FCS, Gen Med, etc (Gait, w/c, ADA, t/f assistance levels, lines/tubes, etc) Flashcards

Question

Average velocity of gait

Answer 1

AKA trendelenburg weak glute med will see bending to same side as weakness

Answer 2

aka Glut Max gait weak glut max

Answer 3

weak quads; hip/knee flexor contractures

Answer 4

weak hip extensors; tight hip/knee flexors

Answer 5

weak quadricepss; knee flexor contractures

Answer 6

weak quads; PF contracture; extensor spasticity (of quads or PF)

Answer 7

heel does not touch ground. Spasticity or contracture of the PF

Answer 8

AKA steppage gait Compensatory response to shorten the limb; result of weak DF (diabetic neuropathy, fibular neuropathy, L4-5 radiuclopathy)

Answer 9

Midstance since it requires the greatest amount of DF (at 10-15 deg of DF)

Answer 10

* 6 inches to the side of the toes to the ulnar styloid or wrist crease with a 20-30 deg elbow flexion * minimal stability...more for balance. * used opposite of the deficit side

Answer 11

Two point: cane with involved LE followed by uninvolved LE Delayed two point: cane -- involved LE -- uninvolved LE

Answer 12

20-25* elbow flexion while arms are 4-6 inches in front of body,

Answer 13

20-25* elbow flexion ~ at ulnar styloid process

Answer 14

* 6 in in front of 2 inches lateral. * Axillary pads should sit 2-3 fingers widths below the axilla (no more than 3) * The elbow should allow for 20-25 deg elbow flexion * ~ at ulnar styloid process

Answer 15

* highest level of coordination * 20-25* elbow flexion with handgrip * positioned 6 inches in front and 2 inches lateral * arm cuff - 1-1.5" below olecranon process

Answer 16

1. Crutches advanced first, lower extremities swing for- ward beyond the point of crutch. 2. Used in non-weight-bearing status or bilateral lower extremity involvement.

Answer 17

1. One crutch and opposite extremity move together, fol- lowed by the opposite crutch and extremity; requires use of two assistive devices (canes or crutches). 2. Allows for natural arm and leg motion during gait, good support and stability from two opposing points of contact.

Answer 18

1. Crutches and involved lower extremity are advanced together, followed by the uninvolved limb. 2. Indicated for use with involvement of one extremity; e.g., lower extremity fracture.

Answer 19

1. Crutches advanced first followed by the involved lower extremity; then uninvolved lower extremity. 2. Indicated when patient requires increased stability and slower movement.

Answer 20

1. One crutch is advanced forward, followed by the con- tralateral lower extremity, then the second crutch is advanced forward, followed by that contralateral limb. 2. Used with bilateral lower extremity involvement.

Answer 21

* With handrail, stand opposite and behind * No handrail, stand behind pt and twds affected

Answer 22

* with handrail, stand opposite side and in front of pt * No handrail, stand in front and twds affected side

Answer 23

Pt is always below pt and typically on weaker side.

Answer 24

Pt releases crutches Grab handrail Help lower to the ground

Answer 25

hip tend to slide forward, thighs tend to adduct and IR. Also tend to go into PPT position. Poor support

Answer 26

pressure-relieving accommodates moderate to sever postural deformity They are low maintence They may get interfere with slide transfers

Answer 27

Can be custom molded Accommodates moderate to severe postural deformity Some maintenance required, they are heavier, and more expensive

Answer 28

Accommodates moderate to sever postural deformity Lightweight with improved pressure distribution Expensive May be unstable for some Requires continuous maintenance

Answer 29

facilitates stroke efficiency, increases distance per stroke lighter weight

Answer 30

Standard rubber: durable, low maintenance, indoor only, heavier; rougher ride Pneumatic: smoother, increased shock absorption; require more maintenance

Answer 31

pts with extensor spasms that may throw the pt out of the chair or for pressure relief It maintains normal seat to back angle for duration.

Answer 32

at a slight anterior pelvic tilt.

Answer 33

lower to the ground for propulsion with noninvolved arm and leg Can potentially add one-arm drive

Answer 34

Cambered to add better access to the wheel and better on the shoulders. Also helps with stability

Answer 35

Places the drive wheels POSTERIOR (by 2 inches) to the vertical back support. This increases length off BOS and posterior stability.

