SCI Tx Consideration: Part 2 Flashcards
Wheel Chair pressure relief schedule freq/duration
Freq: Every 15-20 mins
Duration: 2-4 mins holding pressure relief position
For pushup method, only hold for 30-90 secs
Bed Rolling pressure relief schedule
Rolling every 2 hours
T/F: Skin checks should be done daily and may require adaptive equipment like a long-handled mirror.
True
What’s a very common problem in acute stages with upright tolerance? What are the S&S of this problem?
Orthostatic Hypotension
S&S: hypotension + tachycardia, dizzy, pale, diaphoresis, slurred speech, foggy, blurred vision, N/V
check BP every 2 mins
3 Strategies to manage/progress upright tolerance
1 Slow transitions
2 Compression garments (stockings, abd binders, ACE wrap)
3 Equipment (tilt n’space, tilt table, ERIGO, standing frame)
Assisted standing has many benefits for these pts. What are some assisted standing devices and frequency of standing for this pt population?
1) Tilt table, stand-in table, BWS, standing frames, ERIGO
2) 2-3x/week in acute care, 1x/week in OP
Which of the following is not a consideration for assisted standing?
A) incorporate trunk/UE strengthening (AROM, TB, DB, Ball tosses, fine motor)
B) LE isometrics/small range strengthening
C) use of FES
D) Monitor vitals closely ESP. BP
E) all of these are considerations
E
Goals for standing are typically ___-based, but can incorporate ___ LE goals as well.
1 tolerance based
2 LE strengthening
Respiratory examination should be done throughout care. Exam includes: (5)
1 RR, breathing pattern, chest excursion
2 cough
3 posture
4 breath support w/ speech
5 may need Pulmonary Function Testing
A Functional cough is loud and forceful, and consists of ___ or more coughs per exhalation. What is the functional significance?
1) 2 or more
2) Ind. w/ resp. secretion clearance
A weak functional cough is soft and less forceful, and consists of __ cough(s) per exhalation. What is the functional significance?
1) 1 cough
2) Ind. for clearing throat & small amts of secretions. Assistance needed for clearing large amts of secretions
A nonfunctional cough is a sigh or throat clearing, and consists of ___ cough(s) per exhalation. What is the functional significance?
1) NO TRUE COUGHS
2) Assistance needed for airway clearance
T/F: Pneumonia is the most common sequelae cause of death for pts with SCI.
True
___ breathing aka “__ breathing” is ideal for quiet breathing. Place the pt in supine and place a light obj (box of tissue) on abdomen and instruct pt to watch themselves breathe. Instructing the pt to ___ can encourage diaphragmatic response.
1 Diaphragmatic breathing
2 belly breathing
3 sniff
add resistance to abdomen to progress exercise
T/F: The diaphragm is innervated by the thoracic spine.
False, C3-C5 keeps the patient alive!
below T10 = normal ventilatory & resp. fxn