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Theory and Practice I > Exam 3 Study Guide > Flashcards

Exam 3 Study Guide Flashcards

1
Q

Stage 1 pressure ulcer

A

Intact skin with
nonblanchable redness of a localized area, usually over a bony prominence. Darkly pigmented skin may not have visible blanching; Its color may differ from the surrounding area.

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2
Q

Stage 2 pressure ulcer

A

Partial-thickness loss of dermis presenting as a shallow, open ulcer with a red-pink wound bed without slough. May also present as an Intact or open/ruptured, serum-filled blister.

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3
Q

Stage 3 pressure ulcer

A

Full-thickness tissue loss. Subcutaneous fat may be visible, but bone, tendon, or muscles are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

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4
Q

Stage 4 pressure ulcer

A

Full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present on some parts of the wound bed. Often Includes undermining and tunneling.

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5
Q

Duration of wound healing for pressure ulcers

A
  • Stage 1: 1-7 days
  • Stage 2: 5-90 days
  • Stage 3: 30-180 days
  • Stage 4: 180-360 days
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6
Q

turning and positioning schedule

A
  • Hospital Bed: Reposition every 2 hours (waking hours)
  • Seated in W/C: Pressure relief Every 15-30 minutes
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7
Q

Joint contracture

A

caused by shortening of muscles, tendons, ligaments, and joint capsules or by heterotopic ossification.

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8
Q

Common joint contractures in supine

A
  • Hip and knee flexors
  • Ankle plantar flexors
  • Shoulder extensors, adductors and IR/ER rotators
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9
Q

Common joint contractures in side lying

A
  • Hip and knee flexors
  • Hip adductors and internal rotators
  • Shoulder adductors and internal rotators
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10
Q

Common joint contractures in sitting

A
  • Hip and knee flexors
  • Hip add and internal rotators
  • Shoulder add, ext, IR
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11
Q

Common joint contractures in prone

A
  • Ankle plantar flexors
  • Shoulder ext, add, IR/ER
  • Neck rotators R or L
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12
Q

Positioning After a Total Hip Arthroplasty (posterolateral approach)

A
  • Avoid hip flexion beyond 60° to 90°.
  • Avoid hip adduction past 0°.
  • Avoid hip internal rotation past 0°.
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13
Q

Independent transfer

A

a transfer by which the individual requires no human assistance to perform.

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14
Q

Modified independent

A

The patient requires an assistive device or aid, requires more than a reasonable amount of time or there is a safety risk in completing the activity.

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15
Q

Min assist transfer

A

pt does 75% or more

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16
Q

Mod assist transfer

A

pt does 50% to 74%

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17
Q

max assist transfer

A

pt does 25-49%

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18
Q

Dependent transfer

A

total assist, some sources say <24%

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19
Q

You can teach the pt 3 different ways to position themselves at the edge of the chair.

A
  1. Depression lift
  2. R and L unweighting and scooting
  3. Backwards lean
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20
Q

Motor Control

A

the ability to regulate or direct the mechanisms essential to movement

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21
Q

Stages of Motor Control

A

Mobility, Stability or static postural control, Controlled Mobility or dynamic postural control, and skill

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22
Q

Mobility

A

availability of range of motion to assume a posture and the presence of sufficient motor unit activation to initiate a movement

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23
Q

Stability or static postural control

A

the ability to maintain a static steady position in a weight bearing, antigravity posture

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24
Q

Controlled Mobility or dynamic postural control

A

the ability to maintain a dynamic posture/position in a weight bearing, antigravity posture (standing or sitting weight shifts, controlled movements)

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25
Q

Skill

A

Mobility is superimposed on stability in non weight bearing conditions

  • Also requires a specific goal and a coordinated movement sequence to achieve the goal.
  • Skills have a specific purpose, they have voluntary movement control and require a quality of performance (consistency, fluency, timing, economy of effort)
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26
Q

Cognitive

A

Attempting to understand task
Develop plan
Evaluate response

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27
Q

Associative

A

Strategy selected
Refinement of skill
Less attention required

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28
Q

Autonomous

A

Requires little to know attention Can perform other tasks in conjunction

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29
Q

Phases of the sit to stand

A

Weight shift/flexion momentum
Bottom leaves the seat
Lift/extension
Stabilization

