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PHTH 508: Foundations of Patient Assessment > Final Exam Prep > Flashcards

Final Exam Prep Flashcards

1
Q

What is traction?

A

-A force applied to separate two joint surfaces and elongate surrounding tissue
-Distraction

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2
Q

What is medical traction? What is it used for?

A

-Continuous and static traction
-Used to promote reduction and immobilization following trauma

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3
Q

What is spinal traction?

A

-Encourages separation and/or movement within the spine between individual segments
-Can be applied manually or mechanically
-Can be continuous or intermittent

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4
Q

What are the grades of manual traction?

A

-Grade I
-Grade II
-Grade III

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5
Q

What are manual traction characteristics?

A

-Oscillatory
-Progressive
-Positional

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6
Q

How did Kaltenborn describe traction to a joint?

A

-With use of three-dimensional traction, which described traction that has been positioned with respect to cardinal planes of motion
-Ex: painful joint positioned into pain-free range
-Ex: hip was positioned in flexion and abduction

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7
Q

What can traction do to different types of tissues?

A

-Stretches soft tissue
-Relaxes muscles
-Mobilizes joints
-Separates joint surfaces
-Reduces protrusion of nuclear disc material

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8
Q

What must occur in order to have true distraction?

A

A force strong enough must be applied to elongate the surrounding tissue and allow the joint surfaces to separate

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9
Q

What percentage of a patients body weight is required to increase the length of the lumbar spine?

A

30-50%

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10
Q

What percentage of a patients body weight is required to increase the length of the cervical spine?

A

7%

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11
Q

What pathologies are treated with traction?

A

-Nerve impingement
-Disc herniation/prolapse
-Joint hypomobility
-Arthritic conditions of facet joints
-Muscle spasm
-Generalized joint pain

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12
Q

What tissues are affected by spinal traction?

A

-Ligaments
-Intervertebral discs
-Facet joints
-Muscles
-Nerves

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13
Q

What does ligament deformation allow for?

A

It allows spinal vertebrae to temporarily move apart

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14
Q

How does traction affect ligaments?

A

-Ligaments can be contracted or shortened by injury or chronic postural problems
-Traction encourages adaptive changes in length and strength
-Places pressure on structures within the ligamentous complex (proprioceptive nerves)
-Activation of proprioceptive fibers provide a gating mechanism similar to TENS

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15
Q

What is the function of normal intervertebral discs?

A

-Act to dissipate compressive forces within the spine
-Internal pressure increase, but nucleus pulposus does not move out with change in weight bearing forces
-80% of compressive load in spine is taken up by the disc

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16
Q

What happens to the intervertebral discs when they are herniated?

A

-Lose fullness, which moves vertebrae closer together
-Annular fibers bulge
-Nucleus shifts according to fluid-dynamic principles (path of least resistance if annulus is damaged)

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17
Q

How does traction help treat intervertebral disc abnormality?

A

-Decreases central pressure
-Return of nucleus to central position
-Tension on annulus fibrosus and ligaments surrounding disc (helps to push disc material more centrally)
-Movement of structures relieves pain if pressure is on vascular or nervous tissues
-Allows for improved fluid exchange within disc and spinal canal
-Possible reduction of disc herniation

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18
Q

How does traction affect the facet joints?

A

-Traction separates joint surfaces up to 1-2mm
-Decompresses articular cartilage, increasing synovial fluid exchange to the cartilage
-Stimulates proprioceptive nerves at the facet joint capsules

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19
Q

What type of traction is best if you are trying to promote fluid movement?

A

Intermittent traction, because traction, then release will move the fluid around

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20
Q

How does traction affect muscles?

A

-Decrease in spinal musculature EMG from 1-10 minutes of traction
-Increased muscle EMG from 10-15 minutes of traction
-For muscle tone, use high load, continuous traction less than 10 minutes

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21
Q

What can pressure on nerves be from?

