Exam 2- Speech/OT/PT

Question 1

dysphagia

Answer 1

swallowing disorder incl oral cavity, pharynx, esophagus,or gastroesophageal junction

Question 2

dysphagia- what caused by

Answer 2

always secondary to another dis
neuro event (stroke, injury spinal cord/ brain, ALS, parkinsons, multiple sclerosis
cancer, chemorad, meds, GERD, elderly

Question 3

dysphagia symptoms

Answer 3

drooling, poor secretion management, fluid leaking from oral or nasal cavity, complaints food is “sticking”, pain when swallowing, gurgly sounding voice after eating, difficulty coordinating breathing and swallowing, extra time need to chew, weight loss/ dehydration, recurrent aspiration pneumonia

Question 4

chin tuck or oral care

Answer 4

chin tuck not always work!

oral care important bc bac enters into lungs

Question 5

dysphagia- common tip offs

Answer 5

coughing, trouble swallowing, choking, drooling, frequent lung infections

Question 6

oral care considerations- general

Answer 6

socioeconomic status, spiritual practices, dev lvl, heath state

Question 7

oral care considerations- specific

Answer 7

chemo agents cause lesions, poor nutrit, diet, self care abilities, comatose, paralyzed, oral surgery

Question 8

oral care-skills

Answer 8

toothbrush 45 degree angle, brush from gum line to crown, brush biting surfaces,

Question 9

oral care- floss

Answer 9

18 in, 1-1.5 between fingers

Question 10

oral care- comatose

Answer 10

patient on side, head tilted forward, open mouth w/ pressure on bottom jaw

Question 11

nutrition- considerations

Answer 11

swallowing ability, dev lvl, age, pregnancy, mental health, trauma, chronic dis, meds, religion/preference, economic factors, culture

Question 12

nutrition- measuring intake types

Answer 12

24 hour recall, food diaries, food frequency, diet history

Question 13

nutrition- skills help w eating

Answer 13

sit eye level, involv pat as much as possible, do not rush, use special utensils if needed, open containers and cut food prn

Question 14

measuring urine output- continent

Answer 14

have pat. pee in specimen hat, urinal or bed pan

Question 15

measuring urine output- incontinent

Answer 15

drain urine into measuring device, do not touch spout to bag, wipe spout w/ alcohol before replacing

Question 16

urinary catheters- types

Answer 16

intermittent urethral cath- (straight cath, used for short time to drain), indwelling urethral cath (continuous bladder drainage)
suprapubic cath (long-term contin drainage) (surgically inserted, diverts urine from urethra)

Question 17

foly cath- care

Answer 17

clean area, encourage fluid intake, chart input and output every 8 hours, look for signs of infection (cloudy urine, chills), keep bag lower than bladder, educate self care and hygiene, change leg bags every 5-7 days

Question 18

urinary diversion

Answer 18

creation of stoma, (sm intestine to skin)
ileal conduit
cutaneous ureterostomy (ureters attached to skin)
continent urinary divers. (CUD)(pouch created in sm intestine)

Question 19

incentive spir-purpose

Answer 19

before surgery
inc lung vol and venous return
visual reinfor for deep b
sustain max inspiration
prevent/reduce atelectasis
clear secretions, inc gas exchange

Question 20

incentive spir- how

Answer 20

sit patient up, assess for pain, admin meds if needed, hold mouth piece and container w/ diff hands, inhale completely with mouth on hose, exhale normally without lips connected

Question 21

sterile def

Answer 21

all path and microo destoyed

Question 22

examples sterile procedures

Answer 22

cath, preperation inject meds, dressing changes

Question 23

sterile fields

Answer 23

1inch around not sterile, pinch from center, fold over hands if moving, do not bend/ reach over

Question 24

posterior hip replacement precautions

Answer 24

no bending beyond 90 hip flexion, no crossing legs, turning toes in

Question 25

anterior hip replacement precautions

Answer 25

no crossing legs, no turning toes out when leg is behind

Question 26

total knee replacement precautions

Answer 26

no pillow directly under knees, bed locked flat, weight bearing as tolerat.

Question 27

back precautions

Answer 27

no bending, lifting or twisting

Question 28

sternal precautions

Answer 28

no pushing/pulling w/ both arms, no arms above shoulders, no lifting

Question 29

WBAT
NWB
TTWB

Answer 29

weight bearing as tolerated
non weight bearing
toe touch of touch down weight bearing