AOTA/NBCOT Immediate things we need to know Flashcards
Rancho I presents as?
OT?
No response (in coma stage) almost TOTAL A
OT: Sensory Stimulation, positioning
Rancho II?
OT?
Generalized response (respond to stimuli inconsistently to sounds/touch) TOTAL A
OT:Sensory stimulation, PROM, splinting
Rancho III?
OT?
Localized response (respond to pain stimuli or more specific stimuli, awake) TOTAL A
OT: Sensory Stimulation, PROM, visual/auditory tracking, safety adaptations
Rancho IV?
OT?
Confused Agitated
- Alert
- heightened state of activity
- no STM
- unable to cooperate with treatment
- perform activities (sitting-standing) without any purpose and don’t really know what’s going on with your surroundings
OT: A/AAROM, begin ADLs, simple cognitive tasks, simple reaching
Rancho V?
OT?
Confused, inappropriate
- inappropriate use of objects (apraxia) and words
- Attention span is few mins
- Disoriented
- Cannot learn new tasks
- Wander randomly
OT: A/AROM, simple reaching activities, single-step fine motor tasks, orientation to self, place; basic hygiene, SAFETY adaptations
Ranchi VI?
OT?
Confused Appropriate MOD A
- Sometimes oriented
- Attention span is up to 30 mins
- Can follow simple directions
- Complete familiar activities with supervision
- May remember events but not details.
OT: Cognitive activities, like simple sequencing, short term memory, simple cold food prep, labels to compensate for memory
Rancho VII
OT?
Automatic Appropriate MIN A
- IND for BADLs
- Appropriate Behavior
- Yes to new learning
- Unrealistic future plans
- Overestimating abilities
- Able to follow schedule
- Can initiate steps but forgets the purpose of what you’re doing
OT: Simple cooking tasks (microwave, oven, toaster), cognitive actvities
Rancho VIII
OT
Purposeful Appropriate
- Both LTM and STM is INTACT
- Can learn new information at a slower rate
- May begin driving
- Can compensate for problems
- IRRITABLE
OT: Provide AT for memory aids,
Rancho IX
OT
Purposeful appropriate SBA
- attend to more than 2 hours on a task
- Can do work/leisure
- Aware of impairments
- Depression
- Able to think about consequences
- Self monitor appropriateness
OT: memory aids, emotional regulation for frustration tolerance, coping skills
Rancho X
Purposeful appropriate MOD I
- able to multitask
- IND maintains memory
- anticipates consequences/impacts of impairments
- socially appropriate
ASIA SCALE: A
Complete motor and sensory SCI
ASIA SCALE B:
INCOMPLETE: Sensory intact, but no motor function below the injury site
ASIA SCALE C
INCOMPLETE: Motor intact, but half of the muscles below neurologic level is graded
less than 3
ASIA SCALE D
INCOMPLETE: Motor function yes, but at least half of the muscles below the injury site is graded above 3
What muscle does C4 innervate?
Trapezius, Levator Scapulae, Diaphragm
Movement: breath on your own and shoulder elevation
What movement does C5 innervate?
Shoulder ABD
What movement does C6 innervate?
Wrist Extension, Elbow flexion
What muscle does C7 innervate?
Elbow Extension, Wrist flexion
What muscle does C8 innervate?
Thumb extension, finger flexion
What muscle does T1 innervate?
Thumb ab/adduction
What are sternal precautions?
No shoulder flexion above 90
No push/pull
No lifting beyond 10 lbs
What do you expect in Phase 1 of Cardiac Rehab?
Inpatient- MET: 1-3.5
5-14 days since onset
- Prioritize and monitor vitals (EKG, pulse, BP)
- Progress ADL’s based on MET levels
- Monitory Sxs and activity tolerance
- Bed mobility WC move, transfers, Seated grooming/feeding, dressing
- HEP regarding activity guidelines,
- ID Appropriate DC place next (Home? subacute? Acute?)
What do you expect in Phase 2 of Cardiac Rehab?
Outpatient MET: 3.5 +
- OT 3 days/week for 4-8 weeks
- Weight training 2-4 weeks if symptoms are controlled
- Warm Showers, Bowel movement, climb stairs, house chores, biking
- Work hardening if indicated
What do you expect in Phase 3 of Cardiac Rehab?
Community—Maintenance
- only via physician referral
- Not covered by Medicare
What does MET means?
Metabolic Equivalent of Task
Stage 1: Met LEVEL 1- 1.4
- Seated Feeding, Hands/face wash
- Transfers
- Bed mobility
- Reading, light handwork, table games
Stage 2: Met LEVEL 1.4- 2.0
Seated: bathing, grooming, shaving, dressing
- Light ambulation
- Unlimited sitting
- Crafted activities while seated
- NO ISOMETRIC EXERCISES
Stage 3: Met LEVEL 2.0-3.0
- Seated warm shower
- Transfer of light items
- Ironing
Stage 4: Met LEVEL 3.0-3.5
- STANDING: bathing, dressing , grooming, showeringWARM water,
- light vacuum, light laundry
- Unlimited ambulation distance
- Climb Stairs
- Driving
Stage 5: Met LEVEL 3.5-4.0
WASH CLOTHES/dishes, ironing
hang light clothes, MAKE BED, Swimming
BM on toilet
Stage 6: Met LEVEL 4.0-4.5
Most home management, SEX, HOT SHOWER
Carpal Tunnel syndrome
median nerve compression presents with numbness in the 1st to 4th digit
What is the OT tx for Carpal tunnel syndrome?
Avoid repetitive motions and place wrist in neutral with wrist cock-up splint, and median gliding exercises
Cubital Tunnel syndrome
Ulnar compression at the elbow, presents with tingling and numbness along with forearm/hands, pain elbow, weak power grip.
Tests: Wartenberg and Froment
What is OT tx for cubital tunnel syndrome?
Elbow splint
Guyon’s canal syndrome
ulnar nerve compression at the hand
What is OT tx for Guyon’s canal?
Wrist splint in neutral, work activity modification
Pronator Teres
median nerve compression to forearm, no pain at night, palmar numbness
ELBOW SPLINT AT 90 WITH FOREARM NEUTRAL
WHAT IS RADIAL NERVE PALSY?
Wrist drop treatment with wrist cock up splint
What is Radial tunnel syndrome?
Forearm radial nerve injury
treated with wrist cock up (w/ surgery) or long arm splint (w/out surgery)
What is ape hand deformity
high and low median injury loss of thumb ABD and default fixed position
Treated with C-bar splint with thumb opposition
What is Claw hand deformity?
trauma to ulnar nerve, decreased power grip, trouble cutting
TX: ulnar nerve injury splint, dynamic static splint to MP flexion