A

-Bulging disc material
-Irritated facet joints
-Bone spurs
-Narrowed intervertebral foramen

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22
Q

How does traction affect the nerves?

A

-Can decrease pressure on the nerve
-Can increase blood flow to the nerve, decreasing edema and allowing return to normal function if there is no permanent damage

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23
Q

What are indications for traction?

A

-Nerve root impingement
-Disc herniation
-Spondylolysthesis
-Osteophyte formation
-Degenerative joint disease (arthritis)
-Sub acute sprain
-Joint hypomobility
-Discogenic pain
-Muscle spasm or guarding
-Muscle strain
-Ligament or connective tissue contractures

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24
Q

What are contraindications for traction?

A

-Acute sprains or strains
-Acute inflammation
-Fractures
-Joint instability
-Tumors
-Bone disease
-Osteoporosis
-Infections in bones/joints
-Vascular conditions
-Pregnancy (loose ligaments)
-Cardiac or pulmonary problems (because strap around chest can compress chest)

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25
Q

What are the different types of traction?

A

-Continuous
-Intermittent
-Manual
-Positional
-Gravity-assisted
-Hydrotherapy traction

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26
Q

What is continuous traction?

A

Constant force that is sustained over a period of time

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27
Q

What is intermittent traction?

A

Applies force, then releases force for brief intervals of time

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28
Q

What is manual traction?

A

Force applied by the therapist and can vary from constant, intermittent, or sudden thrust

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29
Q

What is positional traction?

A

Positioning in a way to effect bony tissue and alleviate pressure

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30
Q

What is gravity-assisted traction?

A

-Using gravity to traction a joint
-Inversion
-Hanging

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31
Q

What is unilateral leg pull manual traction used for?

A

-Hip problems
-Lateral shifts
-SI joint problems
-Caudal force w/ leg in 30 degrees flexion, 30 degrees abduction, and full ER

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32
Q

What is a bilateral leg pull manual traction used for?

A

-Lumbar traction
-Done in hook lying

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33
Q

What are the parameters for mechanical lumbar traction?

A

-Pt. position (prone, supine, hip position)
-Force
-Intermittent vs. sustained
-Duration of treatment

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34
Q

How should patients be positioned for mechanical lumbar tractioning?

A

-Neutral spine because it allows for the greatest IVF opening
-Prone may allow application of further modalities and easier assessment of spinous process separation
-Supine & hips flexed to 90 degrees allows for greater intervertebral separation
-Overall determined by patient comfort level

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35
Q

What is short time (< 10sec.) intermittent tractioning used for?

A

Activates joint and muscle receptors and facet joint movement

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36
Q

What is longer time (> 10sec.) intermittent tractioning used for?

A

Stretches ligamentous and muscular tissues for separation

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37
Q

How long should rest times be for intermittent tractioning?

A

They should be long enough for the patients to relax between cycles

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38
Q

How long should continuous tractioning be applied?

A

-Suspected disc protrusion: 8-10 minutes
-If symptoms only partially relieve, can gradually increase up to 30 minutes

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39
Q

What is progressive vs regressive tractioning?

A

-Progressive: force slowly increases during the time of traction
-Regressive: force slowly decreases during the time of traction

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40
Q

What are contraindications for inversion table tractioning?

A

-Circulatory issues
-GERD

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41
Q

How long should cervical traction be applied for?

A

3-10 minutes

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42
Q

What is the positioning for cervical traction?

A

-Supine
-Cervical spine flexed at 30 degrees for greater intervertebral foramen separation
-Neutral head position for greater O-A and A-A separation

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43
Q

What is the on/off ratio for intermittent cervical traction?

A

30:10 seconds

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44
Q

What is independent (I) level of assistance?

A

-Pt requires no assistance or supervision
-Patient provides 100% effort

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45
Q

What is modified independence (Mod I) level of assistance?

A

-Patient completes task using an assistive device (walker, cane, BSC) or requires extra time to complete task
-Pt provides 100% of the effort

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46
Q

What is supervision (S) or stand by assist (SBA) level of assistance?