Answer 36

width of hips at widest part and add 2 inches *If too wide: difficulties reaching drive wheels and effectively propelling chair * If too narrow: pressure/discomfort on the lateral pelvis Average: 18 inches

Answer 37

posterior buttock to posterior aspect of lower leg in popliteal fossa and subtract 2-3 inches *Too long: compromise posterior knee circulation, kyphotic posture, or PPT/sacral sitting. *Too short: fails to support the thigh and decreases surface area to distribute the forces * Avg: 16 inches

Answer 38

bottom of shoe to below popliteal fossa. Must include cushion height into measurement. Should be in 90/90 position * Too long: encourage sacral sitting and sliding forward in chair * Too short: uneven weight distribution on thigh and excessive weight on the ischial seat.

Answer 39

Minimum clearance between floor and footplate is 2 inches

Answer 40

(add 1 inch!) seat platform just below the elbow held at 90 deg with shoulder in neutral position. Add 1 inch to the pts hanging elbow measurement. * Too tall/high: shoulder elevation * Too short/low: encourage leaning forward or laterally

Answer 41

Seat width: 18 inches Seat depth 16 inches Seat height: 20 inches

Answer 42

Ascend: front casters up on curb, lean forward, push rear wheels up curb using momentum to assist Descend: descending backward with forward head and trunk lean OR descend forward in a wheelie position

Answer 43

32 inches (barely enough to fit the w/c or walker)

Answer 44

17-19 inches from the floor

Answer 45

7 inches height 11 inches depth (minimum) Steps should no exceed 7 inches. Greater makes increasingly more difficulty for those with disabilities

Answer 46

1:12 (8.3% grade) For every inch of vertical rise there must be 12 inches of length. Must be a minimum of 36 inches wide. Ramp landing - 60 inches (straight)

Answer 47

Americans with Disability Act -- 1990 Prohibits discrimination and ensures equal opportunity for persons with diabilities

Answer 48

Health Insurance Portability and Accountability Act

Answer 49

Pts are usually able to maintain a position before they can attain it.

Answer 50

No shoulder flexion above 90 degrees No shoulder abduction No pushing/pulling with bilateral UE’s No lifting > 8-10 pounds (gallon of milk)

Answer 51

Pt. does not require physical assist May need supervision for decreased safety May require verbal cues for sequencing of t/f May require verbal cues for problem solving May require assistance in an emergency Does not necessarily mean close proximity Pt requires therapist to observe throughout task. (usually for safety)

Answer 52

Can perform activity without physical assist but requires clinician maintain contact with pt. to be able to provide assistance immediately Occurs when there is a significant likelihood that the pt. with require physical assistance for support or balance Usually because of LOB

Answer 53

Pt performs ≥75% of task (Pt requires <25% of help)

Answer 54

pt. performs 50-74% of task (pt requires ~50% of help)

Answer 55

pt. performs 25-49% of task (pt requires ~75% from theapist to complete task)

Answer 56

pt. performs <25% of task * pt is unable to participate or therapist must provide all of the effort to perform task.

Answer 57

Strong side or unaffected side to maximize safety and build pt confidence.

Answer 58

The person at the head of the pt with multiple person t/f

Answer 59

* t/f from stretcher t bed/treatment plinth. * one at head, trunk, and feet.

Answer 60

* t/f b/n surfaces of differing heights or when t/f from floor * 1 behind pt with arms under axilla and other at mid thigh

Answer 61

* for someone that can't stand Ind but can bear some weight through trunk and LE * pt positioned 45* to surface and pts arm on therapists arm (but not pulling) * arms around hips and under buttock with blocking pts knees. * use momentum and maintain in a squatted position as the therapist.

Answer 62

Clean technique: refers to efforts to reduce infectious organisms in the immediate environment. Sterile technique: is a specialized process designed to eliminate pathogens from the clinical environment

Answer 63

* when pt is obese * 1 therapist is avaialbe t assist when pt is totally dependent * keeping webbing in place for return trip.

