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Ortho Rehab Flashcards

1
Q

why is it important to know the stages of tissue healing?

A

avoid excessive stress and strain
ensures tissues are challenged during recovery to encourage optimal return to function

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2
Q

why must tissues be challenged during recovery?

A

encourages optimal return to tissue function

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3
Q

what are the stages of healing?

A

post-operative
regeneration
remodelling

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4
Q

when does the post operative healing phase occur?

A

24-48 hours post op

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5
Q

when does the regeneration healing phase occur?

A

day 5 - week 3

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6
Q

when does the remodelling phase of healing occur?

A

6 weeks to 1 year

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7
Q

are the stages of healing the same for bone and soft tissue?

A

yes

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8
Q

what is experienced by the patient during the post op healing period?

A

pain
oedema
beginning of tissue healing

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9
Q

what is involved in the treatment of patients during the post operative healing phase?

A

reduction of pain through multimodal analgesia
cryotherapy
rest
easy movement only

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10
Q

what is the purpose of cryotherapy in wound healing?

A

vasoconstriction and reduction of oedema

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11
Q

what is treatment is critical during the post operative healing phase?

A

rest
analgesia

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12
Q

what movement should the patient be doing in the post op period?

A

easy movement only (non-weight bearing or supported weight bearing)

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13
Q

what is happening to the patient surgical site during the regeneration phase of healing?

A

still fragile
new collagen fibres beginning to form
callus forming around bone

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14
Q

why is relative rest still needed in the regeneration healing phase?

A

area is still fragile

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15
Q

what is involved in patient treatment during the regeneration phase of healing?

A

controlled lead exercise
passive/active ROM exercises

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16
Q

why can movement start to be gently introduced during the regeneration phase of healing?

A

new collagen fibres forming around site

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17
Q

what are the 2 stages in the remodeling phase of soft tissue healing?

A

consolidation
maturation

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18
Q

what is involved in the consolidation phase of remodelling in healing?

A

tissue moves from cellular to fibrous and becomes stronger
increase in strength and alignment

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19
Q

what is involved in the maturation phase of remodelling in healing?

A

vascularity increases
metabolic rate returns to normal

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20
Q

when does the maturation phase of remodelling in healing occur?

A

10 weeks to 1 year

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21
Q

what happens during the regeneration phase of bone healing?

A

bridging callus forms

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22
Q

what happens during the remodelling phase of bone healing?

A

clinical union of bone - crucial for bone healing

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23
Q

what sort of exercises may be involved in the remodelling phase of healing?

A

active e.g. hydro

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24
Q

what is a common factor in cruciate disease?

