is a CABG surgery?

Answer 21

Coronary Artery Bypass Graft

Question 22

Traditional sternal precautions (maintained for 4-6 wks)

Answer 22

-do not reach B arms over head (flex)
-do not reach B arms out to the side (ABD past 90)
-do not reach arms behind back
-do not lift more than 5-8 lbs
-do not push w/ arms
-beneficial to hold pillow w/ arms during functional tasks of rolling, supine to sit, and sit to stand
-beneficial to hold pillow during cough or sneeze

Question 23

Cervical spinal restrictions

Answer 23

-if in place; no lifting >10 lbs, aspen collar in place all the time, ROM restrictions per surgeon, no flexion >90 degrees

Question 24

Lumbar spinal precautions

Answer 24

-primarily after spinal laminectomy, decompression surgery
-if precautions in place; NO twisting, forward bending, >90 degrees, minimize SB
-use log roll when moving from supine to sit or sit to supine

Question 25

Complications of being in supine

Answer 25

Flexion contractures of hips, knees, or foot PF

Question 26

Purpose for prone

Answer 26

Relieve pressure to posterior bony prominences, reduce joint contractures, and provide relief to spine

Question 27

Purpose of side lying

Answer 27

Assists w/ relieving pressure from bony prominences but majority of BW is on downside hip and shoulder

Question 28

What is Fowler’s position? Purpose?

Answer 28

-pt sitting upright in bed w/ legs resting on bed
-used to facilitate abdominal drainage, relieve difficulty w/ breathing, tension on abdominal sutures, facilitate eating, reading, socializing, and relaxes large muscles of back

Question 29

High, semi and low Fowler positions

Answer 29

High: 75-90 degrees
Semi: 40-45 degrees
Low: 30 degrees