Answer 64

* some sitting balance, some UE strength, and can adequately follow directions. * position at end of w/c and lean to one side while placing one end sufficiently under proximal thigh * place lead hand ~4-6inches away from sliding board and use both arms to initiate a push-up and scoot across board. * Avoid direct contact between skin and sliding board

Answer 65

* for pts able to stand and bear weight through one or both LE. * Must have functional balance ability to pivot. * Unilateral WB restriction or hemiplegia -- lead with uninvolved side (strong side)

Answer 66

*pt has necessary strength and balance to weight shift and step during the t/f. * actually takes a step versus pivoting

Answer 67

Bacteria that thrives in water and is opportunistic in moist tissue of burn victims Gram negative (-) Resistant to many antibiotics – require antibiotic cocktail – these may work (fluoroquinolones, gentamicin, and imipenem) Smells “icky sweet” or “fruity” May have blue pus

Answer 68

Gram (+) positive Normally present in nose and on the skin Causes pus-forming infections and toxinosis in humans Superficial skin lesions - Boils (furuncles), styles (infection of gland or hair follicle of eyelid More serious infections - Pneumonia, mastitis, phlebitis, meningitis, & UTI Deep-seated infections - Osteomyelitis (infection of the bone) & endocarditis

Answer 69

Spread by skin-to-skin contact Common with compromised immune systems S&S of skin infection: Red, swollen, and painful area to the skin; Pus or other fluids drain from the area; May look like a boil S&S of severe infections: Chest pain, Cough or shortness of breath, Fatigue, Fever & chills, Headache, Rash, Wounds that do not heal

Answer 70

Gram (+) positive found in human intestines and in female genital tract Spread person to person or contaminated surfaces

Answer 71

Infection of the colon Causes diarrhea (watery diarrhea 3 or more times /day for 2 or more days) Usually develops during or shortly after course of antibiotics.

Answer 72

Gloves and mask

Answer 73

Private room, gown, gloves, leave pt equipment in pts room. MRSA, VRE, c-diff

Answer 74

Private room, gown, gloves, MASK (if within 3 ft of pt) Pt wears mask if transported out of room Mumps, flu/influenza, RSV, pertussis, strep

Answer 75

Contact precautions * private room, gown, gloves, and private equipment in room

Answer 76

N95 respirator, private isolation room (negative air flow room), essential transport only. Measles, Tuberculosis (TB), chickenpox, herpes zoster

Answer 77

MRSA, VRE, c-diff

Answer 78

Mumps, Influenza/flue, RSV, pertussis, strep

Answer 79

TB, Measles, chickenpox, herpes zoster

Answer 80

Sanitizer/hand rub: remove jewelry and cover all surfaces of hands with the cleansing agent. Rub dry (~15 sec); do not rinse. Antimicrobial soap and water: MUST use - when hands are visibly dirty. - when pathogen is known to be C. difficile. - after multiple applications of sanitizer or hand rub. Wash 15-60 sec.

Answer 81

Soap and water -- wet hands, apply soap product, rub vigorously for 15 sec Alcohol based hand sanitizer -- put on hands and rub all surfaces for 20 seconds

Answer 82

Supine: reposition at least every 2 hours (for dependent patients) Sitting: pressure relief off buttocks at least every 10-15 mins.

Answer 83

On the weaker side

Answer 84

1.5-2.5 mEq/L

Answer 85

2.6-4.5 mg/dL Red flag > 5.1

Answer 86

3.5-5.0 mEq/L Red flag < 3.2; 5.1

Answer 87

8.5-10.5 mg/dL

Answer 88

10-20 mg/dL Caution >20

Answer 89

22-26 mEq/L

Answer 90

98-106 mEq/L

Answer 91

135-145 mEq/L Caution <120

Answer 92

0.5-1.1 mg/dL Females 0.6-1.2 mg/dL Males Caution > 1.2

Answer 93

87-107 mL/min Females 107-139 mL/min Males

Answer 94

70-110 mg/dL Red flag < 60 or > 300-350

Answer 95

(average over 3 months) 5.7-6.4% - Pre diabetic range 6.5% - diagnosed with diabetes ** goal of individuals with diabetes is to maintain A1C less than 7%

Answer 96

iron containing protein that has strong affinity for oxygen 14-18 g/100mL Males 12-16 g/100mL Females Caution 8-10 Red flag <8

Answer 97

measure of % of whole blood occupied by cells 42-52% Males 36%-48% Females (Text says 37-47) Caution 25-30% Red flag < 25%

