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ADL > ADL Exam 2 Review > Flashcards

ADL Exam 2 Review Flashcards

1
Q

Complications from prolonged immobility

A
  1. blood clots
  2. orthostatic hypotension
  3. increased insulin requirements
  4. risk of aspiration
  5. constipation
  6. pressure injuries
  7. decreased muscle mass and strength
  8. loss of joint ROM, difficulty breathing
  9. pneumonia
  10. calcium loss in bones
  11. general inability to perform daily activities
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2
Q

requires therapist to move patient’s joints through full or available range

A

range of motion (ROM)

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3
Q

AROM

A

patient performs movement independently

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4
Q

PROM

A

movement of a body segment through the full motino possible by an external force (therapist) or uninvolved extremity

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5
Q

striping pattern in which sensory neurons are arranged

A

dermatomes

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6
Q

sensory neurons

A

nerves that detect pressure, pain and touch

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7
Q

How people with normal sensation avoid too much pressure on certain bony places

A

lean forward
shift from one hip to another
scoot bottom back in chair
roll from right side to left

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8
Q

Agency for Health Care Policy and Research statement on re-positioning patients

A

every 2 hours for bed, 15-30 minutes for seated

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9
Q

Another name for pressure injury

A

decubitus ulcer

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10
Q

pressure injury arises from

A

pressure applied to an area of skin over a long period of time

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11
Q

Factors that can cause or exacerbate pressure injuries

A

friction force
shearing force
comorbidities

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12
Q

Soft tissue contracture sites in supine

A

hip and knee flexors
ankle plantar flexors
shoulder extensors, adductors, internal rotators

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13
Q

Soft tissue contracture sites in prone

A

ankle plantar flexors
shoulder extensors, adductors, internal rotator and external rotators
neck rotators

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14
Q

Soft tissue contracture sites in sidelying

A

hip and knee flexors
hip adductors and internal rotators
shoulder adductors and internal rotators

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15
Q

Soft tissue contracture sites in sitting

A

hip and knee flexors
hip adductors and internal rotators
shoulder extensors, adductors, internal rotators

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16
Q

Generally desired position to avoid contractures

A

neutral

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17
Q

Reasons for positioning

A

avoid contractures
decrease likelihood of pressure injury
comfort
access for therapist to body part
to maximize patient function

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18
Q

areas where 25% of all pressure injuries are found

A

sacrum
heel
ischium
patella

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19
Q

supine common areas of pressure

A

scapulae (spine and inferior angle)
spinous processes
posterior iliac crests
ischium
*heels (posterior calcanei)
*sacrum
elbows (medial epicondyle)
back of head (occipital tuberosity)

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20
Q

sidelying common areas of pressure

A

ear
later ribs
*lateral acromion process
lateral head of humerus
medial/lateral epicondyles
*greater trochanter
medial/lateral condyles
*malleoli
5th metatarsal of foot

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21
Q

prone common areas of pressure

A

forehead
lateral ear
anterior acromion process
clavicles/sternum
anterior head of humerus
anterior superior iliac spine (ASIS)
tips of toes
patella

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22
Q

sitting common areas of pressure

A

*ischial tuberosities
scapular and vertbral processes
sacrum
coccyx
medial epicondyle of humerus
calcanei (heels)

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23
Q

restraint

A

anything that would prevent a patient from being able to move or change position on his/her own

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24
Q

things that might be considered restraints

A

medications, tying patient to bed or WC, WC cushions, WC toughs, , lap trays, bed rails, seat belt, pillows, towel rolls, bolsters, other positioning devices

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25
Q

A restraint can be ordered by

A

physician or other licensed healthcare personnel authorized by state and facility

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26
Q

positioning for transtibial amputation

A

keep hip and knee fully extended, avoid prolonged sitting

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27
Q

positioning for transfemoral or transtibial amputation for some time each day

A

prone

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28
Q

contracture risk for transfemoral amputation

A

hip flexion
also external rotation and abduction of hip

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29
Q

positioning for burn patient

A

discomfort

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30
Q

general goal of positioning limb after stroke

A

position patient in opposite of position of tone, support for flaccid extremity

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31
Q

contraindicated movements for THA, posterior approach

A

hip flexion past 90, hip adduction, hip internal rotation

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32
Q

contraindicated movements for THA, anterior approach

A

hip hyperextension, hip external rotation

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33
Q

general rule for limb edema

A

position patient’s limb in elevation (higher than the heart)

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34
Q

position to make breathing easier for patients with pulmonary issues

A

HOB elevated

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35
Q

HOB raised upright to 90 degrees

A

Fowler’s position

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36
Q

HOB raised between supine and 90 degrees

A

semi-Fowler’s

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37
Q

reasons for draping

A

modesty
warmth
access
protects clothing

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38
Q

action to take upon seeing a patient in bed whose skin is red and does not blanch

A

re-position patient, notify nursing staff and supervising PT; document

39
Q

patient positioned in supine with towel roll under bilateral knees, pillow under head, and heels elevated with towel rolls to prevent pressure and maximize comfort is an example of which part of a SOAP note?