A

-Pt does not require any physical contact from PT, but due to fall risk or cognitive impairments, the PT should be close by
-Pt provides 100% of the effort

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47
Q

What is contact guarding (CGA) level of assistance?

A

-Pt requires light physical contact from PT
-Less than 5% effort from PT
-Greater than 95% effort from pt

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48
Q

What is minimal assistance (Min A) level of assistance?

A

-PT provides 25% or less physical support
-Pt provides 75% of the effort

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49
Q

What is moderate assistance (Mod A) level of assistance?

A

-Pt provides 50% effort
-PT provides 50% support

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50
Q

What is maximal assistance (Max A) level of assistance?

A

-Pt requires 75% support from PT

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51
Q

What is dependent total assistance (Total A) level of assistance?

A

Pt requires 100% assistance to complete transfer

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52
Q

What are the different weight bearing levels?

A

-Full weight bearing (FWB)
-Weight bearing as tolerated (WBAT)
-Partial weight bearing (PWB)
-Toe touch weight bearing (TTWB)
-Heel touch weight bearing (HTWB)
-Non weight bearing (NWB)

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53
Q

What percentage of body weight can be placed on a limb for partial weight bearing (PWB)?

A

50%

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54
Q

What percentage of body weight can be placed on a limb for toe touch weight bearing (TTWB)?

A

25%

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55
Q

What percentage of body weight can be placed on a limb for heel touch weight bearing (HTWB)?

A

25%

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56
Q

Are there any weight bearing precautions for total knee arthroplasty (TKA)?

A

Weight bearing as tolerated (WBAT) due to pain

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57
Q

Are there any weight bearing precautions for total hip arthroplasty (THA)?

A

Weight bearing as tolerated (WBAT) due to pain

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58
Q

What precautions are there for a THA lateral approach?

A

None

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59
Q

What precautions are there for a THA anterior approach?

A

-No extension past neutral
-No external rotation of hip
-No adduction

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60
Q

What precautions are there for a THA posterior approach?

A

-No internal rotation
-No hip flexion greater than 90 degrees
-No adduction

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61
Q

What precautions are there for open reduction internal fixation (ORIF)?

A

-Typically non weight bearing (NWB)
-Precautions will be set by surgeon

62
Q

What is open reduction internal fixation (ORIF)?

A

When pins/rods or screws are placed following a fracture to keep the bone in place

63
Q

What are traditional sternal precautions?

A

-No flexion past 90 degrees
-No abduction past 90 degrees
-No reaching behind back
-No lifting more than 5-8 pounds
-No pushing w/ arms (i.e. out of a chair)
-Beneficial to hold onto a pillow during functional tasks or when coughing or sneezing

64
Q

What are cervical spine precautions following surgery?

A

-If aspen/cervical collar is in place, no lifting more than 10 pounds
-No shoulder flexion greater than 90 degrees
-Other precautions per surgeon

65
Q

What are lumbar spinal precautions following surgery?

A

-Usually after spinal laminectomy
-No twisting
-No forward bending past 90 degrees
-No side bending
-Use log roll to get up
-Most surgeons require spinal orthosis

66
Q

What is endurance?

A

-The ability to sustain an activity over a period of time
-Both cardiovascular and muscular endurance

67
Q

What is activity tolerance?

A

The amount of activity/exercise that can be sustained before becoming overexerted as measured physiologically and symptomatically (vitals, VO2 max, etc.)

68
Q

How should we monitor patients pre and post endurance tests?

A

-Vitals!!!
-HR
-Oxygen saturation
-Blood pressure
-Rate of perceived exertion (RPE)
-Dyspnea scale

69
Q

What scale is used for the rate of perceived exertion (RPE)?

A

-Borg scale (6-20)
-Modified Borg Scale (0-10)

70
Q

What grades are used in the dyspnea scale?

