bed mobility

Question 1

common barriers to mobility intrinsic to patient

Answer 1

elevated ICP
neuro storming
unstable hemodynamics
absence of bone flap
pain

Question 2

common barriers to mobility intrinsic factors

Answer 2

decreased arousal
impaired cognition
physical impairments
obesity
unstable spine
surgical precautions

Question 3

common barriers to mobility extrinsic

Answer 3

external ventricular drains that cannot be clamped
lines/tubes
staffing/resources
fear/uncertainty/safety/knowledge
adequate equipment
inappropriate or absence of activity orders
timing of PT consults

Question 4

STNR

Answer 4

flexion of neck elicits flexion of UE and extension of LE
extension of neck elicits extension of UE and flexion of LE

Question 5

ATNR

Answer 5

ext to side facing, flexion to side not facing

Question 6

tonic lumbar

Answer 6

rotation to R- elicits flexion RUE, ext RLE, ext LUE, flexion LLE

Question 7

physical management

Answer 7

ROM
joint mobs
exteroceptive stimulation
prolonged stretch
weightbearing normalizes tone

Question 8

generalized spasticity pharmacological management

Answer 8

extensor spasms - oral meds

Question 9

focal spasticity pharmacologic management

Answer 9

phenol block - washes genera area
botox - more precise

Question 10

managing agitation

Answer 10

activate ANS
calming effect

Question 11

rolling essential elements

Answer 11

rotation and flexion of neck
hip and knee flexion
flexion of shoulder and protraction
rotation in trunk

Question 12

undesirable compensatory patterns

Answer 12

grabbing and pulling with unaffected arm
use of excessive hypertonicity in arm/leg
learned disuse of hemi limbs

Question 13

sidelying to sitting movement elements

Answer 13

lateral flexion of trunk
extended arm - weightbearing through forearm
body weight taken over hip

Question 14

sidelying to sitting essential elements

Answer 14

lateral flexion of neck
lateral flexion of trunk
legs lifted and lowered over side of bed

Question 15

extensor tone/decorticare posture

Answer 15

ROM and relaxation techniques
rhythmic rotation
start prox (trunk) then extremities
ONLY do ROM and relaxation to areas of tightness and rigidity

Question 16

bed mobility with patient with severe extensor tone/posturing

Answer 16

keep patient in more than 90 deg of hip flexion
patient most likely will be dependent

Question 17

rolling - dependent/severe tone

Answer 17

perform PROM through trunk and LEs achieve hip and knee flexion
maintenance of position once in sidelying

Question 18

sidelying to sit - dependent/severe tone/posturing

Answer 18

-maintain 90 deg hip flexion/trunk flexion
-keeping pressure at knees/lower legs - drop legs off table
-flexing trunk into both lateral flexion and forward flexion raise trunk
-maintenance of position in flexion once sitting

Question 19

momentum style

Answer 19

flexing head and trunk, reaching and lifting UEs

Question 20

force control style

Answer 20

lift leg opposite of the rolling side and place foot on bed