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30
Q

Intrinsic feedback(patients have altered intrinsic feedback)

A

Feedback that comes to the individual simply through the various sensory systems as a result of the normal production of the movement

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31
Q

Extrinsic feedback

A
  • Augments intrinsic feedback through cueing.
  • Example: Telling a patient to lift their leg higher to clear an object while walking
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32
Q

Knowledge of Performance

A

Feedback relating to the movement pattern used to achieve a goal

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33
Q

Knowledge of Results (form of extrinsic feedback)

A

Terminal feedback regarding the outcome of the movement

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34
Q

NWB (non–weight-bearing)

A

foot does not touch ground

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35
Q

TTWB (toe-touch or touch-down WB)

A

foot contacts ground for balance only or up to 20% of body weight

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36
Q

PWB (partial WB)

A

usually 20% to 50% of body weight

37
Q

WBAT (WB as tolerated)

A

limited only by patient tolerance (>50%)

38
Q

FWB (full WB)

A

no restriction (100%)

39
Q

Four Point Gait Pattern

A
  • Requires use of bilateral ambulation aids
  • Very slow and stable pattern (good to use in crowded areas)
  • Low energy demand
  • Approximates a “normal” gait pattern
40
Q

3 Point Gait Pattern

A
  • Used when one LE is full weight bearing and the other is NWB
41
Q

Two Point Gait Pattern

A
  • Used with two or one AD
  • Low energy, similar to normal gait
  • Requires more coordination and is less stable
42
Q

“Step to” or “Swing to” Gait Pattern

A
  • The trail LE will only advance as far as the lead LE
  • More stable
  • Good for cognitive stage of learning
  • Slower speed, more taxing
43
Q

“Step through” or “Swing through” Gait Pattern

A
  • The trail LE with advance past the lead LE
  • Increased speed and improved energy conservation
  • Decreased stability, requires increased control/balance
44
Q

Parallel bars advantages

A

o Maximal stability, support and safety to build skills
o Great place to initiate gait training, balance training and to evaluate fit of other ADs

45
Q

parallel bars disadvantages

A
  • Severely limits mobility (progress pt as soon as possible)
  • Bars must be wide enough for pt to ambulate through
  • Not practical
46
Q

Walkers advantages

A
  • Used when Maximal stability, support, and mobility are required
47
Q

walkers disadvantages

A
  • Difficult to store/transport, difficult or impossible to use on stairs, decreases speed of ambulation, difficult to perform a normal gait pattern, difficult to use in narrow areas
48
Q

walkers w/ Trough/Platform Attachments advantages

A
  • Used for patients who are unable to bear weight through their wrists and hands OR have severe deformities of the UE
  • May help those with UE amputation or are unable to extend elbow
  • Provides additional stability
49
Q

walkers w/ Trough/Platform Attachments disadvantages

A
  • Unable to use triceps
  • May require additional assist
  • Not as effective on stairs
  • Difficulty to manage in home environment or around obstacles
50
Q

Crutches advantages

A

greater selection of gait patterns and able to increase gait speed but still offer stability, adjustable, easily stored, can be used in narrow or crowded spaces.

51
Q

Crutches disadvantages

A

less stable than a walker, injury to axillary vessels and nerves if not used or measured properly, need good standing balance, functional strength of the UE and trunk must be considered. Difficult for the elderly to use.

52
Q

Lofstrand crutches advantages

A

Able to reach for objects with the crutch remaining on the UE. Eliminate pressure to the axillary vessels and nerves, more functional on stairs and in narrow confined places.

53
Q

Lofstrand crutches disadvantages

A

provide less stability and support than axillary crutches, walker or parallel bars, require functional standing balance, UE strength for many gait patterns, forearm cuff can make it difficult to remove, elderly pts feel insecure

54
Q

Canes advantages

A

Used to compensate for impaired balance or to improve stability/confidence. More functional on stairs and in narrow confined areas/community areas. Easily transported.