A

-Grade 0: no dyspnea
-Grade 1: slight dyspnea
-Grade 2: moderate dyspnea
-Grade 3: severe dyspnea
-Grade 4: very severe dyspnea

71
Q

What is grade 0 on the dyspnea scale?

A

-No dyspnea
-Not troubled by breathlessness except with strenuous exercise

72
Q

What is grade 1 on the dyspnea scale?

A

-Slight dyspnea
-Troubled by shortness of breath when hurrying on a level surface or walking up a slight hill

73
Q

What is grade 2 on the dyspnea scale?

A

-Moderate dyspnea
-Walks slower than normal based on age on a level surface due to breathlessness or has to stop for breath when walking on a level surface at own pace

74
Q

What is grade 3 on the dyspnea scale?

A

-Severe dyspnea
-Stops for breath after walking 100 yards or after a few minutes on a level surface

75
Q

What is grade 4 on the dyspnea scale?

A

-Very severe dyspnea
-Too breathless to leave the house or becomes breathless while dressing or undressing

76
Q

What tests/functional outcome measures can be used to assess endurance?

A

-6 minute walk test
-2 minute walk test
-2 minute step test

77
Q

What tests/functional outcome measures can be used to assess functional strength?

A

-30 second chair raise
-5 times sit to stand
-Functional strength such as glute bridge, straight leg raise, etc.

78
Q

What types of assistive devices can be used for gait?

A

-Cane
-Crutches
-Walker

79
Q

How are canes useful for gait?

A

-Least stable assistive device
-Offloads 10-30% of body weight
-Mostly used for balance

80
Q

What side should someone use a cane on?

A

Their non-affected side to distribute/shift weight off the injured/painful side

81
Q

What types of canes are there?

A

-Standard
-Tripod
-Quad

82
Q

What should the height of the cane be?

A

-Pt should be standing in a relaxed position
-The lowest point of the handle should line up w/ the ulnar styloid process

83
Q

What can crutches be used for during gait?

A

-Can offload varying degrees of body weight w/ PWB
-Can be used w/ NWB
-Different types of crutches have different UE strength requirements
-Typically used in pairs

84
Q

What types of crutches are there?

A

-Standard (axillary)
-Forearm

85
Q

What are the measurements for axillary crutches?

A

-3 fingers or 10 cm below the axillary fold (armpit)
-Hand grips should align w/ ulnar styloid processes

86
Q

What are the measurements for forearm crutches?

A

-Handgrip should be level w/ ulnar styloid process
-Forearm cuff should be 2 inches distal to the tip of olecranon process

87
Q

What types of walkers are there?

A

-Standard
-2 wheeled walker/front wheeled walker (FWW)
-4 wheeled walker

88
Q

What are the pros and cons of a standard walker?

A

Pros
-Very stable
-Can slow impulsive patients down
-Can be used w/ weight bearing restrictions
-Helps w/ pain and weakness
Cons
-Bulky
-Heavy
-Inhibits normal gait pattern
-Can get in the way
-Demand more energy than FWW

89
Q

What are the pros and cons of a front wheeled walker (FWW)?

A

Pros
-Smooth
-Allows for a more normal gait pattern
-More energy efficient
-Can be used w/ weight bearing restrictions
Cons
-A little less stable than standard
-Can “get away” from patient

90
Q

What should be the measurements for the walker?

A

-Patients should stand inside the walker
-Handles should be at the ulnar styloid process

91
Q

What is a 4 wheeled walker good for?

A

-Not very stable
-Good for poor endurance
-Easy maneuver
-Large wheels make it easier to use outdoors
-Good for patients with decreased endurance because most have a seat and have breaks that lock
-Not able to use with partial weight bearing or non weight bearing

92
Q

What is a hemi-walker used for?

A

-Used for individuals w/ stroke
-People with a fractured arm or has to have their arm in a sling but also requires assistance from a walker

93
Q

What should the measurement for a hemi-walker be?

A

The handle should be at the ulnar styloid process

94
Q

What kind of assistive devices are there for toileting?

