Chapter 8 exam 3

Question 1

Work related pain in PTA

Answer 1

65 % experince it mostly from handeling patients and movement involved in therapeutic activities.

Question 2

SPHM

Answer 2

Safe Patient Handling and Mobility - “no lift” policies

Question 3

Why is SPHM rare

Answer 3

equipment and time constraints. Not knowing how to use equipment. or not operable in patient care space.

Question 4

Nusrsing staff sometimes believe

Answer 4

injury is part of the job.

Question 5

SPHM activites

Answer 5

Grouped into lifting transfers, lateral transfers or repositioning transfers.

Question 6

SPHM decision making

Answer 6

Factors include:
Person
Task
Environment

Question 7

Total Body Lift

Answer 7

ceiling lifts
Floor lifts ->Hoyer lifts

Sling lifts

Question 8

Hoyer lifts

Answer 8

u or v shaped bases either manually or battery operated.

Question 8

Hybrid total body lift

Answer 8

freestanding but with an overhead A-frame to lift from above.

Question 9

sling lift

supine or seated to floor and back

Answer 9

the most versitile total body lifts can do this but not all.

Question 10

sling lift

Choosing a sling

Answer 10

size:
area of the body the sling will support
where the seat edge of the sling fits ont he body
location of the leg straps
the psostion of the overhead sling bar.

Question 11

sling lift

pediatric sling weight limit

Answer 11

100lbs

Question 12

sling lift

bariatric sling weight limit

Answer 12

1000lbs

Question 13

sling lift

adult size sling weight limit

Answer 13

between 250 and 450

Question 14

sling lift

For patients who weigh less than 300 or 400 pounds the upper and lower straps of the sling are connected

Answer 14

to a single cross bar

Question 15

sling lift

For patients over 300 to 400 pounts the upper and lower straps of the sling are connected

Answer 15

to seperate lift components.

Question 16

Key non-intuitive steps for Bed to chair and chair to bed lifts

Answer 16

widen the base before hooking up straps to frame
only lift as far as you need to clear surfaces.
Set all breaks.
Have a second person to position pt.
For positioning on a bed - have drawsheet under them bofore setting them down.
When moving to a temporary surface the sling is left in place.

Question 17

sit to stand lift

Answer 17

for patients that require moderate to maximum assistance for mobility
are able to flex and achieve a sitting position
maintiain sitting balance
do not have LE weight bearing restrictions
do not have severe back problems or other conditions

Question 18

Sit to stand as therapeutic exercise

Answer 18

No adverse effects of sphm equipment use on patients rehabiolitation outcomes have been found. (PT at Madona Rehab in Lincoln said it taught stroke patients the wrong thing (to push back against strap rather than stand upright), but that was 9 years ago and studies show she was wrong.)

Increase therapy options.

Question 19

Lateral transfer Devices

Answer 19

Air assisted devices
Slippery sheets
Ridgid and semirigid full body transfer boards.

Question 20

Safety of drawsheets

Answer 20

hand and spine forces exceed safety limits when clinicians use a drawsheet for all but the lightest-weight adult patients.

Question 21

transfer board/slippery sheet/air-assisted device

Number of clinicians for transfer

Answer 21

> 100 lbs- two people with transfer board
200 to 100 lbs. two people with air assisted device or slippery sheet
<200 lbs. min of 3 people. with air-assisted device, slipper sheet, or transfer board.

Question 22

transfer board/slippery sheet/air-assisted device

Number of motions

Answer 22

If there are safe stopping points, clinicians can reposition and safety is enhanced.

Fear- some patients perfer one move. Others appreciate several smaller moves.

Question 23

transfer board/slippery sheet/air-assisted device

min clinician trunk flexion

Answer 23

For narrow to narrow surface, - golfer’s lift if it can be done safely.
Head and foot of bed with unobstructed lateral path
For wider surfaces it may need to be done in multiple steps.
seperate the surfaces for better body mechanics once the pt is safely supported by the new surface.

Question 24

transfer board/slippery sheet/air-assisted device

Head control

Answer 24

often have hand grips or supportive devices near the head.
May need another clinician to support head for transfer. - that technician would coordinate the tranfer

Question 25

transfer board/slippery sheet/air-assisted device

HALO

Answer 25

an aditional clinician may be necessary to support the weight of the halo.

Question 26

air assisted device.

Answer 26

the air assisted device matress is placed under the patient
perforations in the lower chamber create a cushioned film of air that supports the patient and lowers friction for lateral transfes.

reduce injury to clinicians
also help patients with integumentary problems.

Question 27

Slippery sheets

Answer 27

low friction coating such as silicone elastomer.

reduce mechanical load involved in a lateral transfer, but still exceed recommeded limits with average to above average weight.

Question 28

Rigid or semi rigid transfer boards

Answer 28

slide boards or patient shifters.

friction reducing to some degree.

support full length of body (shorter transfer boards are used for seated transfers.)

Can be easier to use when there is a slight difference in height between the transfer surfaces.

Question 29

Drawsheets

Answer 29

creates a sling out of sheets or blankets.
Number or clinicians: 3-5
small virtical lift necessary to reduce friction

Question 30

Head to feet or accross surfaces

Answer 30

when head to feet can’t be used, and transfering lateraly accross two surfaces, cliinician saftety is a problem becase of trunk flexion. \
stabalize trunk.
flex at hips
support thighs against the transfer surface to stabalize lower body.

Question 31

Lateral transfer

If wheels don’t lock on one of the surfaces

Answer 31

Need an extra person to secure the surface.

Question 32

Lateral transfer

Tallest clinician

Answer 32

usually placed near the pt’s head.

Question 33

Lateral transfer

Complications

Answer 33

• Fear the patient is experiencing
• pain caused by transfer
• Movement precautions
• External fixation devices
• skin conditions interacting with shearing forces
• Can the patient help - AMAP/ANAP

Question 34

Repositioning sheets

Answer 34

friction reducing sheets with handles that can be left under patient after repositioning.

Question 35

bed repositioning with sheets/chuck/ air assisted device, transfer board

Rule 1 of repositioning

Answer 35

Have HOB flat.
2 is height of bed (top of clinician pelvis.)

Question 36

bed repositioning with sheets/chuck/ air assisted device, transfer board

Clinician safety when repositioning

Answer 36

Semi-lunge stance minimizes trunk rotation.

Question 37

Some Air assisted devices

Answer 37

are designed to be left under patient. - ideal for bariatric pts.