Case Studies Flashcards
Pt. is age 68 and s/p R CVA L hemiparesis. Pt. has an inferior subluxation with 6/10 pain with shoulder movement at 1/3 flexion or abduction of the shoulder. Pt. has no further movement of the shoulder. Pt.has beginning return of the L biceps and can flex to 1/3 range but cannot actively extend. Wrist flexion and extension are about 1/3 range and lacks any finger or thumb return. Tone is low in the UE, high in the scapula. Pt. wants to complete toileting, toilet hygiene and clothing management independently.
Compare and contrast theoretical approaches to case management
Apply a theoretical approach to an intervention
Discuss and align the patient education process to the theoretical approach and provide one example
Explore one rehab technology item to support occupational performance
Pt. is 80 and had a L CVA with R hemiparesis. They have a hypotonic RUE with no active motor return. Tone is low in the trunk with difficulty weight shifting and weight bearing to the R side in sitting and standing due to proprioceptive deficits. Pt. has significant STM loss and L neglect. They are unable to recall events from prior sessions and require frequent repetition. Pt. needs to be able to complete toileting, feeding and oral care.
Compare and contrast theoretical approaches to case management
Apply a theoretical approach to an intervention
Discuss and align the patient education process to the theoretical approach and provide one example
Explore one rehab technology item to support occupational performance
Pt. is 48 and has hemiparesis due to a parietal lobe brain tumor. They have hypertonicity of the dominant LUE with the shoulder moving in a superior subluxation of abduction and elbow flexion whenever attempting forward flexion motions. Flexor tone dominates the wrist and hand with Mod A to open the hand for grasp, without physically pulling the fingers open with the R hand. Pt. needs to reach clothing in the closet including placing and removing clothes on hangers and dressing upper and lower body. Pt.needs to grasp and release with affected hand..
Compare and contrast theoretical approaches to case management
Apply a theoretical approach to an intervention
Discuss and align the patient education process to the theoretical approach and provide one example
Explore one rehab technology item to support occupational performance
Pt. is s/p ABI with STM is moderately impaired procedural memory with forgetting of managing finances and medications, IADLs. Social interaction is poor and pt. Is passive and waits for others to initiate communication . Attention span is limited to about 5-10 minutes for most tasks before redirection is needed. Attention to detail and safety is poor with impulsivity noted. Visual memory and visual closure are moderately impaired. Low tone with beginning return noted in left arm and leg with a Modified Ashworth score of 1+. Pt. is beginning to use the L arm in bending/straightening elbow and position it on table. Pt. has impaired proprioception throughout left foot and leg. Pt. completes meal prep and laundry with max A and LE dressing with mod A. Pt. completes stand pivot transfers to bed, toilet and tub/shower with Mod A.
Compare and contrast theoretical approaches to case management
Apply a theoretical approach to an intervention
Discuss and align the patient education process to the theoretical approach and provide one example
Explore one rehab technology item to support occupational performance
Patient has Multiple Sclerosis with ataxia of the trunk, and dominant LUE and leg. They require Mod A for coordination and accuracy when reaching for items with LUE. Dynamic sitting balance is poor. Client requires Max A to achieve trunk lateral flexion from the lower trunk & pelvis, rotation and scooting. Tone is mixed with higher tone in the LUE and low tone in the trunk. Patient has difficulty with lower body dressing, opening containers, shaving and performing any ADL that requires precision such as handwriting.