A

-Bed side commode
-Drop arm commode
-Metal hand bar near toilet for support

95
Q

What kind of assistive devices are there for bathing?

A

-Bath bench
-Sliding toilet/shower bench
-Shower chair

96
Q

What kinds of items are needed for shower safety?

A

-Grip/shower mat to avoid slipping
-Rails if needed
-Shower chair or other bathing assistive devices if needed

97
Q

What are considerations for safe ambulation?

A

-Use of gait belt
-Weight bearing status
-Pain during weight bearing
-Decreased strength
-Impaired balance
-Alteration in coordinated movements
-Attention to lines and equipment
-Type of surface ambulating on
-Altered stability
-Absence of a lower extremity
-Ability to use upper extremities
-Patient cognition and attentiveness
-Use of a second person
-Proper stance, guarding, and hand placement

98
Q

What is involved in preparing for ambulation?

A

Review medical chart

Assess patient
-ROM
-Muscle performance
-Sensation screen
-Balance/coordination
-Cognition/attentiveness/ability to follow commands

99
Q

What are pre-ambulation considerations?

A

-Assistive device to use
-Amount of assistance required (height, weight)
-Safety (1 or 2 person)

100
Q

Where should the therapist stand when guarding a patient on level ground?

A

-Stand behind and slightly to one side of the patient
-Stand on patients affected/weak side (unless they have weight bearing restrictions)
-Grasp under the gait belt w/ forearm supinated
-Other hand above or on nearest shoulder

101
Q

How can ambulation be progressed?

A

-Decrease level of assistance
-Able to meet modified surface challenges
-Improvement in impairments
-Increase in safety awareness

102
Q

What type of gait patterns are there with assistive devices?

A

-Four point
-Two point
-Three point

103
Q

What is a four point gait pattern?

A

-Used with 2 canes or 2 crutches
-Four points touch the floor in sequence (1-2-3-4) with three points always on the ground
-Crutch-opposite foot-crutch-opposite foot
-Used for people with poor balance
-Patient unable to lift more than one point off the ground safely
-Cannot use with non weight bearing

104
Q

What is a two point gait pattern?

A

-Used with 2 canes or 2 crutches
-Two points are on the ground at all times (1-2-1-2)
-Right crutch, left leg- left crutch, right leg
-Approximates a normal gait pattern
-Cannot be used for non weight bearing
-More stable than four point pattern

105
Q

What is a three point gait pattern?

A

-Three points touch the ground, not in sequence
-2 crutches or a walker
-During stance phase, 1 point is on the ground, during the other stance phase, two points are on the ground
-Used for non weight bearing, PWB, or WBAT
-Fast ambulation is possible
-High energy expenditure

106
Q

What is three point non weight bearing pattern?

A

-Patient able to bear full weight on one leg, but non weight bearing on the other leg
-Bilateral ambulation aids (crutches) or a walker

107
Q

What is three point partial weight bearing pattern?

A

-Crutches or a walker
-FWB on one LE and PWB on the other
-Walker or crutches advance simultaneously with the PWB LE, then the FWB LE is advanced

108
Q

What functional activities can be done with assistive devices?

A

-Stairs
-Curbs
-Rough or uneven surfaces
-Sitting in and standing from different types of chairs

109
Q

Where should the therapist stand when guarding a patient who is ascending stairs?

A

-Stand behind and slightly to the side of the patient
-Outside foot on stair where the patient is standing and inside foot on the step below
-Advance your feet up one step after the patient has advanced one step

110
Q

Where should the therapist stand when guarding a patient who is ascending stairs with a handrail and walker?

A

-Position walker along the side farthest from handrail with closed side of the walker towards the patient
-Front wheel of walker placed one step above the patient
-Patient grabs handrail and other hand holds middle point of the walker
-PT stands behind and slightly to the side of the patient

111
Q

Where should the therapist stand when guarding a patient who is descending stairs?

