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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
gait sequencing
move device first then weaker leg then strong leg if unilateral, device on side of strong leg
26
pre for ambulation
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
27
which leg do questions refernece?
right leg unless left is specified
28
how many periods of double support
2 10% periods
29
step length
right to left foot
30
stride legnth
right to left to right
31
step width
right heel to left heel
32
what happens when demands increase?
keep foot under COG narrower step width
33
foot angle
from heel to 2nd toe
34
length of track to test gait speed
3m acceleration 5m test 2m deceleration max, preferred, both
35
normative values
step length - 28in stride length - 56 in foot angle - 5-7 degrees step width - 3.5in gait speed - 2.7-3.1 mph
36
initial contact
weight acceptance stance phase (heel strike) moment in time
37
loading response
weight acceptance stance phase (foot flat) ends: opposite toe off
38
midstance
single limb support stance phase ends: opposite heel off
39
terminal stance
SLS stance (heel off) ends: opposite heel strike
40
pre swing
limb advancement stance ends: toe off
41
initial swing
LA swing phase ends: feet adjacent
42
mid swing
LA swing ends: tibia vertical (malleoli equal)
43
terminal swing
LA swing ends: next initial contact
44
plan of care
what you will do to address problem plan for entire treatment in your setting
45
POC includes
ST goals LT goals intervention plan discharge plan
46
factors influencing POC and prognosis
comorbidities medical complexities complicating factors cognitive status / psychological issues social and economic factors
47
pt care goals must be ...
... functional measureable patient specific
48
why write goals
justify therapy helps to determine treatments set priorities assist with monitoring cost and effectiveness communicate motivate
49
intervention plan may include
modalities amb transfer and bed mobility training exercises neuromuscular re-education home program pt education include amount, frequency, and duration of services
50
discharge plan
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
origins of professional behaviors
educators in med, law, pharm, vet med
52
clinical decorum
pt safety clothing/shoes hair jewelry hygiene
53
potential errors in clinical decorum
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
accidents occur when
careless inadequately trained inattentive excessively busy
55
nagi model
active pathology impairment functional limitation disability
56
WHO
disease impairment disability handicap
57
ICF model
impairment activity limitation participation restrictions disability
58
difference about ICF
illustrates the person in his or her world language places emphasis on function rather than condition
59
body functions
physiological functions of body systems
60
body structures
anatomical body parts
61
activity
execution of task
62
participation
involvement in life situation
63
environmental factors
environment where person conducts life
64
personal factors
demographics
65
ABCD's of goal writing
Audience - who exhibits skill Behavior Condition - what circumstances Degree - how well done
66
SMART goals
specific measurable attainable realistic timely
67
who what how much why
who - focus what - unit of measure how much - degree of improvement you hope for why - how does this change relate to pt function
68
short term goal
most common is ~1 week my be as long as 2-3 weeks
69
long term goal
total duration of plan of care describes final product
70
tips for writing goals
pt problem list pt functional deficits start with LTG and make STG to reach LTG list in order of priority
71
how does an AD help?
expand BOS decrease WB if needed permit/increase mobility and independence potentially decrease pain
72
greatest to least stability
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
considerations when choosing an AD
diagnosis prognosis WB cognitive status need for stability/support vs mobility pt assessment - general condition, strength, ROM, balance, stability, coordination, sensation
74
how to fit a device
ideally, pt standing straight up with feet flat on floor in proper footwear
75
fitting a cane or walker
ulnar styloid at hand grip elbow angle 20-25 degrees
76
fitting axillary crutches
2 inches below axilla 2 inches out, 4 forward elbow angle 20-25 degrees
77
fitting forearm crutches
2 inches out, 4 forward elbow angle 20-25 degrees cuff 1-1.5 inches below elbow
78
common errors when fitting a device
if pt wrist/arm is flexed or extended footwear not considered crutches fitted without tripod position
79
verbal communication
vocal or written 7%
80
nonverbal communication
body language, gestures, ect 55%
81
paralinguistics
pitch, pace 38%
82
sympathy
agreement in feeling try to move on pity
83
empathy
better relate vicarious participation support emotions understand their perspective
84
why communicate with physician
enhance pt care enhance pt as profession
85
when communicate with physician
no news is good news before pt returns to physician per protocol
86
eval and treat
use professional judgement in treatment
87
peer communication
understand each profession teritorial dispute dominance issue
88
barriers in communicating with children
ego rigidity semi logical literal concerned about peer opinions
89
barriers to communicating with pt families
high emotions multiple sources of info opinions differ from pt
90
barriers to communicating with elderly
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
dementia communication
simple commands yes/no repetition short sentences touch cues call by name move on if frustrated say goodbye to end decrease extraneous conversation
92
stressors to alzheimers
fatigue change in routine change in caregiver stimuli demands exceeding functional capacity physical stressors - pain - discomfort - infection - illness - depression
93
communicating with alzheimers
environment orderly clear, concise repetition regular schedule same therapist similar exercise program support group for family
94
communicating with parkinsons
give time to respond clear, concise don't repeat quickly demonstrate instruct with functional activities
95
when ascending stairs
up with the good strong side next to railing strong > weak > device
96
how to guard ascending
posteriolateral stagger step hand on gait belt static when pt is moving
97
when descending stairs
down with bad strong side next to railing device > weak > strong
98
how to guard descending
in front of pt stagger gait belt static

summer 2024 (19 decks)

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