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summer 2024 > foundations final > Flashcards

foundations final Flashcards

1
Q

seating/mobility goals

A

maximize function/independence
normalize tone/decrease spasticity
minimize orthopedic deformity
manage/prevent pressure sores
enhance QOL
improve self image
increase comfort

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2
Q

standard wheelchair dimensions for adults

A

18in in width
16 in seat depth
20 in seat height

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3
Q

types of wheelchairs

A

semi-reclining - 30 degrees extension
reclining - fully horizontal may be achieved
- tilt-in-space chair
externally powered chair (electric)
sports chair
lightweight/ultralight wheelchair
standard wheelchair
outdoor chairs
adaptive controls

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4
Q

seat height measurement

A

heel of shoe to popliteal fold
add 2 inches unless using a seat cushion

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5
Q

leg length

A

minimum clearance between floor and footplate is 2 inches
measured from lowest part on bottom of footplate

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6
Q

seat depth

A

posterior buttock to posterior aspect of lower leg on popliteal fossa
subtract 2 inches

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7
Q

seat width

A

hip width at widest part
add 2 inches

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8
Q

back height

A

measure from seat of chair to axilla
subtract 4 inches
measure with seat cushion if applicable

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9
Q

arm rest height

A

from seat of chair to olecranon process with elbow flexed 90 degrees
add 1 inch
measure with seat cushion if applicable

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10
Q

purpose cushions

A

improves pelvic position
relieves pressure
types: contoured foam, custom molded, air cushion

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11
Q

common diagnoses for adults

A

spinal cord injury
TBI
neurodegenerative diseases
ALS
muscular dystrophy
multiple sclerosis
CVA
CP

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12
Q

common diagnoses for children

A

CP
developmental delay
spina bifida/myelomeningocele
muscular dystrophy/SMA
hydrocephalus/microcephalus

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13
Q

stance

A

leg in contact with floor or supporting surface
60% in walking
40% in running

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14
Q

swing

A

leg not in contact with floor
40% in walking
60% in running

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15
Q

NWB

A

non weight bearing

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16
Q

TTWB

A

toe touch weight bearing

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17
Q

PWB

A

partial weight bearing (% or lbs)

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18
Q

WBAT

A

weight bearing as tolerated

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19
Q

four point gait

A

bilateral ambulation aid
RA, LF, LA, RF

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20
Q

three point

A

one leg NWB
walker or bilateral amb aid
R&LA, F

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21
Q

two point

A

bilateral amb aid
RA&LF, LA&RF
TWO MOVNG TOGETHER

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22
Q

three point one

A

PWB
bilateral amb aid
injured foot moves with AD, strong foot

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23
Q

modified four point

A

one amb aid
hemi
LF, RF, RA

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24
Q

modified two point

A

one amb aid
hemi
RF, LF&RA

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25
Q

gait sequencing

A

move device first
then weaker leg
then strong leg
if unilateral, device on side of strong leg

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26
Q

pre for ambulation

A

review medical chart
assess, examine, evaluate limitations and capabilities
what are ambulation goals
determine proper equipment
determine appropriate pattern
explain process to patient
obtain consent
prepare pt and environment
ensure proper footwear
apply gait belt
confirm proper fit of device
explain and demo pattern to pt
guard using gait belt and pt’s shoulder and trunk

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27
Q

which leg do questions refernece?

A

right leg unless left is specified

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28
Q

how many periods of double support

A

2 10% periods

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29
Q

step length

A

right to left foot

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30
Q

stride legnth

A

right to left to right

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31
Q

step width

A

right heel to left heel

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32
Q

what happens when demands increase?

A

keep foot under COG
narrower step width

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33
Q

foot angle

A

from heel to 2nd toe

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34
Q

length of track to test gait speed

A

3m acceleration
5m test
2m deceleration

max, preferred, both

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35
Q

normative values

A

step length - 28in
stride length - 56 in
foot angle - 5-7 degrees
step width - 3.5in
gait speed - 2.7-3.1 mph

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36
Q

initial contact

A

weight acceptance
stance phase
(heel strike)
moment in time

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37
Q

loading response

A

weight acceptance
stance phase
(foot flat)
ends: opposite toe off

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38
Q

midstance

A

single limb support
stance phase
ends: opposite heel off

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39
Q

terminal stance

A

SLS
stance
(heel off)
ends: opposite heel strike

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40
Q

pre swing

A

limb advancement
stance
ends: toe off

41
Q

initial swing

A

LA
swing phase
ends: feet adjacent

42
Q

mid swing

A

LA
swing
ends: tibia vertical (malleoli equal)

43
Q

terminal swing

A

LA
swing
ends: next initial contact

44
Q

plan of care

A

what you will do to address problem
plan for entire treatment in your setting

45
Q

POC includes

A

ST goals
LT goals
intervention plan
discharge plan

46
Q

factors influencing POC and prognosis

A

comorbidities
medical complexities
complicating factors
cognitive status / psychological issues
social and economic factors

47
Q

pt care goals must be …

A

… functional
measureable
patient specific

48
Q

why write goals

A

justify therapy
helps to determine treatments
set priorities
assist with monitoring cost and effectiveness
communicate
motivate

49
Q

intervention plan may include

A

modalities
amb
transfer and bed mobility training
exercises
neuromuscular re-education
home program
pt education
include amount, frequency, and duration of services