A

-Stand in front and to the side of the patient
-Outside foot on the step where the patient will be stepping
-Inside foot on the step that is one lower

112
Q

Where should the therapist stand when guarding a patient who is descending stairs with a handrail and walker?

A

-Walker should be on opposite side of the patient from the handrail w/ closed side towards the patient
-Front wheel of walker placed one step below the step where the patient is standing
-Rear feet of walker on the step where the patient is standing
-Weaker LE lowered first
-Therapist should stand in front of the patient

113
Q

Where should the therapist stand when a patient is ascending a curb?

A

-Stand behind and slightly to one side of the patient
-Pt steps onto the curb, then the therapist does

114
Q

How should a patient go up the curb with a walker or a cane?

A

-Walker or cane gets placed on the curb first
-Stronger LE steps up first and the pt elevates the body using UE and LE

115
Q

Where should the therapist stand when a patient is descending a curb?

A

-Stand in front of and slightly to one side of the patient
-Place outside foot on the curb
-Inside foot on the surface where the patient will step

116
Q

How should a patient descend a curb with a walker?

A

-Move to the edge of the curb
-Place walker down first
-Weaker LE down first and lower the body down with the UE and stronger LE

117
Q

How should a patient descend a curb with a cane?

A

-Step down simultaneously with weaker LE and cane
-Lower body with stronger LE

118
Q

Who is on the interdisciplinary team that is involved in discharge?

A

-Nursing
-Family/friends
-Rehab team (OT, PT, ST)
-Healing and spiritual services
-Physician
-Discharge planner/case manager (usually an RN)

119
Q

What are skilled services?

A

-Skills of a therapist are necessary to provide safe and effective interventions whose goal is to improve impairments of functional limitations
-Includes therapeutic exercise, training for transfers, wheelchair and assistive device training, ambulation with assistive device

120
Q

What are non-skilled services?

A

-Services that can be safely and effectively provided by non-skilled personnel or family members
-Includes use of hoyer lift, personal hygiene, ROM

121
Q

What are the key elements for clinical reasoning for acute care PT’s?

A

-Examination
-Evaluation
-Diagnosis
-Prognosis
-Intervention
-Outcomes
-Discharge planning
-Reassessment

122
Q

What are the elements of the examination in acute care?

A

-Pt history/chart review
-Systems review

123
Q

What are the objective measures that PT’s should evaluate in acute care?

A

-Aerobic capacity/endurance
-Anthropometric
-Assistive device need
-Balance
-Circulation
-CN testing
-Environmental factors
-Gait
-Integumentary integrity
-Joint integrity
-ROM
-Cognitive function
-Muscle strength
-Pain
-Posture
-Skeletal integrity
-RR
-ADL’s and IADL’s

124
Q

What is considered when making discharge recommendations?

A

-Structural impairments & activity limitations/participation restrictions
-Patient ability and willingness to participate
-Discharge environment
-Patient/family wants & needs
-Caregiver support
-Insurance
-Prognosis

125
Q

What does discharge to home health care look like?

A

-Wide range of health care services
-Services provided by nursing, OT, PT, ST
-Length of time can vary depending on diagnosis but is typically needed for 4-6 weeks

126
Q

What does discharge to a skilled nursing facility (SNF) look like?

A

-High level of medical care needed that must be provided by licensed professionals
-Average length of stay is 28 days
-Pt will receive one or more therapies per day (PT/OT/ST)
-Therapy length 1-2 hours per day

127
Q

What does discharge to sub-acute care look like?

A

-Needed for those with high level medical care needs such as intensive wound care, IV treatment, GI tube issues, long lasting stroke, critical illness
-Therapy lasts for 2 hours or less each day
-Frequent meetings with family and patient
-Goal is to return patients to their normal, daily environments with the highest level of strength and functionality possible

128
Q

What does discharge to acute rehab look like?

A

-For patients that will benefit from intensive multidisciplinary rehab
-Pts receive PT, OT, and ST as needed
-Average length of stay is 16 days
-Pt must participate in a minimum of 3 hours of therapy per day, 5 days a week

129
Q

What does discharge to long term acute care hospital (LTACH) look like?

