Preparation for Patient Care

Question 1

Describe the five steps for descending a curb backwards with a wheelchair?

Answer 1

1. Properly position the patient in the chair before approaching the curb
2. Grasp the handles and move the chair backwards slowly and evenly lower the back wheel to ground-level.
3. Maintain the tilt of the chair and move the chair backwards until the front wheel is in the air.
4. Slowly lower the front wheel to the ground.
5. Ascending may be done in the reverse fashion

Question 2

Describe the four steps to the descend a curb with a wheelchair and the two precautions.

Answer 2

(make sure the patient is not bigger than you)

1. This method is more difficult to maintain control of the wheelchair.
2. Only suggested for Low curbs
3. Face the chair towards the curb
4. Tilt the chair back so that the front wheels are off the ground.
5. move the chair forward and music down the curb.(Wheels have to go over the curb at the same time)
6. Gently lower the front wheels to ground level.
7. Ascending can be done to reverse fashion.

Question 3

What are the three steps to push a wheelchair through a door forwards or backwards?

Answer 3

1. Open-door and hold open with 1 foot or hand
2. Guided chair through the door being careful of the patients elbows etc.
3. Do not let the door contact the patient or the chair.
4. If the door opens away from you, you will Back out.
5. If the door opens towards you, you will go forward.

Question 4

How does a therapist guard A patient to learn wheelchair wheelies?
How does the patient perform wheelchair wheelies?

Answer 4

Therapist stand behind the patient to Guard. Guard by placing fingers lightly under the chair handles. A wide base allows you to have stable movement.

Question 5

What is the general rule for spending time in one position?
What do you do if it is the patients first time in a new position?
How often must pressure be relieved when a patient is sitting?

Answer 5

No more than two hours.

Check skin after 5 to 10 minutes

Pressure must be relieved every ten minutes

Question 6

What are you looking for when you inspect skin on patient?3

Answer 6

Color–redness… Does it blanch? (if it doesn’t Blanche, then you have a concern. If no change in 10 to 15 minutes… there’s a problem.)
Integrity–blister, open wound
Check closely over bony areas. (of redness and skin breakdown are negative effects of pressure and not sitting)

Question 7

What are the 3 effects of positioning on the integumentary system?

Answer 7

Redness
Skin breakdown
Decreased range of motion

Question 8

What are the four effects of positioning on the musculoskeletal system?

Answer 8

1. Loss of range of motion–shortening on one side with lengthening on the other
2. Compromised joint nutrition–degeneration of cartilage.
3. Decreased joint stress–bone demineralization
4. Loss of strength–loss of sarcomeres

Question 9

What are the four effects of positioning on the neuromuscular system?

Answer 9

1. Pressure on periferral nerves can cause damage.
2. Pain
3. decreased sensation
4. Loss of range of motion
   (loss of blood supply = loss of sensation, tingling, pain, and the loss of extensibility… Neural Tension)

Question 10

What are the effects of positioning on the circulatory system? 3

Answer 10

1. Reduced circulation
2. Pain
3. Decreased nutrition to distal tissues–exacerbate integumentary problems.

Question 11

How do you bridge the gap?

Answer 11

Do not put a pad under a bony prominence. But support approximately and distal to prominence. This prevents contact of the bony prominence with a surface