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THE BOARDS > GI, renal, endocrine, immunological, integumentary systems > Flashcards

GI, renal, endocrine, immunological, integumentary systems Flashcards

1
Q

conditions that impact swallowing

A
  • facial paralysis
  • praxis/motor planning deficits
  • sensory impairment in oral cavity
  • weakness of tongue and pharynx
  • vocal cord paralysis
  • clinical aspiration
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2
Q

swallowing dysfunction observation

A
  • person coughs during or after drinking water
  • face changes color
  • sometimes can visualize the obstruction and remove it
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3
Q

aspiration

A

needs immediate action!
- heimlich maneuver
- BLS if LOC

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4
Q

bedside swallowing eval

A
  • assess level of alertness, ability to follow directions, level of awareness, orientation to activity
  • assess sensory and motor components of swallowing
  • assess ability to manage own secretions
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5
Q

Modified barium swallow study (MBSS)

A
  • person upright on radiology table
  • needs sitting balance
  • administer trial boluses of mixed food consistences laced with barium
  • video records moving x-ray of swallow
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6
Q

Fiberoptic endoscopic esophageal swallow (FEES)

A
  • food consistences are laced with green food coloring
  • given a variety of consistencies to swallow
  • endoscopic catheter with mini video camera
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7
Q

OT eval and intervention with swallowing disorders

A

should include collaboration with the person (and SLP, dietitians, nurses, fam members)
consider their roles socially and with family around eating

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8
Q

small bowel obstruction

A
  • from scar tissue, radiation, tumor
  • surgical treatment
  • rehab: self-care aspects of stoma care must be addressed (consider cog status)
  • abdominal precautions
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9
Q

neurogenic bowel

A
  • sympathetic nerve impairment, usually with SCI above T-6
  • loss of control of anal sphincter
  • sensory loss –> lack of awareness of feces in the bowel
  • flaccidity of muscles
    autonomic dysreflexia can occur*
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10
Q

kidney disease - risk factors

A
  • diabetes
  • hypertension
  • systemic lupus erythmatosus
  • dehydration, smoking, alcohol, medications, physical inactivity, salt and sugar
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11
Q

stages of kidney disease

A

1-5, worsening of glomerular filtration rate
Medical management during each stage:
Stage 1. prevention of progression
Stage 2. management of health conditions
Stage 3. management of anemia and bone loss
Stage 4. education of further management (dialysis)
Stage 5. for life to be sustained, must have dialysis or kidney transplant

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12
Q

s/s chronic kidney disease

A

vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in urination output and color, muscle cramps, swelling, persistent itching, HTN

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13
Q

stress incontinence

A

after having children, morbid obesity, weakening of musculature with normal aging
- kegels/strengthen pelvic floor
- timed routines for emptying bladder to prevent spillage
- medications

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14
Q

cancer risk factors and prevention

A
  • hereditary
  • envrionmental
  • habit or lifestyle related
  • screening tests
  • avoid environmental contributing factors
  • avoid/change contributory habits
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15
Q

cancer stages

A

Stage 1: tumor present, no perceived spread, good prognosis, operable
Stage 2: localized spread of the tumor, limited and usually responds well to tx
Stage 3: tumor spread to other organs in the body, some can be operated, including lymphatics
Stage 4: inoperable primary lesion, multiple metastases

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16
Q

scleroderma

A
  • rheumatic, connective tissue disease associated with impaired immune response
  • vascular, fibrotic, and autoimmune

2 types: limited (skin involvement with good prognosis) or systemic (internal organs, life threatening - lesions can later occur in spine/brain)

17
Q

CREST syndrome

A

Calcinosis (calcium in the skin)
Raynaud’s
Esophageal dysfunction
Sclerodactyly of fingers and toes
Telangiectasis (red spots)

18
Q

Acquired Immunodeficiency Syndrome (AIDS)

A

infection from HIV
- attacks the lymphatic system
- 4 stages: acute, asymptomatic, symptomatic, advanced (AIDS)
- fatigue, neurological, ADL impairments, sensory, vision
*Protease inhibitors work to suppress the viral load; must be taken consistently on time or effectiveness is lost