Answer 98

Leukocytosis – WBC > 11,000/mm3 Leukopenia – WBC < 4,000/mm3 or <5,000 with fever Thrombocytosis - PLT > 400,000/mm3 Thrombocytopenia –PLT < 140,000/mm3

Answer 99

2.0-3.0 Prophylaxis of venous thrombosis (high risk surgery) DVT and PE DIC (disseminated intravascular coagulation) prevention and treatment Afib Valvular heart dz *Recurrent systemic embolism Cardiomyopathy 2.5 – 3.5 Acute MI Mechanical prosthetic heart valve replacement

Answer 100

Values between 3.5-5.0 Consider fall risks Possible bleeding during debridement

Answer 101

>5.0 (some references site 6.0 as bedrest) Consider holding all debridement and pulsed lavage May be on bed rest Consult MD

Answer 102

* excessive levels of calcium in blood (Norm: 8.5-10.5) * Most commonly associated with hyperparathyroidism since excessive parathyroid hormone raises the level of circulating calcium above normal. * Symptoms: constipation, pain, nausea, vomiting.

Answer 103

* excessive levels of potassium in blood (Norm 3.5 - 5) * (>7): Can cause significant hemodynamic and neurologic consequences * (>8): cause respiratory paralysis or cardiac arrest * Symptoms typically related to abnormalities in muscular or cardiac function

Answer 104

* excessive level of magnesium in blood (Norm: 1.5-2.5) * relatively rare since the kidneys are able to eliminate excess magnesium by rapidly reducing its tubular absorption. * Most often caused by renal failure. * Symptoms: hypotension and respiratory depression

Answer 105

* excessive level of sodium in blood (Norm: 135-145) * Occurs when there is a net water loss or a sodium gain and reflects too little water in relation to total body sodium and potassium. * Most often caused b impaired thirst or restricted access to water and can be facilitated by pathologic conditions with increased fluid loss * Primary symptoms is thirst .

Answer 106

Neck Flexion range - 0-45 deg Neck Extension range - 0-65 deg Neck Rotation range - 0-60 deg Neck Lateral Flexion range - 0-35 deg

Answer 107

Shoulder Flexion range - 180 deg GHJ Flexion/Elevation range - 120 deg GHJ Extension range - 60 deg Shoulder ABD range - 180 deg GHJ ABD range - 90 - 120 deg Shoulder Horizontal ADD range - 135 deg Shoulder Horizontal ABD range - 45 deg Shoulder IR range - 70 - 90 deg Shoulder ER range - 90 deg

Answer 108

Elbow flexion range - 150 deg Elbow Extension range - Ext: 0 deg, hyper-Ext: 15 deg Elbow Pronation range - 80 - 90 deg Elbow Supination range - 80 - 90 deg

Answer 109

Wrist flexion range - 80 deg Wrist extension range - 70 deg Wrist Ulnar deviation range - 30 deg Wrist Radial deviation range - 20 deg

Answer 110

DIP flexion: 90 deg DIP extension: 10 deg PIP Flexion: 0-100 deg MCP Flexion: 0-90 deg MCP Extension: 0-45 deg

Answer 111

CMC flexion: 0-50 deg IP flexion: 0-80 deg

Answer 112

Hip Flexion range - 0-120 deg Hip Extension range - 0-30 deg Hip ABD range - 0-45 deg Hip ADD range - 0-30 deg Hip IR range - 0-45 deg Hip ER range - 0-45 deg

Answer 113

Knee Flexion range - 0-135 deg Knee Extension range - 135-0 deg

Answer 114

Ankle PF range - 0-50 deg (talocrural) Ankle DF range - 0-20 deg (talocrural) Ankle Inversion range - 0-30 to 35 deg (midtarsal/transverse tarsal) Ankle Eversion- 0- (15-20) deg (midtarsal/transverse tarsal) Subtalar Inversion/Eversion - 0-5 deg

Answer 115

Flexion: 0-80 deg Extension: 0-25 deg Sidebending (Lateral Flexion): 0-35 deg Rotation: 0-45 deg

Answer 116

systolic >250 mm Hg. diastolic >115 mm Hg. systolic drop >10 mm Hg from baseline. failure of the systolic pressure to increase with increasing workload.

