Positioning, Bed Mobility And Activities Of Daily Living Flashcards
What are activities of living?
Activities of self living are daily self care activities
Give some examples of basic ADLs 6
Basic ADLs refer to self care such as:
- Eating
- Bathing
- Dressing
- Transferring
- Toiletting
- Walking or moving around
What are instrumental ADLs and list some examples? 7
Instrumental ADLs allow an individual to live independently in a community and are needed for fundamental functioning. These include:
- Shopping
- Driving
- Cleaning the house
- Cooking
- Using a phone
- Doing a hobby
What is independence? 1
- A patient is independent if they do not depend on others for help
What are the therapeutic consideration of ADLs? 6
- Should be as economic as possible (use of cost effective devices/ improvisation)
- Should be as normal as possible (alignment, sequencing, posture)
- Should be activities they do regularly to promote self responsibility
- Reeducation should be task orientated
- Should fit into a patients daily outine
- Focu on the patient’s highest level of function
What are the reasons for correct positioning of a patient? 5
- Attempt to inhibit abnormal posture typical of hemiplegia
- Sensory stimulation through weight bearing on the affected side
- Prevention of pressure sore
- Prevention of soft tissue contractures
- Maintenance of clear airway and a reduction of the risk of aspiration
Describe the physiological benefits of correct postioning of the patient: 5
- To improve blood oxygen saturation: whe patients are sat up, their blood oxygen is significantly higher than when lying flat
- To increase cerebral perfusion: when patients who are hypovolaemic are sitting, they may have reduced cerebral perfusion and possibly increased cerebral ischaemia: these patients have to lie flat
- To reduce cerebral oedema: intracranial pressure is highly dependant on posture, being higher in patients who are lying flat and lower when sitting up
- To prevent tissue damage which may occur due to overstretching when the limbs are not well supported
- To provide comfort
When positioning a patient who has had a stroke, how should one position on the affected side? 3
- This should always be encouraged with the scapula protracted so that the body weight is supported on the scapula and not the head of the humerus
- The unaffected leg should be brought forward and placed with the knee bent on a pillow in front of the affected leg for comfort. This will prevent the patient rolling back onto their back
- Flex the neck forward, to prevent aspiratio
When positioning a patient who has had a stroke, how should one position on the unaffected side. 4
- The affected arm should be well forward, keeping the elbow straight and supported on a pillow
- The affected leg should be brought far enough in front of the body to prevent the patient rolling onto their back, the knee bent and supported by a pillow
- A small pillow can the be placed under the patient’s waist to maintain the line of the spine
- The patient should have enough pillows to support the head while maintaining the alignment of the spine
When positioning a patient who has had a stroke, how should one position in the supine lying postion? 3
- This is the position most likely to encouarge spasticity but some patients do like to lie on their back for a while and it will be required for some treatments
- A small pillow is placed under the buttocks of the affected side and should extend just to the knee, this will relax the knee and prevent external rotation
- A pillow is placed under the affected arm which is kept straight at the elbow and if possible, the palms of the hand facing upwards or downwards
When moving in bed using bridging, what should one remember?
- Always support the affected leg
- Move the patient to the side while in a bridging position.
- Assist/ Facilitate lateral movement of the pelvis
- Move patient up in bed while in a bridging position
- Remind patient to push-up with their feet
Is one independant if they use an assistive device
