Psych and mobility devices Flashcards
What is the accurate way to measure the length the crutches should be?
2-3 ginger widths between the pad and the anterior axillary fold (armpit)
Tip of crutch is a point lateral (6 inches) and slightly in front of foot (6 inches)
Handgrip - angle of elbow is 30 degree and wrist at the level of the handgrip
What should you NOT use to measure crutches
ANY landmark on the foot or anything that says axilla
What is a 2 point gait? Uses?
Move the crutch and opposite foot together
Example: right crutch and left leg
Used for mild bilateral leg weakness
What is a 3-point gait?
Move 2 crutches and the bad leg together followed by the unaffected foot
What is the 4-point gait?
Move crutch, then opposite foot, then other crutch, then opposite foot
VERY slow but VERY stable
What is the swing through? Uses?
Unaffected foot passes the tip of both crutches
Amputees
Non-weight bearing
What is the rule for which gait of crutches should be used?
Use even point gait for even and odd-point gait for odd
Use even numbered gait when the weakness is bilateral - 2 point for mild and 4 point for severe
Use odd numbered gait when one leg is affected
How do you go up the stair with crutches? How do you go down?
Up with the good, down with the bad
Lead with good foot and crutches follow when going up
Lead with bad foot and crutches then follow with good when going down
Which side should a cane be held? Where should the handgrip be?
Hold cane on the unaffected side and handgrip should be at the level of the wrist
What is the correct way to use a walker? Can you tie things to it? Can you have things on the feet?
Picks it up, sets it down, walks to it
Holds onto chair, stands up, then grabs walker
If things MUST be tied to it, tie to the side so doesn’t fall over
NOTHING on feet of walker including wheels and tennis balls
What is the first question you should ask when a psych question comes up?
Is the patient a non-psychotic patient or a psychotic patient?
How do you respond to you patient if they are non-psychotic?
Therapeutic communication
How are you feeling, that must be overwhelming, that must be difficult, I can see you are sad, tell me more
Reflection, amplification, restatement
What is a psychotic patient?
A patient that has no insight and is not reality based
They do not think they are sick and everyone else is the problem
Has delusions, hallucinations, illusions
What is a delusion?
A false, fixed belief or idea or thought that is all in their head
What are the 3 types of delusions?
Paranoid
Grandiose - false belief that you are superior (I am the president, I am the smartest person ever)
Somatic - false belief about your body (I have x-ray vision, there are worms in my arm)
What is a hallucination?
Sensory experience without external stimuli
Nothing there
Auditory, visual, tactile, gustatory, olfactory
What is an illusion?
A misinterpretation of reality
There is a referent (something that both the pt and clinician can refer to) such as a cord, or people talking
What is function psychosis? Examples?
Can function in everyday life. D/t chemical imbalance in brain
Skeezo, Skeezo, major, manic
Schizophrenia, schizoaffective disorder, major depression, mania
What is psychosis of dementia? Examples?
Actual brain damage/destruction
Alzheimers, stroke, organic brain syndrome, anything that says senile/dementia
What is psychotic delirium?
Temporary, sudden, dramatic, episodic, secondary to something else
UTI, thyroid imbalance, adrenal crisis, thyroid store, electrolytes, medications/drugs, overdose, withdrawal, DT, ICU for a long time, infection
How do you approach a function psychotic patient?
There have the ability to learn
Acknowledge feelings (you seem sad, you seem angry)
Present reality (I know you see that demon but I don’t)
Set limits (We are not going to address that, stop talking about that)
Enforce limits (I see you’re too ill to stay in reality so our conversation is over)
How do you approach psychosis of dementia?
They cannot learn reality d/t brain damage so don’t present it!
Acknowledge feelings
Redirect them - give them something that they can do
How do you approach psychosis of delirium?
Acknowledge feelings
Reassume them of safety and temporariness of their condition
What are ideas of flight?
Going from thought to thought to thought rapidly. Each thought is coherent but they are not coherent together
What is neologism?
Make up words
What is narrowed self concept? What do you not want to do with these patients?
Patient refuses to change their clothes or leave their room - this is because there two things define who they are and they are scared to change them b/c they wouldn’t know who they are without it
Never make them change their clothes, tell them you see they feel uncomfortable and only to change when they feel comfortable doing so
What is idea of reference?
Thinking everyone is talking about you