A

obesity

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25
what may need to be started prior to cruciate surgery?
weight loss programme
26
what may be used to aid pre-op weight loss for cruciate patients?
hydrotherapy
27
why must hydrotherapy be stopped for a time post operatively for cruciate patients?
to aid wound healing
28
when could hydrotherapy restart following cruciate surgery?
once wound is sealed and sutures removed
29
what are the main cruciate repair options?
TPLO TTA lateral suture
30
what is involved in the rehabilitation of cruciate disease patients?
active exercise may retrun to toe touching the day after surgery
31
what is the most common cruciate repair procedure?
TPLO
32
what dogs may TTA and lateral suture be less suitable for?
working dogs
33
what does the rehabilitation of fracture patients depend on?
degree of fractures and site presence of pre-exisiting disease degree of soft tissue damage presence of open wounds
34
what preexisting disease may affect wound healing?
diabetes
35
what are the main components of a fracture rehabilitation plan?
adequate analgesia restricted exercise cold compress encourage limb use supportive dressing if applicable
36
what fracture patients is restricted exercise essential for?
THR those who have had epidurals
37
how can usage of a limb following fracture repair be encouraged?
PROM exercises can be used carefully
38
what is the purpose of a supportive dressing for fracture patients?
pain relief joint stability
39
what is the main difficulty if external fixators have been used for fracture repair?
can be difficult to apply treatments to the whole limb
40
what type of external fixators make massage and PROM more possible?
linear or ring
41
what physio therapy techniques are vital for external fixator patients?
active exercise extension of the distal limb
42
why is extension of the distal limb in external fixator patients crucial?
natural flexion of the distal limb often seen with external fixation
43
what are the main issues seen post-op from joint surgery?
pain and swelling
44
what treatment should be used in the post op period following joint surgery?
cryotherapy pressure dressings PROM massage analgesia
45
when should cryotherapy be utilised post op in joint surgery patients?
immediately post op
46
how long should pressure dressings be applied to joints following joint surgery?
12-24hours post op
47
what is the purpose of cold therapy in joint surgery patients post op?
aids reduction of swelling
48
what is the purpose of PROM following joint surgery?
maintains normal ROM encourages blood flow and lymphatic circulation stimulates sensory awareness
49
what is the benefit of increasing blood and lymphatic circulation in joint surgery patients?
assists reduction of oedema
50
how should joint replacement surgeries be managed?
slow and controlled walking must be settled and calm clear signage on kennel
51
what can be done if joint replacement patients are stressed?
administration of sedation due to the risk of catastrophic damage to the implant
52
how is tendon injury managed?
rest NSAIDs
53
when can PROM be started for tendon injury patients?
after 3 weeks rest
54
how long should exercise be limited for in tendon injury patients?
3-6 weeks
55
is the tendon at full strength after 6 weeks?
now
56
what can be used to assist a patient with a tendon injury?
support aids (e.g. boot)
57
what are the primary goals of rehabilitation?
weight bearing active range of movement (ROM) muscle building
58
what is the purpose of building muscles?
support of joints and limbs
59
what does rehabilitation assist with?
return to function minimisation of stress on surgical site
60
what is required to perform rehabilitation well?
full understanding of the condition
61
what ways of measuring efficacy of rehab are there?
subjective - how you feel they're doing objective - actual measurement using scales
62
what is essential throught the rehab period?
adequate pain relief
63
what may be involved in rehab as well as post op care?
pre-emptive or surgical management
64
what is involved in pre-emptive / surgical management of ortho cases?
cryotherapy support dressing weight bearing encouraged where possible pain management assessment of other conditions / lifestyles
65
what is the role of a support dressing?
reduction of oedema and analgesia
66
what is the role of weightbearing in pre-surgical management?
reduced muscle atrophy
67
when is cryotherapy most effective?
initial 72 hour period post op/injury
68
what is the role of cryotherapy?
vasoconstriction analgesia reduction of oedema
69
how often should cryotherapy be performed?
3 x a day
70
how long should each session of cryotherapy be?
15 mins
71
what temperature is advised for heat therapy?
46 degrees C is sufficient
72
what is the benefit of heat therapy?
increased blood flow to region increased elasticity of tissues muscle relaxation
73
what must you be careful about when using hot and cold therapy?
test on self to ensure not too hot wrap cold in a towel to prevent burns
74
what is the purpose of massage in rehabilitation?
increases blood flow and so oxygen supply to muscles aids removal of waste products helps muscle work more effectively alleviates pain settles patient mobilisation of adhesions
75
when can massage be used?
before and after exercise or physiotherapy
76
what must always be performed before a physiotherapy session?
massage
77
what are the main types of physio exercises involved in rehabilitation?
assisted exercises active exercises
78
what is the difference between assisted and active exercise?
assisted involves external support of the patient by RVN active is the patient doing it for themselves
79
what are the main assisted rehabilitation exercises?
assisted standing weight shifting side bending and cervical flexion/extension balance boards swiss balls muscle stim
80
what are the main active rehabilitation exercises?
slow walks stair climbing sit to stand or down to sit treadmill walking
81
what is involved in advanced rehabilitation exercises?
dancing wheelbarrowing hydrotherapy
82
when would advanced rehabilitation exercises be started?
6-12 weeks post op
83
what is essential when managing a patient's long term rehab?
communication between nurses, vet and client having clear primary goal
84
how can we ensure effective communication regarding patient rehab?
clear notes on progress any procedures recorded videos of patient can help discussion as a team of plans and any proposed changes
85
what must be communicated to an owner during rehabilitation?
progression exercises how they can help management of expectations get them to invest

Advanced Clinical Nursing Theory (36 decks)

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