PT management of sev-mod TBI

Question 1

what is RLA Level IV

Answer 1

confused agitated

Question 2

what is the description of Level IV

Answer 2

-heightened state of activity
-bizarre behavior
-unable to cooperate direction with treatment efforts
-verbalizations incoherent or inappropraite to environement
-no selective attention
-no short or long term recall

Question 3

what is the Pt role for Level IV?

Answer 3

-mobilize with considerations
-low stimulation environement
-structured therapy times
-assist with sleep-wake cycle
-short sessions

Question 4

what is RLA Level V

Answer 4

confused inappropriate

Question 5

what is the description of RLA level V

Answer 5

-follows simple commands
-without structure and complicated- responses less purposeful
-highly distractable
-lacks ability to focus on specific task
-verbalization inappropriate
-memory imparied
-may use objects inappropriately
-may perform previously learned tasks
-difficulty with new info

Question 6

what are the PT roles with level V

Answer 6

-environmental modification
-progress mobility
-structured, short sessions
-directed tasks vs automatic
-implicit learning

Question 7

what is RLA Level VI

Answer 7

confused appropriate

Question 8

what is the description of RLA Level VI

Answer 8

-shows goal directied behavior
-dependent on external input
-follows simple directions
-shows carryover
-multiple reps and guidance needed
-past memories more in depth than recent
-responses may be incorrect due to memroy but appropriate to situation

Question 9

what is the PT role in Level VI

Answer 9

-prevent learned non-use
-constrained induced therapy may be inititated
-BW support TM training
-incorporate goal-directed tasks

Question 10

what is ELL

Answer 10

errorless learning
-cog ther techinuq for those w severe memory impairments
-if explicit, cant be corrected

-use verbal and visual cues
-hand over hand assistance
-discouragement of guessing
-gradual fading of prompts
-part task practice of disecrete portions of a larger skill

Question 11

what is retrograde amnesia

Answer 11

partial or total loss of ability to recall events that have occurred during the times immediatley before hte injury

Question 12

what is anterograde memory

Answer 12

abiity to form more complete new memories, complicated by decreased attention and perception

Question 13

what is posttraumatic amnesia

Answer 13

time betwen injury and point at which functional memory returns

Question 14

what is RLA Level VII

Answer 14

automatic appropriate

Question 15

what is the desription of Level VII

Answer 15

-min A needed
-patient appears appropriate and oriented within hospital and home settings
-goes through daily routine
-has shallow activity recall]
-shows structure
-judgment remains impaired

Question 16

what is the PT role in level VII

Answer 16

-add more complex environmental tasks
-community interaction
-stimulation and problem solving
-more self directed and trail and error learning

Question 17

what is level VIII

Answer 17

purposeful appropraite

Question 18

what is the description of level VIII

Answer 18

SBA needed for cog-behavior
-pt can recall and integrate past and recent events
-shows carryover for new learning
-may continue to show dereased ability relative to premorbid ability, tolerance for stress and judgement

Question 19

whats the pt role in level VIII

Answer 19

-community re-entry
-increasing levels of problem solving w stress exposure
-increase independence

Question 20

what is the goal with ranchos L II-III

Answer 20

stimulation

Question 21

what is the goal with ranchoes levels IV-V

Answer 21

allowing

Question 22

what is the goal with ranchos VI-VIII

Answer 22

initiation, more stucture, new learning, gaining independence

Question 23

what is the goal wtih ranchoes IX-X

Answer 23

return to optimal lvel of function and participation

Question 24

Which of the following is a reason why children may have poorer outcomes after moderate to severe TBI than adults?

Answer 24

Children have less physical and developmental infrastructure for recovery

Question 25

Which of the following is a poor prognostic sign after moderate to severe traumatic brain injury?

Answer 25

Intracranial pressure 25 mm Hg

Question 26

The Monroe-Kelly Doctrine contributes to the fact that if the volume of edema, CSF and/or blood in the skull increases, potentially damaging pressure will be placed on the brain, causing secondary injury. What is another possible and serious consequence of increased pressure in the brain/skull?

Answer 26

Brain herniation or midline shift

Question 27

Which of the following is the most diffuse type of brain injury?

Answer 27

Anoxic brain injury

Question 28

Which of the following scales is the most comprehensive and complete test of disorders of consciousness?

Answer 28

Coma Recovery Scale-Revised

Question 29

Which type of traumatic brain injury brings the greatest risk of infection?

Answer 29

open

Question 30

Which of the following is a type of generalized seizure?

Answer 30

Bilateral convulsive seizure with tonic and/or clonic manifestations