Module 5 TBI

Question 1

When to use Glasgow Coma scale (GCS)

Answer 1

for TBI to categorized the severity as severe, moderate, or mile

Question 2

What are the 3 response score on the GCS

Answer 2

motor response, verbal response, and eye opening

Question 3

Severe GCS

Answer 3

8 or less

Question 4

Moderates GCS

Answer 4

btw 9 -12

Question 5

Mild GCS

Answer 5

13 - 15

Question 6

Mild TBI

Answer 6

LOC - 0-30min
AOC - brief > 24hr
PTA - 0-1 day
GCS - 13-15
neuro image - normal

Question 7

Moderate TBI

Answer 7

LOC - >30min and <24hr
AOC - >24 hr
PTA - >1 and <7 days
GCS - 9-12
Neuro image - normal or abnormal

Question 8

Severe TBI

Answer 8

LOC - >24hr
AOC - >24hr
PTA - >7 days
GCS - <9
Neuro imaging - normal or abnormal

Question 9

Post-traumatic amnesia (PTA)

Answer 9

length of time btw the injury and the time at which the pt is able to consistently remember ongoing events, and is also an important factor in predicting recovery

Question 10

Decorticate rigidity

Answer 10

UE are in flexed posture and the LE are extended

Question 11

Decerebrate rigidity

Answer 11

both UE and LE are postilion in extension

Question 12

Coma Recovery Scale - Revised

Answer 12

recommended to assess pt with disordered consciousness

Question 13

CRS-R subscales

Answer 13

auditory, visual, motor, oromotor, communication, and arousal

Question 14

Disorders of conscious Scale

Answer 14

measures arousal and neurobehavioral recovery in pt with disorders of consciousness

Question 15

DOCS tests

Answer 15

social knowledge; taste/swallow; olfactory function, proprioception; tactile sensation; auditory function; visual function

Question 16

LOCF - I. NO Response

Answer 16

pt appears to be in a deep sleep and is completely unresponsive to any stimuli

Question 17

LOCF - II. Generalized Response

Answer 17

pt. reacts inconsistently and nonpurposefully to stimuli in a nonspecific manner. Responses are limited and often the same regardless of stimulus presented. Responses may be physiological changes, gross body movements, and/or vocalization

Question 18

LOCF - III. Localized Response

Answer 18

pt. reacts specifically but inconsistently to stimuli. Responses are directly related to the type of stimulus presented. May follow simple commands such as closing eyes or squeezing hand in an inconsistent, delayed manner

Question 19

LOCF - IV. Confused-Agitated

Answer 19

pt. is in a heightened state of activity. Behavior is bizarre and nonpurposeful relative to immediate environment. Does not discriminate among persons or objects, is unable to cooperate directly with treatment efforts. Verbalizations frequently are incoherent and/or inappropriate to the environment; confabulation may be present. Gross attention to environment is very brief; selective attention is often nonexistent. pt lacks short and long term recall

Question 20

LOCF - V. Confused-Inappropiate

Answer 20

pt. is able to respond simple commands fairly consistently. However, with increased complexity of commands or lack of any external structure, responses are nonpurposeful, random, or fragmented. Demonstrates gross attention to the environment but is highly distractible and lacks ability to focus attention on a specific task. With structure, may be able to converse on a social automatic level for short periods of time. Verbalization is often inappropriate and confabulatory. Memory is severely impaired; often shows innapropiate use of objects; may perform previously learned task with structure but is unable to learn new info.

Question 21

LOCF - VI. Confused-Appropriate

Answer 21

pt. shows goal-directed behavior but is dependent on external input or direction. Follows simple directions consistently and shows carryover for releamed tasks such as self care. Responses may be incorrect due to memory problems, but they are appropriate to the situation. Past memories show more depth and detail than recent memory.

Question 22

LOCF - VII. Automatic - Appropriate

Answer 22

pt. appears appropriate and oriented within the hospital and home settings; goes through daily routine automatically but frequently robot-like. Pt. shows minimal to no confusion and has shallow recall of activities. shows carryover for new learning but at a decreased rate. With structure is able to initiate social or recreational activities; judgement remains impaired

Question 23

LOCF - VIII. Purposeful-Appropriate

Answer 23

pt. is able to recall and integrate past and recent events and is aware of and responsive to environment. Shows carryover for new learning and needs no supervision once activities are learned. May continue to show a decreased ability relative to premorbid abilities, abstract reasoning, tolerance for stress, and judgement in emergencies or unusual circumstances

Question 24

Sensory Stimulation

Answer 24

an intervention to increase the level of arousal and elicit movement in individuals with low levels of arousal

Question 24

Serial casting

Answer 24

maintain or improve ROM

Question 25

Special considerations for confused and agitated pt

Answer 25

consistent; expect no carryover; model calm behavior; expect egocentrically; be flexible; safety; environment