Rancho Scale/Allen Scale/Glasgow

Question 1

Glasgow Coma Scale

Answer 1

traditional method to assess levels of TBI

scores range from 3-15

Question 2

Glasgow Come Scale - Scores below 8

Answer 2

indicate severe brain injury

Question 3

Glasgow Come Scale - Scores between 9-12

Answer 3

indicate moderate brain injury

Question 4

Glasgow Come Scale - Scores above 14

Answer 4

indicate minor brain injury

Question 5

Glasgow Come Scale - Motor responses assessed

Answer 5

No response (1 pt)
response to pain
movement to painful stimulus
obeys commands

Question 6

Glasgow Come Scale - Verbal responses assessed

Answer 6

No response (1 pt)
incomprehensible speech
inappropriate words
confused conversation but able to answer
oriented to person, place, time

Question 7

Glasgow Come Scale - Eye opening responses assessed

Answer 7

No response (1 pt)
to pain only
when asked w/lout voice
eyes open on own

Question 8

Rancho Los Amigos Scale

Answer 8

awareness/cognitive function after TBI

Question 9

Rancho Los Amigos Scale - Level I (no response)

Answer 9

no response to any stimuli

Question 10

Rancho Los Amigos Scale - Level II (generalized response)

Answer 10

inconsistent /non-purposeful reaction to stimuli

Question 11

Rancho Los Amigos Scale - Level III (localized response)

Answer 11

reaction specifically to stimuli but inconsistent

Question 12

Rancho Los Amigos Scale - Level IV (confused/agitated)

Answer 12

heightened state of activity w/severely decreased ability to process info

• short attention span
• limited short term memory

Question 13

Rancho Los Amigos Scale - Level V (confused/inappropriate non-agitated)

Answer 13

appears alert w/fairly consistent reaction, although increased complexity of commands causes more random responses

• overstimulated by environment
• wander

Question 14

Rancho Los Amigos Scale - Level VI (confused/appropriate )

Answer 14

goal-directed behavior but dependent on external input for direction

• may show carry-over for tasks he has relearned
• able to attend a 30 min structured task
• aware of need for food, thirst, toileting

Question 15

Rancho Los Amigos Scale - Level VII (automatic/appropriate)

Answer 15

appears appropriate and oriented to place/routine but frequently displays shallow recall

• oriented x3
• mannerisms are robot-like
• limited judgement

Question 16

Rancho Los Amigos Scale - Level VIII (Purposeful/appropriate)

Answer 16

client is alert/oriented and able to recall and integrate past/recent events.

• needs no supervision once activities are learned
• indep in home/community
• decreased tolerance for stress, abstract reasoning, judgement in emergencies

Question 17

Allen’s cognitive disabilities groups

Answer 17

level 1 - pts would not benefit from the group

level 2 - pts would be successful in situations in which they can move around/copy movement that is modeled

level 3 - pts focus on elements of repetition/manipulation

level 4 - pts work on goal-directed activities such as crafts

level 5 - pts engage in activities w/a graded structure (clay modeling/mosaic project.

Question 18

Dementia effects on occupational performance - Early Stage

Answer 18

• ADLs remain intact
• first signs of memory loss happen in IADLs
• affects orientation to place
• learning/reading become hard
• social withdrawal

Question 19

Dementia effects on occupational performance - Middle Stage

Answer 19

• the person can no longer live alone
• no longer attend to ADLs
• weight loss occurs
• IADLs are neglected
• dependent in community mobility
• safety is a concern

Question 20

Dementia effects on occupational performance - Late Stage

Answer 20

• All areas of occupations are lost
• dependent in all ADLs
• can no longer ambulate safely
• communication is lost

Question 21

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 6 - Planned actions

Answer 21

-client is indep

Question 22

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 5 - exploratory actions

Answer 22

• supervision is needed
• pt learns through visible, concrete, meaningful stimuli
• pt explores the effects of self-initiated motor actions on physical objects
• pt uses trial-error problem solving
• pt has problems w/judgement, reasoning, planning

Question 23

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 4 - goal directed activity

Answer 23

• pt needs min cognitive assistance
• attention is to visual/tactile cues
• can no longer problem solve
• can follow two/three step activities
• activities must be simple, concrete, supportive
• labels/pictures
• task setup
• eat indep but needs supervision for amount of food
• 24 hour supervision

Question 24

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 3 - manual actions

Answer 24

• mod cognitive assistance
• cannot learn new behaviors
• activities (wiping countertops, vacuuming, walking)
• needs routine
• should avoid sensory overload
• able to wash hands/face and brush teeth
• during bathing items presented to client one at a time
• 24 hour supervision

Question 25

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 2 - postural actions

Answer 25

• max cognitive assistance
• motor actions are near reflexive
• ADLs can be done by imitating the caregiver
• spontaneous behaviors
• able to eat finger goods
• paces/wanders
• taken to bathroom every 2 hours
• around the clock supervision

Question 26

Claudia Allen’s Cognitive Disability Theory - Cognitive Level 1 - automatic actions

Answer 26

• total cognitive assistance
• motor actions are in response to one-word
• needs assistance w/ambulation and transfers
• needs PROM, AROM to prevent bed sores/contractures
• constant 24 supervision
• terminal phase