A

Objective

40
Q

device used for proper positioning following a total hip replacement

A

hip abduction pillow (or abductor wedge) to prevent hip adduction

41
Q

dependent (FIM 1)

A

patient is unable to assist in any way with bed mobility

42
Q

maximal assist (FIM 2)

A

patient is able to preform 25-49% of the task

43
Q

Moderate assist (FIM 3)

A

patient is able to perform 50-74% of the task

44
Q

Minimal assist (FIM 4)

A

patient is able to perform 75% or more of activity

45
Q

Contact Guard assist–No associated FIM-not used for FIM

A

requires hands-on only assist

46
Q

Supervision/Stand by Assist (FIM 5)

A

No assist, no hands-on guarding, but therapist feels that he/she must be close to patient

47
Q

Modified independent (FIM 6)

A

patient is able to perform task without assistance, including verbal or tactile cues, but patient requires use of an assistive device or equipment

48
Q

Independent (FIM 7)

A

able to perform task with no assistance (no cues, no hands-on, no device/equipment)

49
Q

Which technique is utilized to assist a patient with low back pain or SCI to get in, out of bed?

A

log roll

50
Q

bed mobility includes:

A

any movement in the bed for repositioning or to prepare to get into or out of bed

51
Q

FIM

A

Functional Independence Measure

52
Q

a measure of disability, or what the patient can actually do, records progress on 18 items

A

FIM

53
Q

What to avoid when moving patient with CVA

A

avoid pulling on involved limbs

54
Q

ADA doorway or hallway width

A

minimum: 32inches
recommended: 36 inches

55
Q

ADA door handles

A

operable with one hand, no greater than 48 inches and no less than 34 inches from floor

56
Q

ADA ramps

A

1:12 ratio (~8%); 36 inches wide

57
Q

ADA Wheelchair turning radius

A

60 inches

58
Q

undue burden

A

any action necessary to provide a reasonable accommodation that would cause an employer significant difficulty or expense

59
Q

major life activities

A

communicating, working, walking,
standing, lifting, bending, caring for oneself, breathing,
learning, seeing, hearing, speaking, reading, thinking,
sleeping, concentration, eating, performing manual tasks

60
Q

disability

A

Physical or mental impairment that substantially limits a major life activity

61
Q

qualified individual with a disability

A

Must have knowledge, skill, mental and physical capabilities to perform essential elements of job

62
Q

reasonable accommodations

A

Modifications that will enable persons with disability to perform specific job
– Physical accessibility of workplace
– Adjusting work schedule
– Assistive devices such (teletypewriter, large print manuals)

63
Q

Americans with Disabilities Act

A

serves as a law recognizing persons with disabilities as minority groups who deserve equal opportunity

64
Q

true leg length

A

ASIS to base of medial malleolus

65
Q

apparent leg length

A

umbilicus to base of medial malleolus

66
Q

landmarks used to measure length of upper extremity

A

anterior tip of acromion
tip of middle finger

67
Q

landmarks used to measure girth of upper extremity

A

tip of ulnar styloid
olecranon process

68
Q

landmarks used to measure girth of lower extremity

A

inferior pole of patella
base of lateral malleolus

69
Q

uses artificial kidney to remove waste and extra fluid from the blood; small amount of blood is taken out and filtered through a machine-then blood is returned to body; takes 4 hours; done 3x/week

A

hemodialysis

70
Q

cleanses blood inside body by having plastic catheter surgically inserted into abdomen; abdomen is filled with dailysate; waster and extra fluid is drawn out into the dialysate

A

peritoneal dialysis

71
Q

head down position of bed

A

Trendelenberg

72
Q

head up/feet down position of bed

A

reverse Trendelenberg

73
Q

measures pressure in right side of heart; allows for blood samples to measure blood oxygen flow

A

pulmonary artery catheter (Swan Ganz)

74
Q

normal intracranial pressure

A

5-15 mmHg

75
Q

abnormal intracranial pressure

A

anything greater than 20mmHg

76
Q

HOB elevation for ICP

A

above 30 degrees

77
Q

allows medications, blood, nutrients, fluids to be entered directly into blood; allows for extracting blood samples; used often for chemotherapy to prevent repetitive sticks

A

central venous catheter (CVC)

78
Q

indwelling right atrial catheter placed in vein under collar bone; used for drawing blood, administering meds, providing nutrition and fluids

A

Hickman catheter

79
Q

measures blood pressure continuously; inserted into radial artery

A

arterial line

80
Q

DVT prevention

A

TED stockings
intermittent compression
medications such as Coumadin

81
Q

S/S of deep vein thrombosis

A

erythema
edema
heat
pain

82
Q

has 2 tips that rest just below nose and blow oxygen up into nasal passageways; for patients requiring little to moderate oxygen concentration and temporary need for O2

A

nasal cannula

83
Q

mask that covers nose and mouth; delivers higher concentration of oxygen

A

oronasal mask

84
Q

measurement of oxygen delivery

A

Liters (L)

85
Q

Usually utilized when long term catheter use is required; is immediately removed

A

straight catheter

86
Q

Inserted surgically just above pubic symphysis

A

suprapubic catheter

87
Q

Applied externally, only for males

A

condom catheter

88
Q

Inserted through the urethra into the bladder, held in place by a small balloon; urine drains into bag

A

Foley catheter

89
Q

bed designed for spinal cord injured patients or surgical patients that cannot move on their own; can remain in spinal traction because bed turns patient

A

Turning frame (Stryker)

90
Q

has silicone-coated beads in mattress, suspended by heated air; for patients with wounds or at risk of wounds

A

Air fluidized support bed (Clinitron)

91
Q

segmented mattress with individually filled air bladders; for patients with pressure injuries or at risk for pressure injuries

A

Low air loss bed

92
Q

wider and longer beds; heavy duty-can hold up to 1200 pounds

A

bariatric bed

93
Q
A

ADL (4 decks)

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