Final Exam Review

Question 1

Your patient is in his mid 30’s and has a L AKA as a result of an accident and is completing hot meal prep in the rehab kitchen. Identify two safety instructions you would provide to your patient below

Answer 1

He could be holding on to a quad cane or straight cane. Where is his device in relation to the oven and what instruction is he getting about when to put the hot dish down and then grab he cane.

Have a chair near by to take a rest brake

Take out area rug.

Question 2

What is the name of this infectious disease causes watery diarrhea or colitis, abdominal tenderness and nausea. The OT must wash their hands with SOAP and water as hand sanitizer is not effective in killing this organisms spores.

Answer 2

C-Diff

Question 3

This diagnosis results in intellectual and developmental disabilities that are chronic and before the age of 25 in 3 or more areas. Identify one of these areas?

Question 4

This diagnosis results in intellectual and developmental disabilities that are chronic and before the age of 25 in 3 or more areas. Identify one of these areas?

What are some assessments

Answer 4

Sensory specific assessments.
Barthel
Balance assessments
manual muscle testing

if you’re doing an assessment that is not standardized, it’s not designed for this population and scores may not reflect ability.

Question 5

This diagnosis results in intellectual and developmental disabilities that are chronic and before the age of 25 in 3 or more areas. Identify one of these areas?

What is the treatment focus

Answer 5

• Community mobility
• Safety and problem solving
• sensory system and how it impacts behaviors - what makes them calmer
• want them to be as independent as possible with basic self care needs. Toileting and eating.

Question 6

Your patient has a graft taken from their inner arm to the dorsum of the hand. What type of graft is this and what is the time frame for which OT can likely begin to mobilize the hand and wrist.

Answer 6

autograft
7-10 days of immobilization. there will most likely be sutures. once we get clearance we’ll do gentle ROM and gentle PROM at end range.

Question 7

Waht is the name of the splint we might use for the grafted hand

Answer 7

burn hand splint (check that this is correct)
70 MP flex
wrist is at 30
fingers are straight.
foam under first two fingers.

Question 8

Identify 2 qualifying conditions for OT services based on cancer related impairments

Answer 8

• fatigue
• neuropathy - caused by chemo and radiation
• Lymphodema - swelling. need to know who to refer to. PT and OT’s can be lymphodema certified. \
• cognitive decline - chemo brain.
• infection
• balance and fall risk
• decreased ROM and decreased fine motor skills.

Question 9

What is a potentially reversible form of dementia?

Answer 9

drug toxicity or a metabolic disturbance. infection, people who are severely diabetic can become confused.

Question 10

What is the role of Occupation with this population, dementia

Answer 10

Keep goals very short. directing it towards care givers. enhancing safety, maximizing environmental safety. may be instructing caregivers to perform ADLs safely.

Question 11

If the patient can’t recall precautions they go to where

Answer 11

subacute care so they can have around the clock care

Question 12

What can we do with ADLs with Dementia who has this as a comorbidities or primary diagnosis

Answer 12

simplified tasks, simplifying instructions. keeping it content specific. get down to the room when it’s breakfast and work on feeding when it’s actually time to eat. Toilet when they actually have to go to the bathroom. work within their natural timeframe.

Question 13

If a person with dementia gets dementia what do you do

Answer 13

look at the mood and see what the cause is. Are they afraid? can we address it? can we walk it back and explain in a calm way? redirecting.

Question 14

WHAT ARE THE LUMBAR LAMINECTOMY PRECAUTIONS?

Answer 14

No bending, lifting or twisting. 4-12 weeks. or listed by the surgeon. No driving until medically cleared. no housework. log rolling.

Question 15

what is a lumbar laminectomu

Answer 15

they remove the lamina of the spine. they do what they can to maximize functioning.

Question 16

Pain, numbness or tingling that occurs mainly in the cervical or lumbar regions is known as what?

Answer 16

redicuopathy (look this up)

Question 17

what do we do about redicuopathy?

Answer 17

how to recruit different muscle groups. address other issues that they have like shoulder pain.

Question 18

What burn depths typically require OT intervention ?