19
Q

hepatitis

A

viral infection (has a prev vaccine)
risk factors: type A - contaminated seafood, types B&C - body and blood exposure
*contact precautions for healthcare workers

20
Q

MRSA

A

mild skin infections or more serious infections in surgical wounds/skin
risk factors: weakened immune system, being in the hospital, close quarters, skin contact from someone else

antibiotic tx
*contact precautions for healthcare workers

21
Q

rehab for immunological system disorders

A
  • preventative, restorative, supportive, and/or palliative
  • psychological disorders may develop
  • counsel about screening, personal goals for lifestyle changes
  • activity level problems: self-care (adaptations and energy conservation), work modifications, rest/sleep
22
Q

example intervention for scleroderma

A
  • alter grasp/pinch patterns and level of upper extremity demand
  • alter size of feeding utensils and tooth brushes to accommodate decreased ability to open mouth
  • prevent shearing forces on skin during specific personal ADL tasks
23
Q

acute hospitalization phase

A
  • early mobilization
  • preservation of function
  • positioning
  • psych/emotional support
  • prevent long term disability
24
Q

inpatient rehab phase

A
  • eval and restoration of functional abilities
  • ADLs, IADLs, energy conservation, work simplification
  • use of Pizzi Assessment of Productive Living (PAPL) for adults with HIV
  • activity/exercise tolerance
  • home care and goals
  • quality of life, roles
  • community based care (return to work, school)
25
Q

diabetes

A

type 1: insulin dependent (autoimmune, genetic)
type 2: non-insulin dependent, 95% of cases (old age, obesity, fam history, impaired glucose tolerance, physical inactivity)
gestational: during pregnancy, usually resolves but may get type 2 later in life

26
Q

hypoglycemic symptoms

A

*metabolic emergency
- vagueness, dizziness, tachycardia, pallor, weakness, diaphoresis, seizures, coma
- if the person is conscious, immediately provide carbohydrates in the form of hard candy, fruit juice, or honey
- unconscious: call for emergency medical care

27
Q

ketoacidosis signs

A
  • dehydration, rapid and weak pulse, acetone breath
    hyperosmolar coma signs: stupor, thirst, polyuria, neurologic abnormalities
    *call for emergency med services immediately - IV fluids and insulin are required
28
Q

lyme disease

A

impairs the immune response and affects the neurological and orthopedic systems

tx: antibiotics
rehab: treat joint pain and swelling, arthritic flares, nervous system abnormalities and pain
bell’s palsy

29
Q

heat stroke

A

characterized by hot, dry red skin, body temp higher than 104, slow and deep respiration, tachycardia, dilated pupils, confusion, progressing to seizures an possible LOC

while waiting for EMS, try to lower their body temp (cooler area, ice packs on arterial pressure points)

30
Q

heat cramps and exhaustion

A

usually do not require hospitalization

  • loosen clothing
  • lay in cool place
  • replace fluid with fruit juice/balanced electrolyte drinks
  • massage muscles if cramps are severe
  • IV fusions and O2 may be needed if severe symptoms
31
Q

Poor tongue control

A

can’t make a bolus, will pocket food in cheeks

32
Q

Hyperactive gag

A

put food on tip of tongue

33
Q

Bite reflex

A

want to inhibit – put pressure on bottom of mouth (or up/down side/side never circular)

34
Q

hardest thing to swallow

A

THIN LIQUIDS. Someone with dysphagia should not be given water

35
Q

Thromboangiitis obliterans: Buerger’s disease

A

diminished temperature sense, paresthesia, pain, cold extremities (common in young men who smoke) – at risk for burns – water temp too hot

36
Q

raynauds tx

A

dressing in layers of clothing for neutral warmth
biofeedback, guided imagery to concentrate on improving distal circulation
encourage skin inspection
activity modifications to prevent trauma to fingers and toes

37
Q

contracture tx in scleroderma

A

splinting at optimal resting length for hands/wrists to attempt to slow progressive dev

silicone gel in palms of hands

electrical vibration (muffled) to stimulate rapidly adapting nerve fibers and decrease burning sensation

THE BOARDS (31 decks)

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