Answer 117

Normal: <120/80mmHg Elevated: 120-129/80mmHg Stage 1: systolic 130-139 OR diastolic 80-89 Stage 2: systolic atleast 140 OR diastolic atleast 90mmHg Hypertensive crisis: systolic over 180 and/or diastolic over 120

Answer 118

98.6 deg F OR 37C (measured rectally)

Answer 119

95-100 Need O2 if 88 or below

Answer 120

5-12 repetitions ~5-10 sec per cycle 3-5 time/wk

Answer 121

Initiate Motion Learn a Motion Change Rate of Motion Increase Strength Increase Stability Increase coordination and control Increase endurance Increase Range of Motion Relaxation Decrease Pain To promote functional movement, inhibition, strengthening, and relaxation of muscles.

Answer 122

Relation to PNF The effect of stimulus continues after the stimulus stops. Increase strength and duration of a stimulus will cause a larger afterdischarge.

Answer 123

In relation to PNF A succession of weak stimuli occurring within a short period of time will combine to create excitation.

Answer 124

In relation to PNF Weak stimuli applied simultaneously to different parts of the body reinforce each other and summate to cause excitation.

Answer 125

In relation to PNF A spreading and increased strength of a response. The response can be excitation or inhibition (the absence of contraction). i.e. as the body puts forth effort, other body parts participate to assist (push hard with one leg, the other leg starts pushing too) OR another definition: Spread of energy from agonist to complimentary agonists and antagonists within a pattern. aka overflow

Answer 126

In relation to PNF An increased excitation of an agonist muscle follows stimulation of the antagonist (techniques involving reversals make use of this property- slow reversal)

Answer 127

In relation to PNF When one set of muscles contracts, the antagonistic muscles are inhibited. This is essential for coordinated movement. Relaxation techniques make use of this property.

Answer 128

Traction (elongation of muscles), facilitates a pull back. To enhance isotonic movement. Should be applied through the entire range. Approximation (stabilization) facilitates a push back – promotes weight bearing. Increases proprioception with each. Stimulates joint receptors and facilitates isometric contractions around the joint.

Answer 129

Facilitates the muscle that is being stretched and other synergists to contract with it. You stimulate muscles by giving a quick stretch in the opposite direction. (This is a reflex that can be over-riden in normal people but need to watch for in people with neurological dysfunction- ankle plantarflexors) Facilitates the muscles ability to contract with greater force

Answer 130

Technique of PNF Used when a pt is unable to initiate a specific movement From PROM – AAROM – AROM. May be used to instruct on proper sequencing.

Answer 131

Technique of PNF Rhythmic concentric contraction of all components of the agonist and antagonist patterns Slow reversal hold - same but ISOM at end range Resistance should allow as much ROM as possible while still eliciting maximal motor response. Good for endurance

Answer 132

Technique of PNF Used to increase contraction by eliciting the stretch reflex repeatedly through ROM A quick stretch is applied to the whole synergistic group Do a quick stretch at any point of the moton to elicit contraction. Do this when the pt is fatiguing and has not completed the full ROM.

Answer 133

Technique of PNF Used to increase the contraction of a component of a movement pattern Typically only applied to one muscle after ISOM of the stronger muscles iin the pattern A quick stretch is applied to one component of the synergistic group (only to the weak component)

Answer 134

Technique of PNF Both concentric and eccentric contractions of the same movement Can be performed through a specific range or throughout the whole range if more control is needed.

Answer 135

Technique of PNF Combines the concentric, eccentric, and isometric/staiblizing contractions Start in position where pt has the most strength or best coordination Concentric contraction – ISOM – eccentric with no relaxation between contractions.

Answer 136

Used to promote stability of a body part in specific range Muscle demands must be very slow and specific

Answer 137

Normal Ability to complete full ROM (AG) & tolerate maximal resistance

Answer 138

Good Able to complete full ROM (AG) & tolerate moderate resistance

Answer 139

Fair Moves through full ROM (AG) without resistance

Answer 140

Fair+ can complete full ROM (AG) and pt. can hold end position against Mild resistance or ½ range with mod resistance

Answer 141

Poor Muscle moves through full ROM (GE)

Answer 142

Trace PT can palate muscle contraction or visually observe tendon move, there is no structural movement as result of the contractile activity

Answer 143

Completely absent upon palpation or visual inspection

Answer 144

Visual: indented transverse lines across the nail May result from: Trauma Raynaud’s disease (decreased blood flow to fingers) Psoriasis Infection around nail plate