50
Q

discharge plan

A

what pt will do to continue progress one PT is done
directed from STG and LTG
may include
- exercises
- ADs if needed
- referral to other services if needed

51
Q

origins of professional behaviors

A

educators in med, law, pharm, vet med

52
Q

clinical decorum

A

pt safety
clothing/shoes
hair
jewelry
hygiene

53
Q

potential errors in clinical decorum

A

medication error
surgery/procedure on wrong part
errors in performance of hazardous activities
misdiagnosis
selection of inappropriate treatment
nosocomial infection
production pressures
fatigue and sleep deprivation
stress
human factors

54
Q

accidents occur when

A

careless
inadequately trained
inattentive
excessively busy

55
Q

nagi model

A

active pathology
impairment
functional limitation
disability

56
Q

WHO

A

disease
impairment
disability
handicap

57
Q

ICF model

A

impairment
activity limitation
participation restrictions
disability

58
Q

difference about ICF

A

illustrates the person in his or her world
language places emphasis on function rather than condition

59
Q

body functions

A

physiological functions of body systems

60
Q

body structures

A

anatomical body parts

61
Q

activity

A

execution of task

62
Q

participation

A

involvement in life situation

63
Q

environmental factors

A

environment where person conducts life

64
Q

personal factors

A

demographics

65
Q

ABCD’s of goal writing

A

Audience - who exhibits skill
Behavior
Condition - what circumstances
Degree - how well done

66
Q

SMART goals

A

specific
measurable
attainable
realistic
timely

67
Q

who what how much why

A

who - focus
what - unit of measure
how much - degree of improvement you hope for
why - how does this change relate to pt function

68
Q

short term goal

A

most common is ~1 week
my be as long as 2-3 weeks

69
Q

long term goal

A

total duration of plan of care
describes final product

70
Q

tips for writing goals

A

pt problem list
pt functional deficits
start with LTG and make STG to reach LTG
list in order of priority

71
Q

how does an AD help?

A

expand BOS
decrease WB if needed
permit/increase mobility and independence
potentially decrease pain

72
Q

greatest to least stability

A

parallel bars
standard walker - bilateral connected
FWW
4WW
axillary crutches - bilateral disconnected
forearm crutches
2 canes
single crutch - unilateral
hemiwalker
quad cane
single point cane

73
Q

considerations when choosing an AD

A

diagnosis
prognosis
WB
cognitive status
need for stability/support vs mobility
pt assessment - general condition, strength, ROM, balance, stability, coordination, sensation

74
Q

how to fit a device

A

ideally, pt standing straight up with feet flat on floor in proper footwear

75
Q

fitting a cane or walker

A

ulnar styloid at hand grip
elbow angle 20-25 degrees

76
Q

fitting axillary crutches

A

2 inches below axilla
2 inches out, 4 forward
elbow angle 20-25 degrees

77
Q

fitting forearm crutches

A

2 inches out, 4 forward
elbow angle 20-25 degrees
cuff 1-1.5 inches below elbow

78
Q

common errors when fitting a device

A

if pt wrist/arm is flexed or extended
footwear not considered
crutches fitted without tripod position

79
Q

verbal communication

A

vocal or written
7%

80
Q

nonverbal communication

A

body language, gestures, ect
55%

81
Q

paralinguistics

A

pitch, pace
38%

82
Q

sympathy

A

agreement in feeling
try to move on
pity

83
Q

empathy

A

better
relate
vicarious participation
support emotions
understand their perspective

84
Q

why communicate with physician

A

enhance pt care
enhance pt as profession

85
Q

when communicate with physician

A

no news is good news
before pt returns to physician
per protocol

86
Q

eval and treat

A

use professional judgement in treatment

87
Q

peer communication

A

understand each profession
teritorial dispute
dominance issue

88
Q

barriers in communicating with children

A

ego
rigidity
semi logical
literal
concerned about peer opinions

89
Q

barriers to communicating with pt families

A

high emotions
multiple sources of info
opinions differ from pt

90
Q

barriers to communicating with elderly

A

reluctant to ask questions
don’t fully report complaints
doesn’t feel responsible for own health
thinks HCP too young or inexperienced
hearing/vision loss

91
Q

dementia communication

A

simple commands
yes/no
repetition
short sentences
touch cues
call by name
move on if frustrated
say goodbye to end
decrease extraneous conversation

92
Q

stressors to alzheimers

A

fatigue
change in routine
change in caregiver
stimuli
demands exceeding functional capacity
physical stressors
- pain
- discomfort
- infection
- illness
- depression

93
Q

communicating with alzheimers

A

environment orderly
clear, concise
repetition
regular schedule
same therapist
similar exercise program
support group for family

94
Q

communicating with parkinsons

A

give time to respond
clear, concise
don’t repeat quickly
demonstrate
instruct with functional activities

95
Q

when ascending stairs

A

up with the good
strong side next to railing
strong > weak > device

96
Q

how to guard ascending

A

posteriolateral
stagger step
hand on gait belt
static when pt is moving

97
Q

when descending stairs

A

down with bad
strong side next to railing
device > weak > strong

98
Q

how to guard descending

A

in front of pt
stagger
gait belt
static

summer 2024 (9 decks)

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