crutches/ canes/ walkers/ psych

Question 1

how to measure length of crutches

Answer 1

• 2-3 finger widths below the anterior axillary fold to a point lateral to and slightly in front of the foot
• no landmarks on the axilla or foot
• measure the hand grip: angle of elbow flexion is 30 degrees

Question 2

crutch gates

Answer 2

1. ask yourself how many legs are affected? (even for even, odd for odd)
   - 2 legs: 2 or 4 point gait (even numbers)
   - 1 leg: 3 point gait (odd numbers)

Question 3

2 point gait

Answer 3

• move a crutch and opposite foot together
• for mild bilateral weakness (2 sided weakness)

Question 4

3 point gait

Answer 4

• two crutches and bad leg together
• for one sided weakness

Question 5

4 point gait

Answer 5

• right crutch, left leg, left crutch, left leg )everything move separately)
• for severe bilateral weakness
• very slow but stable

Question 6

swing through

Answer 6

• for non- weight bearing (amputation without prothstetic)

Question 7

stairs

Answer 7

• up with the good first
• down with the bad first
• crutches move with the bad

Question 8

cane

Answer 8

• COAL: Cane opposite affected leg (can on strong side)
• advance with bad leg

Question 9

walkers

Answer 9

• pick it up, set it down, walk to it
• if they must tie something to the walker, tie it to the side not the front
• no wheels or tennis balls on walkers

Question 10

non psychotic

Answer 10

• has insight (know that they are sick and know its messing their life up)
• reality based (they hear, see, smell, feel the same as me)
• use good therapeutic communication: “tell me more about…”

Question 11

psychotic

Answer 11

• don’t think they are sick and has no insight (think everyone else has a problem not them)
• S/S: delusions, hallucinations, illusions
• 3 types: functional, dementia, delirium

Question 12

functional psychosis

Answer 12

• acknowledge feelings
• present reality
• set limits
• enforce limits
• these people dont have brain damage so they can function in every day life
• the schizo schizo major manics (schizoprenia, schizo affective disorder, major depression, mania (bipolar mania stage)

Question 13

dementia

Answer 13

• cannot learn reality because they have brain damage
• acknowledge feelings and redirect
• alziemers
• stroke
• gorganic brain syndrome

Question 14

delirium

Answer 14

• remove the underlying cause
• acknowledge feelings
• reassure them

Question 15

what is delusion

Answer 15

• a false fixed idea or belief. thinking not sensing (no sensory- 5 senses)

Question 16

what is paranoid delusion

Answer 16

• false fixed belief that people are out to harm you

Question 17

what is grandiose delusion

Answer 17

• false fixed belief that you are superior

Question 18

what is somatic delusion

Answer 18

• false belief about your body: x-ray vision, i can melt stone with my eyes

Question 19

what is erotomanic delusion

Answer 19

• false fixed belief another person (usually famous or powerful) is in love with them

Question 20

what is jealous delusion

Answer 20

• false fixed belief that their partner is unfaithful

Question 21

what is persecutory delusion

Answer 21

• false fixed of being treated in a malicious way

Question 22

what is hallucination

Answer 22

• false fixed sensory experience (involves 5 senses)
• most common in order: auditory, visual, tactile
• rare: gustatory (taste), olfactory (smelling)

Question 23

what is illusion

Answer 23

• misinterpretation of reality (sensory experience)
• the difference between hallucination and illusion is with an illusion theres a reference in reality. there is actually something there but they are just misinterpreting it. with a hallucination there is NOTHING there

Question 24

what is delirium

Answer 24

• temporary, sudden dramatic secondary loss of reality usually due to a chemical imbalance in the body
• Ex: people high on uppers, withdrawal from downsers, drugs like tegament, post op, occult uti in elderly, thyroid storm

Question 25

how to treat functional psychotic

Answer 25

1. acknowledge their feelings “you seem angry”
2. present reality “i know that … is real to you but i dont see .. or i am a nurse and this is a hospital
3. set a limit “that topic is off limits in our conversation”
4. enforce limit “ end the conversation, dont punish or restrict them, i see you are too ill to stay reality based so our conversation is over”

Question 26

who else do you treat like a functional psychotic

Answer 26

• abnormal: antisocial, borderline, narcissistic

Question 27

how to treat delirium pt

Answer 27

• remove the underlying cause and keep them safe
  1. acknowledge their feelings “that seems exciting”
  2. reassure them “you are safe and that will go away when you get better”

Question 28

how to treat dementia pt

Answer 28

• there is brain damage so they cant learn reality
  1. ackowledge their feelings “that seems exciting”
  2. redirect them: dont present reality and dont chnage the subject. you can relaity orient them (person, place, time) “okay lets sit here and you can tell me about church while we wait for your dead husband”

Question 29

what are loose associations

Answer 29

• “i like to dance all people have hands my feet are wet”

Question 30

what are flight of ideas

Answer 30

• thought to thought to though to thought

Question 31

what are word salad

Answer 31

• random words (cant make a coherent phrase)

Question 32

what are neologism

Answer 32

• making up imaginary words

Question 33

what are narrow self concept

Answer 33

• when functional psychotic refuses to leave their room or change their clothes
• they define themselves by what they are wearing and where they are so they dont know themselves if they chnage clothes or leave room

Question 34

what are ideas of reference

Answer 34

• pt thinks everyone is talking about them