Answer 18

partial thickness only if it gets infected
deep partial or second degree is where we get patients for OT. Typically grafted or dealt with surgically.
Full thickness typically require surgical care and or amputation.

Question 19

What is our approach with burn rehab?

Answer 19

Stretching, splinting and positioning.

trying to prevent contractures. Try to see them 2x/day even in acute care.

Question 20

is the superficial partial thickness and deep partial thickness both second degree

Answer 20

yes. the matter is how much of the tissue is damaged

Question 21

What do we do for patients who are in inpatient rehab for burns? what is our role there?

Answer 21

Get them out of bed, fitting them for compression stocking. scar reductions, maximizing their range of motion, self care. as scar closes we work with a vendor to order compression garments.

basically we’re trying to get them to have their best outcome.

Question 22

What is a common deformity of the hand following a burn and what type of splint is used to treat it?

Answer 22

claw hand. if they aren’t wearing splints.

Question 23

typically with bilateral hand burns how do we splint?

Answer 23

alternating each hand. maybe split half the day or rotate at night time

Question 24

Identify 2 areas of self- management of diabetes that OT may address with their clients as they are assisting clients in developing new habits and routines?

Answer 24

skin integrity. promote skin checks. Wound care or wound prevention. making sure feet are clean and dry, wear proper shoes.

strategies for healthy meal prep. have them prep for multiple meals. talk about appliances

Medication management - schedule and routines.

Question 25

Identify 2 barriers of obesity to occupational participation as discussed in class?

Answer 25

difficulty pacing themselves.

pain and or arthritis

social anxiety - looking for strategies and ideas for how to get that person to be comfortable in social situations. offer mindfulness.

environment - seating and space, equipment in the bathroom.

exhaustion during physical activity

Question 26

What is a feature of RA that impacts occupational engagement differently than OA?

Answer 26

It’s systemic autoimmune disease and affects both sides or all areas of the body. OA is some joints and specific

Question 27

How does treatment approach differ with OA vs RA

Answer 27

RA will be more whole body including fatigue. What exasperates symptoms, lifestyle redesign.
OA is more how to accomodate that one joint.

Question 28

What spinal cord level would you expect full hand function to be intact?

Answer 28

T1

Question 29

With a T1 injury, you do an upper quarter screen and it looks good, would you pick a functional dexterity of bocks and blocks or 9hole?

Answer 29

Lean towards no. you want to be efficient with your testing. if you can see by observation that their UQS looks good.

We could do pinch and strength.

Question 30

What is the difference between orthostatic hypotension and autonomic dysreflexia?

Answer 30

Orthostatic hypertension is a decrease in blood pressure when changing positions. the person will feel light headed and possibly pass out.

autonomic dysreflexia is from a noxious stimuli from clothing or kink in the catheter. overactivity of the autonomic nervous system.

Question 31

How do we treat orthostatic hypertension

Answer 31

head lower than the heart. tilting wheelchair back. if their on mat table in long sit, lie them back down, elevate feet and the legs. call for nurse.

Question 32

What’s our approach with autonomic dysreflexia

Answer 32

don’t lie them down. if they have a catheter check the tubing. if they have a brace or corsett, check to make sure nothing is pinching. check clothing and smooth it out.

Question 33

does authorstaic hypertension and autonomic dysreflexia get better

Answer 33

yes over time but it could still happen.

Question 34

What is community mobility and what is the OT role?

Answer 34

Make sure people have options. give them schedules for star bus or medical vans. help them get on the bus or subway.

Question 35

our role as a generalist with driving

Answer 35

know who to refer them to

work on safety, self management, ROM, cognition, work on scanning and safe strategies.

Question 36

What is a performance based assessment?

Answer 36

completing a task like Barthel, SCIM, kitchen assessment

Question 37

What are examples used in OT?

Answer 37

Barthel, SCIM, kitchen assessment

Question 38

When would you choose performance based over a screen or more traditional assessment?

Question 39

Precuations

LE ORTHOPEDIC
CARDIAC
ABDOMINAL
STERNAL
BACK SURGERY
BURN REHAB

Answer 39

Know these
hip -
knee - no precautions. try to encourage them to bend that knee and get back to full range of motion.