Canes, Crutches, Walkers/Delusion,Halucinations/Psychosis Flashcards
How do you measure the length of the crutch?
2-3 finger widths below the Anterior Axillary fold with the base of the crutch is lateral and slightly in front of the foot
NEVER us a landmark on the foot for measurement
How low should the hand grips of the crutch be? What angle are the elbows at?
30 degrees
How does a 2-point crutch gait walk?
1 crutch with the Opposite foot move forward together. 1 crutch+opposite leg move forward, then other crutch+opposite foot move
*2 things moving at same time 2, 2, 2, 2
*Mild Bilateral weakness
How does a 3-point crutch gait walk?
2 crutched (Both) + Bad leg move forward together. Then good leg moves forward
3, 1, 3, 1 walking formation
Partial weight bearing
How does a 4-point crutch gait walk?
Everything moves separately
1 crutch–>opposite foot–> 2nt crutch–> opposite foot
**1, 1, 1, 1
For severe Bilateral Weakneess
How does a swing through crutch gait walk?
Effected leg never touched ground
**Non-weight bearing & Amputee
When is a 2 point crutch gait used?
When weakness is EVENLY DISTRIBUTED on Both legs (even # of legs)
Mild Bilateral Weakness
When is a 3 point crutch gait used?
Use when 1 leg is Effected (1=Odd number so 3)
**1 leg effected for–>
PARTIAL WEIGHT BEARING
When is a 4 point crutch gait used?
Use when weakness is on both legs (even * of legs 2)
**Severe Bilateral Weakness
When is a Swing Through crutch gait used?
Non-weight bearing
ex. amputee
How do you go up the stair with crutches?
Good leg up step–> Crutches–> Bad Leg
**Up with the good, down with the Bad
-Crutches then followed by the bad leg
How do you go down the stairs with crutches?
Crutches–> Bad legs–> Good leg
**Up with the good, down with the Bad
-Crutch then followed by by the bad leg
What side is the cane held on strong or weak side?
Strong side
How do you walk with a cane?
Cane(strong side)–> Opposite foot (weak side)–> strong side leg
How do you use a walker?
Pick walker up–> set walker down–> walk forward to the walker (effected then strong leg)
Where do you place tied stuff on a walker?
Place on the side of the walker Not the front
What question should you ask yourself with any psych question?
Is my pt. non-psychotic or psychotic?
What is a non-psychotic pt. like? (description)
Person has insight & is Reality Based
-They are emotionally, mentally, behaviorally ill, BUT they are NOT psychotic
What kind of approach/techniques do you use for a non-psychotic pt.?
Treat them as any Med-surg, OB, normal pt. (nothing special)
*Good therapeutic communication, “Tell me more”
What is a psychotic pt. like? (description)
No personal insight
Not reality based
-Do not believe they are sick, may blame others for their illness
What are 3 characteristics a psychotic pt may have?
Delusions
Hallucinations
Illusions
What are delusions?
False, Fixed (unchanging) idea or belief
(No sensory component just a thought)
What are the 3 types of delusions?
Paranoid delusion: people out to harm them
Grandiose delusion: false belief that they are superior to others
Somatic delusions: false belief about a body part
What are hallucinations?
False, fixed sensory experiences based on all 5 senses
-Auditory (most common)
What are illusions?
Misinterpretations of reality, sensory experience
-There is a referent to reality (smothering a person refers when they say something)
there is actually something there
How to deal with psychotic pt. find out what their problem is?
What are the 3 types of psychosis?
Functions: can still function in everyday life (Includes: Schizos, major depression, manic)
Dementia: No insight/reality due to actual brain damage
Delirium
How do you answer non-psychotic questions?
Pick the best threptic communication response
If a question has a psychotic pt. determine which of the 3 categories they fall under? What are the 3 categories of psychosis?
Functional
Dementia
Delirium
What are the steps to teach functional psychotic pt. reality?
-pt. has potential to learn reality
1. Acknowledge feelings
2. Present reality
3. Set limits
4. Enforce limits (end conversation do not take away a privilege)
What are the steps to care for a dementia psychotic pt.?
Pt. Cannot Learn reality
1. Acknowledge feelings
2. Redirect
-Can reorientate person, place time, but not reality
What are the steps to care for a delirium psychotic pt.?
This is a temporary but sudden change in pt.
1. Remove underlying cause
2. Acknowledge feelings
3. Reassure
Neologism?
make up words