Answer 145

bulbous swelling of fingertips with loss of the normal angle b/w the nail bed & skin Nails appear bluish-gray =cyanotic Nails are boggy -spongy Develops gradually Associated with; longstanding hypoxia; Congenital heart defects; Cardiopulmonary diseases

Answer 146

distal portion of nail turns red, pink, or brown Distinct line of demarcation b/w the two halves Present in renal failure

Answer 147

detachment of nail from nail bed Associated with Trauma; Fungal infections; Psoriasis; Overactive thyroid gland

Answer 148

transverse white lines across the breadth of the nail Associated with systemic disease: Renal failure; Hodgkin’s disease; Malaria; Sickle cell anemia; Associated with arsenic poisoning

Answer 149

Tiny punctate depressions in the nail Caused by systemic diseases: Reiter’s syndrome (reactive arthritis); Psoriasis; eczema

Answer 150

tiny hemorrhages that create reddish lines of blood under the nails Looks like a “splinter” Associated with bacterial endocarditis and trauma

Answer 151

* pain assessment questionnaire with 70 questions in 4 sections * most widely used pain assessment scale * 4 sections: draw where it hurts, choose one word to describe pain, describe pain pattern and relieving factors, and rate the intensity

Answer 152

* 10-15cm line and the pt marks their perceived level of pain on the line * scale can be highly sensitive if small increments such as millimeters are used to measure the pts point of pain on the scale.

Answer 153

The Wong-Baker Faces Pain Rating Scale was created to assist children three years of age and older to communicate about their pain. The scale uses a series of faces and verbal descriptors to categorize the severity of pain. A score of 0 would indicate “No hurt.”

Answer 154

1. Crutches advanced first followed by the involved lower extremity; then uninvolved lower extremity. 2. Indicated when patient requires increased stability and slower movement.

Answer 155

1. Crutches advanced first followed by the involved lower extremity; then uninvolved lower extremity. 2. Indicated when patient requires increased stability and slower movement.

Answer 156

1. One crutch is advanced forward, followed by the con- tralateral lower extremity, then the second crutch is advanced forward, followed by that contralateral limb. 2. Used with bilateral lower extremity involvement.

Answer 157

1. One crutch is advanced forward, followed by the con- tralateral lower extremity, then the second crutch is advanced forward, followed by that contralateral limb. 2. Used with bilateral lower extremity involvement.

Answer 158

1. Crutches advanced first, and lower extremities swing forward to meet the crutches. 2. Used on non-weight-bearing status or bilateral lower extremity involvement.

Answer 159

1. Crutches advanced first, and lower extremities swing forward to meet the crutches. 2. Used on non-weight-bearing status or bilateral lower extremity involvement.

Answer 160

<200 mg/dL = desirable 200-239 mg/dL = Borderline >240 mg/dL = High

Answer 161

< 100 mg/dL = Optimal 100-129 mg/dL = Near optimal 130-159 mg/dL= Borderline 160-189 mg/dL = High > 190 mg/dL =Very high

Answer 162

< 40 mg/dL = Low 260 mg/dL = High

Answer 163

< 150 mg/dL = Desirable 150-199 mg/dL = Borderline 200-499 mg/dL = High ≥ 500 mg/dL = Very high

Answer 164

* Use the known systolic measurement as the baseline value. *The blood pressure cuff should then be inflated to 15-25 mm Hg above the baseline value. * If the patient’s blood pressure is unknown, the therapist can estimate the baseline value by determining the amount of pressure needed to occlude the radial artery (i.e., the pressure at which the artery becomes occluded). * For a patient with a known systolic blood pressure of 140 mm Hg, the cuff should be inflated to 155-165 mm Hg. 160 mm Hg would fall within this range.

Answer 165

* plastic tube inserted through a nostril that extends into the stomach. * Used for short-term liquid feeding, medication administration or to remove gas from the stomach. * The position of the tube in the nostril and back of the throat can inhibit a cough and be irritating for the patient.

Answer 166

* tube inserted through a small incision in the abdomen into the stomach. * Used for long-term feeding in the presence of difficulty with swallowing due to an anatomic or neurologic disorder or to avoid the risk of aspiration.