A

-Patients that require extended hospitalization
-Average stay greater than 25 days

130
Q

What are the basic principles to consider when prescribing wheel chairs?

A

-Independence
-Function
-Setting
-Physical attributes of patient
-Prognosis
-Consult interdisciplinary team
-Patient resources

131
Q

What are specifications for home accessibility in wheel chairs?

A

-Standard hallway and door width must be 36”
-Doorways must be less than 24” deep
-Ramps need to have 1 inch of run for every inch of rise and be no more than 30 feet if it doesn’t have a level platform
-Lever door handles

132
Q

What should be considered when prescribing a patient a wheelchair that would be appropriate for that persons body type?

A

-Height
-Femur length
-Tibia length
-Width across trunk
-Width across hips

133
Q

What is the measurement for seat width, depth, and height?

A

-Trochanter to trochanter
-Posterior buttocks to popliteal fossa
-Ensure there is 2 inches in between front edge and popliteal fossa
-Popliteal fossa to sole of foot w/ shoes on

134
Q

What should be the height of the backrest of the wheelchair on the patient?

A

Backrest should be at the inferior angle of the scapula

135
Q

What should the armrest height be at for a wheelchair?

A

It should allow the elbows and shoulders to relax (not too high where someone has to shrug)

136
Q

What are the differences in frame for manual wheelchairs?

A

-Folding vs rigid
-Weight

137
Q

What are the differences in backrests for manual wheelchairs?

A

Fixed height vs adjustable

138
Q

What are the differences in the seats for manual wheelchairs?

A

-Solid vs sling
-Standard height vs hemi-height (17” from ground)

139
Q

What are the differences in tires for manual wheelchairs?

A

-Pneumatic (softer, more friction) vs solid
-Large castor (front wheels) vs small castor

140
Q

What are the differences in front rigging for manual wheelchairs?

A

-Rigid vs detachable, swing away, elevating
-Heel loops

141
Q

What are the differences in arm rests for manual wheelchairs?

A

-Fixed vs adjustable, removable, or swing away
-Desk length vs full length

142
Q

What are considerations for using cushions on wheelchairs?

A

-Posture for back support
-Comfort
-SKIN!!!!!
-Pressure relief
-Foam, gel, or air
-How much use it will get
-Graded for weight of user

143
Q

What material cushion is better for pressure relief?

A

Gel and air

144
Q

What are common types of cushions for wheelchairs?

A

-Foam flat
-Foam contoured
-Fluid
-Air filled
-Gel
-Hybrid (foam plus gel)

145
Q

What are advantages to foam flat cushions? What are disadvantages?

A

-Advantages: less expensive, stable
-Disadvantages: Frequent replacement, bottoms out, risk for pressure ulcers

146
Q

What are advantages to foam contoured cushions? What are disadvantages?

A

-Advantages: easy to use, inexpensive, maximize contact with patient
-Disadvantages: may interfere with transfers, risk for pressure ulcers

147
Q

What are advantages to fluid cushions? What are disadvantages?

A

-Advantages: decreases shearing forces as fluid moves with person
-Disadvantages: less stable, bottom out, requires maintenance to redistribute fluid

148
Q

What are advantages to air-filled cushions? What are disadvantages?

A

-Advantages: light weight, pressure distribution, multiple styles
-Disadvantages: may interfere with transfers, maintenance required, can puncture

149
Q

What are advantages to gel cushions? What are disadvantages?

A

-Advantages: stable with good pelvic control, molds to buttocks, more even pressure distribution, conducts heat away from skin
-Disadvantages: more expensive, heavy, may leak

150
Q

What are advantages to hybrid cushions? What are disadvantages?

A

-Advantages: combines materials for better control of seating variables (heat, pressure, etc.)
-Disadvantages: weakness of construction components

PHTH 508: Foundations of Patient Assessment (7 decks)

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