Lecture 2 Flashcards
In order to be rated a 6 (modified independent) a patient must …
a household exemption to this rule is
walk/wheel 150 feet and do a full flight of stairs
if their environment does not require those things and they can wheel/walk 50 feet and 4 stairs
New medicare functional tool (1-6)
1: dependent
2: substantial/maximal assistance
3: partial/moderate assistance
4: supervision or touching assistance
5: set up or clean assistance
6: independent
Goals of positioning (3)
safety, increasing stability or facilitate mobility, wound prevention
Depending on the condition. medicare will not cover
ulcers/wounds
Things to consider when positioning a patient (6)
1 explain what you are doing and why
2 have the patient participate
3 spinal alignment
4 body mechanics
5 set up environment
6 pay attention to surroundings
When doing short term positioning for sitting it is important to
keep knees in line with hips to relieve pressure on the glutes
Factors that may make people susceptible to pressure injuries (5)
1 inability to move independently
2 history of skin breakdown
3 incontinence
4 muscle atrophy
5 fragile skin
Contracture
causes?
A permanent tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff.
immobility, certain conditions, inactivity, injury
A few commonly seen contractures
elbow flexion, wrist flexion, ankle plantar flexion, scapular protraction
High risk areas for (2)
supine
prone
sidelying
sitting
su: occiput, ischial tuberosities
pr: shoulder, knees
sl: side of face, medial side of both knees
sit: ischial tuberosities, sacrum
How to prevent edema (2), cardiovascular issues (2), and pulmonary issues (1) in long term positions
e: ankle pumps and propping with pillows
c: gradual movement and monitor vital
p: frequent change of positions
What is a DVT
causes (3)
Deep vein thrombosis: occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs.
being sedentary for too long, obesity, inflammation
Checklist for long term positioning (5)
1 clear airway
2 good spinal alignment
3 minimized pressure over bony prominences
4 immobile extremities elevated
5 support trunk and extremities
Every _ hours in bed a patient should be rotated
Pressure relief every _ minutes in sitting
Always communicate with
2
15
the family regarding proper positioning
For a TKA the knees should …
always be straight (no pillow under the knee, risk on contracture)