Answer 167

* Inserted through endoscopy into the jejunum via the abdominal wall. * The tube can be used for long-term feeding for patients that are unable to receive food by mouth

Answer 168

* Consists of a sterile fluid source, a pumo, a clamp, and a catheter to insert into a vein (Fig. 8-30). * Can be used to infuse fluids, electrolytes, nutrients, and medication. * Most commonly inserted into superficial veins such as the basilic, cephalic or antecubital. * Permit nutrients to be introduced when the gastrointestinal tract is not able to digest and absorb food.

Answer 169

* Monitoring device consisting of a catheter that is inserted into an artery and attached to an electronic monitoring system. * Measure blood pressure or to obtain blood samples. - The device is considered to be more accurate than traditional measures of blood pressure and does not require repeated needle punctures. * If an arterial line is displaced, a therapist should apply direct pressure to limit blood loss and call for assistance

Answer 170

* Used for measuring pressures in the right atrium or the superior vena cava by means of an indwelling venous catheter and a pressure manometer. * Used to evaluate the right ventricular function, right atrial filing pressure, and circulating blood volume. * The use of the catheter significantly reduces the need for repeated venipuncture.

Answer 171

* Inserted through the cephalic or internal jugular vein and threaded into the superior vena cava and right atrium. * The catheter is used for long-term administration of substances into the venous system such as chemotherapeutic agents, total parentaeral nutrition, and antibiotics

Answer 172

* Measures the pressure exerted and the against the skull using pressure sensing devices placed inside the skull. * Excessive pressure can be produced by a closed head injury, cerebral hemorrhage, overproduction of cerebrospinal fluid, or brain tumor. * Types of intracranial pressure monitors include epidural sensory, subarachnoid bolt, and intraventricular catheter.

Answer 173

* Soft, flexible catheter that is inserted through a vein into the pulmonary artery. Sticks out of neck * Provide continuous measurements of pulmonary artery pressure (R atrium, ventricle, and pulmonary artery). -- diagnostic * Should avoid excessive movement of the head, neck, and extremities to avoid disrupting the line at the insertion site.

Answer 174

inserted into the peripheral vein. For meds to be directly administered

Answer 175

- Delivers meds that could irritate the blood vessel lining - Superior vena cava and into the ehart - Med, chemo, parenteral nutrition (glucose)

Answer 176

- a central line that is inserted at a peripheral point and used for prolonged periods (>2 weeks) - Chemo, antibiotics, parenteral nutrition

Answer 177

* Pins, screws, and wires to be surgically inserted into bone for the purpose of applying a traction force using an externally applied weight. * Comminuted femur fractures. * Requires prolonged immobilization and therefore increases the incidence of secondary complications such as contractures or skin breakdown.

Answer 178

- placed in the pleural space around lungs - to remove air or fluid from pleural space - Keep unit below level of lungs - watch for signs of pleural effusion (SOB, difficulty breathing, etc)

Answer 179

- 1-6 L/min of O2 - O2 concentration is 28-44% (the norm is 21%)

Answer 180

- 6-10 L/min of O2 - O2 concentration is 60%

Answer 181

- 6-15 L/min - O2 concentration is 100%

Answer 182

* Holes are drilled into uninjured areas of bone surrounding the fracture. * The fracture is then set in the desired anatomical configuration using specialized wires, pins, bolts, and screws. * An external frame is used to maintain the bony fragments in the desired alignment (Fig. 8-31). * External fixation enhances stability and allows for earlier mobility while maintaining the desired alignment.

Answer 183

* Surgical procedure that attempts to promote the healing process of bone without appliances being applied external to the skin. * Metal plates, rods, wires, screws, and nails. * Comminuted or displaced fractures. * The procedure provides needed stability to healing joints which allows earlier mobility and less postoperative complications.

Answer 184

Intravenous system

Answer 185

- Gastric tube - Jejunostomy tube

Answer 186

- volume cycled

Answer 187

Arthrocentesis Arthrocentesis refers to a technique using a sterile needle to remove fluid from a joint. The obtained fluid is often sent to a laboratory for further analysis.

Answer 188

Arthrocentesis Arthrocentesis refers to a technique using a sterile needle to remove fluid from a joint. The obtained fluid is often sent to a laboratory for further analysis.

Answer 189

chest tube A chest tube is a flexible plastic tube that is inserted through an incision into the side of the chest. The tube uses a suction system to remove air, fluid or pus from the intrathoracic space.

