Exam 2- Speech/OT/PT Flashcards
dysphagia
swallowing disorder incl oral cavity, pharynx, esophagus,or gastroesophageal junction
dysphagia- what caused by
always secondary to another dis
neuro event (stroke, injury spinal cord/ brain, ALS, parkinsons, multiple sclerosis
cancer, chemorad, meds, GERD, elderly
dysphagia symptoms
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
chin tuck or oral care
chin tuck not always work!
oral care important bc bac enters into lungs
dysphagia- common tip offs
coughing, trouble swallowing, choking, drooling, frequent lung infections
oral care considerations- general
socioeconomic status, spiritual practices, dev lvl, heath state
oral care considerations- specific
chemo agents cause lesions, poor nutrit, diet, self care abilities, comatose, paralyzed, oral surgery
oral care-skills
toothbrush 45 degree angle, brush from gum line to crown, brush biting surfaces,
oral care- floss
18 in, 1-1.5 between fingers
oral care- comatose
patient on side, head tilted forward, open mouth w/ pressure on bottom jaw
nutrition- considerations
swallowing ability, dev lvl, age, pregnancy, mental health, trauma, chronic dis, meds, religion/preference, economic factors, culture
nutrition- measuring intake types
24 hour recall, food diaries, food frequency, diet history
nutrition- skills help w eating
sit eye level, involv pat as much as possible, do not rush, use special utensils if needed, open containers and cut food prn
measuring urine output- continent
have pat. pee in specimen hat, urinal or bed pan
measuring urine output- incontinent
drain urine into measuring device, do not touch spout to bag, wipe spout w/ alcohol before replacing
urinary catheters- types
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)
foly cath- care
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
urinary diversion
creation of stoma, (sm intestine to skin) ileal conduit cutaneous ureterostomy (ureters attached to skin) continent urinary divers. (CUD)(pouch created in sm intestine)
incentive spir-purpose
before surgery inc lung vol and venous return visual reinfor for deep b sustain max inspiration prevent/reduce atelectasis clear secretions, inc gas exchange
incentive spir- how
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
sterile def
all path and microo destoyed
examples sterile procedures
cath, preperation inject meds, dressing changes
sterile fields
1inch around not sterile, pinch from center, fold over hands if moving, do not bend/ reach over
posterior hip replacement precautions
no bending beyond 90 hip flexion, no crossing legs, turning toes in
anterior hip replacement precautions
no crossing legs, no turning toes out when leg is behind
total knee replacement precautions
no pillow directly under knees, bed locked flat, weight bearing as tolerat.
back precautions
no bending, lifting or twisting
sternal precautions
no pushing/pulling w/ both arms, no arms above shoulders, no lifting
WBAT
NWB
TTWB
weight bearing as tolerated
non weight bearing
toe touch of touch down weight bearing