55
Q

canes disadvantages

A

very limited BOS due to the base of the cane, not ideal for a 3 point gait pattern or anyone with a weight bearing limitation due to lack of stability.

56
Q

Nasogastric tube

A

provides feedings for patients who are unsafe to swallow food. Keeps the stomach empty after surgery and rests the bowel.

57
Q

Nasal cannula

A

Delivers supplemental oxygen

58
Q

Closed face mask

A

form of oxygen mixed with room air, allows for collection of O2 around mouth and nose

59
Q

Tracheostomy collar

A

provide supplemental humidified oxygen or air

60
Q

Ventilator

A

provides maximum breathing support, pt may be connected via tracheostomy tube or less permanent endotracheal tube

61
Q

Ventriculotomy

A

assists with and monitors intracranial pressure drainage

62
Q

Sequential compression device

A

to prevent the risk of blood clots in the lower extremity, promotes venous return

63
Q

continuous passive motion machine

A

to promote movement and attempt to reduce loss of ROM after surgery

64
Q

pulse oximeter

A

to monitor oxygen saturation at rest and during activity

65
Q

peripheral IV line

A

temporary administration of liquid medications or fluids, electrolytes, nutrients, or blood product transfusions.

66
Q

Peripherally inserted central catheter (PICC)

A

for long term IV administration of medications, fluids, blood products, or chemotherapy

67
Q

patient controlled analgesia pump (PCA)

A

IV pain medication that allows patient to determine when it is administered via a hand held button

68
Q

chest tube

A

removes air or fluid from the pleural or mediastinal spaces, prevents drainage

69
Q

portable telemetry

A

HR and rhythm are continually monitored from a remote room at a facility

70
Q

Percutaneous endoscopic gastrostomy (PEG) tube

A

can be long term or permanent form of nutrition, fluids, or medication delivery to bypass the gastrointestinal system

71
Q

Foley catheter

A

to drain urine from the bladder

72
Q

external urinary catheter (condom catheter)

A

used to collect urine when patient is incontinent, reduces risk of urinary tract infection

73
Q

Closed suction drain with bulb (Jackson Pratt drain)

A

device used to drain blood/fluid after surgery or infection

74
Q

Hemovac

A

to collect blood/fluid after surgery, allows more suction than Jackson Pratt drain

75
Q

Rectal tube

A

continuous collection of feces

76
Q

wound vac

A

used to promote wound healing by “pulling” wound edges closer together via negative pressure, removal of fluid and bacteria.

77
Q

ostomy

A

surgically re-route stool collection

78
Q

Healthcare-Associated Infection (HAI)

A

infections acquired in any healthcare setting.

79
Q

Nosocomial

A

infections are acquired in the hospital.

80
Q

pseudomonas aeruginosa

A

at risk populations are patients with severe burns, on mechanical ventilation, cancer, and immunosuppression

81
Q

Staphylococcus aureus

A

at risk populations are patients who have undergone surgical procedures or invasive techniques (catheter, dialysis ports), immunocompromised, and patients who have ingested contaminated food.

82
Q

C diff

A

antibiotic associated diarrhea, at risk populations are individuals who have prolonged use of antibiotics, immunocompromised, who have undergone gastrointestinal surgery, or are older.

83
Q

e coli

A

Pneumonia, UTI’s, diarrhea, at risk populations are individuals with severe burns, who have undergone surgical procedures

84
Q

Norovirus

A

Gastroenteritis

85
Q

5 main routes of transmission

A

contact, droplet, airborne, common vehicle (food, water, medications, etc), and vector borne (bugs, rats)

86
Q

Standard precautions

A

apply to the care of all patients in all healthcare settings. Includes hand hygiene, PPE, respiratory hygiene, sharps disposal

87
Q

Transmission-based precautions

A

Standard precautions PLUS transmission specific precautions. Includes contact, droplet, airborne, and protective precautions.

88
Q

Medical Asepsis

A

Practices that help to reduce the number and spread of microorganisms

89
Q

Surgical Asepsis

A

Practices that render and keep objects and areas free of all microorganisms

Theory and Practice I (7 decks)

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