Answer 190

nasogastric tube A nasogastric tube is a plastic tube inserted through the nose and extends into the stomach. The position of the tube in the nostril and back of the throat can inhibit a cough and be irritating for the patient. The remaining options all extend through the abdominal wall.

Answer 191

indwelling right atrial (Hickman) catheter An indwelling right atrial catheter is inserted through the cephalic or internal jugular vein and threaded into the superior vena cava and right atrium.

Answer 192

6 liters per minute A nasal cannula consists of tubing extending approximately one centimeter into each of the patient’s nostrils. The maximum oxygen output is 6 liters per minute.

Answer 193

talking An endotracheal tube is inserted into a patient’s airway to allow the delivery of gas from a mechanical ventilator. The tube allows for suctioning to still occur, although significantly affects the patient’s ability to verbally communicate. A patient who is using a ventilator can still perform low-level exercise and ambulation.

Answer 194

right atrium A central venous pressure catheter is an intravenous tube that is used to measure pressures in the right atrium or superior vena cava. This information is used to determine how well the right ventricle is functioning.

Answer 195

obtain blood samples An arterial line is a catheter that is inserted into an artery, typically the radial, dorsal, pedal, axillary, brachial or femoral artery. The device is used to continuously measure blood pressure or to obtain blood samples.

Answer 196

pulmonary embolism A disrupted or loose intravenous (IV) line connection may result in the development of an air embolus. These emboli can be life-threatening if they make their way to the heart or lungs. Other complications with use of an IV line include phlebitis, infection, thrombosis, and local hematoma.

Answer 197

nasogastric tube A nasogastric tube is a plastic tube inserted through a nostril that extends into the stomach. The device is commonly used for short-term liquid feeding, medication administration or to remove gas from the stomach.

Answer 198

volume control ventilation With volume control ventilation (VCV), the ventilator controls the inspiratory flow. The ventilator is set to deliver a constant tidal volume utilizing whatever pressure is required to reach the necessary value.

Answer 199

patient in a coma A nasogastric tube is a plastic tube inserted through a nostril that extends into the stomach. The device is commonly used for liquid feeding, medication administration, and to remove gas from the stomach. Common candidates for nasogastric feeding include comatose patients, patients with neck or facial injuries, premature infants, and patients on a mechanical ventilator.

Answer 200

intravenous Intravenous patient-controlled analgesia (PCA) is the simplest and most common form of PCA. This form of PCA occurs by inserting a needle into a peripheral vein that connects to a catheter or intravenous line.

Answer 201

two inches

Answer 202

increased difficulty with propelling the wheelchair If the back of a wheelchair is too high, the patient may experience difficulty propelling the wheelchair since the shoulders and scapulae will not be able to move as easily. Other complications include excessive irritation to the skin over the inferior angles of the scapulae and difficulty with balance secondary to forward inclination of the trunk.

Answer 203

allows for weight bearing on the ischial tuberosities A slight anterior pelvic in sitting allows for weight bearing on the ischial tuberosities. The ischial tuberosities refer to the bony broadening on the posterior portion of the superior ramus of the ischium.

Answer 204

tuck the chin toward the chest When falling backwards in a wheelchair, the patient should tuck their chin towards their chest and maintain a semiflexed trunk position to avoid hitting their head against the floor. One hand should grasp the opposite armrest to prevent the thighs from moving backwards during the fall, and the other hand should reach forward.

Answer 205

have an assistant control the chair off the curb while facing backward When descending a curb, it is safest for the patient to have someone assist them off the curb. Though the patient can descend the curb either facing forward or backward, it is safest for the patient if it is performed backward. If the assistant loses control of the wheelchair in this position, they are still positioned behind the chair to prevent the patient from falling off the curb.

Answer 206

shorter, faster strokes When ascending a ramp in a wheelchair, the strokes should be shorter and faster than the strokes incorporated on level surfaces. The individual should also lean forward with cervical spine and trunk flexion to prevent backward tipping.

Answer 207

applying a medially directed pressure to the rims A patient with a C6 complete spinal cord injury would lack innervation of the triceps and finger flexors. For this reason applying a medially directed force to the rims is the safest and most appropriate method to control the decent of a wheelchair on a ramp

Answer 208

leak in the ventilator circuit