Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

neuromuscular II > Seating and Mobility > Flashcards

Seating and Mobility Flashcards

1
Q

what are the 3 posture tendencies?

A

posterior, anterior, lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the goal is to reduce or eliminate negative postural tendencies for:

A

loss of ROM, skin breakdown, structural scoliosis, poor head alignment, impaired breathing support, impaired swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

if the postural tendency is happening because of _____, what should your intervention be?
- ROM
- hypertonicity/spasticity
- hypotonia
- visual/perceptual

A
  • intervention should not be setup at end range deviation
  • need setup for tone management strategies
  • critical to position against gravity
  • critical to give lateral support of trunk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

an area of damaged skin usually found over a bony prominence that generally comes from prolonged pressure, friction, shear, heat and/or mositure

A

pressure injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where do the majority of pressure injuries occur?

A

sacrum, coccyx, ITs, GTs, calcaneus, lateral malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the two primary factors that influence skin breakdown?
give two functional examples of this?

A
  1. friction –> force that resists motion of two objects sliding against each other
  2. shear –> distortion from opposing forces at the surface of the skin

examples: sliding down in bed and in wheelchair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are 3 other factors that can influence skin breakdown?

A

moisture
heat
medical issues ex. nutrition, DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some things to educate your patient about regarding skin breakdown?

A

risk factors
daily skin inspections
stages
pressure reliefs
cushion maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does a stage 1 skin breakdown look like?

A

red area that does not go away after 15 minutes of getting off of it
–> look for difference in skin color for darker skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should you do if your patient has stage 1 skin breakdown?

A

if related to the wheelchair: contact wheelchair vendor for modifications and/or to be evaluated by PT and reduce time in w/c until modifications can be made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are 3 techniques used for pressure reliefs?
why do you need to be able to sustain these techniques for at least 2 minutes?

A

wheelchair pressups
forward and lateral leans
powered options –> power tilt and power recline

need to maintain for 2 minutes as that is the time needed for blood reperfusion to the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how often should your patient do pressure reliefs?

A

at least every 20-30 minutes and more often if they have skin breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are considerations when determining your seating intervention?

A

angles on w/c
orientation of w/c frame
materials needed for pressure relief, postural control, or spasticity management
postural support needed
client’s back shape or corrected shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 4 types of seating and back supports?

A

general use
positioning
pressure relieving
pressure relieving and positioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

list types of materials in seating supports

A

air
gel
foam
combination products
offloading
pressure redistribution vs. offloading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

list some supports to correct deviation

A

obliquity pads
abductors
adductors
trunk laterals
hip belts, chest harnesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

primarily what population is interface pressure mapping used with?

A

those at high risk or past/current history of breakdown
it provides feedback to clients on effectiveness of pressure reliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are limitations of interface pressure mapping?

A

only measures pressure, does not measure friction, shear, heat or moisture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some considerations when selecting a seat and back support?

A
  • they must use a w/c to get funding for a cushion
  • will it impact balance and transfers?
  • can pt or caregiver manage it like taking off/on backrests
  • will they be transported on the w/c on a bus? –> specific materials are needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

where should you start when selecting equipment for your patient?

A

know what posture correction you need and what you want for managing pressure risk
–> custom w/c need a certified ATP (help your pt find a good one)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

a patient has a mobility limitation if they cannot get from point A to B _____ (3)

A
  • cannot get from point A to B independently
  • cannot get from point A to B in appropriate amount of time
  • cannot get from point A to B independently as needed throughout the day
22
Q

insurance only considers _______ when choosing to fund a w/c or not
what is the exception?

A

mobility limitations inside the home (not community limitations)
exception is school-based mobility in pediatrics

23
Q

mobility is not ______ and a w/c is not _____

A

exercise
a piece of exercise equipment

24
Q

what are the primary manual wheelchair codes?
funded based on _____ rather than ____

A

K0001, K0002, K0003, K0004, K0005
function ; diagnosis

25
Q

what are the power wheelchair codes?
funded based on _____ rather than _____

A

Group 1, Group 2, Group 3
diagnosis ; function

26
Q

hospital type wheelchairs are categorized as ______
they are not appropriate for what population?

A

K0001-K0003
neuro patients due to minimal customizations

27
Q

what are K0004 wheelchairs?

A

lightweight
–> not typically stocked due to reimbursement

28
Q

what is the most appropriate long term manual w/c for a neuro patient?

A

K0005
custom ultra-lightweight

29
Q

K0005 w/c come in folding and rigid. why would someone choose a rigid frame over a folding frame?

A

rigid is lightest in weight and provide the most options for seat slope and balance needed for SCI population

30
Q

what are considerations of each category for manual wheelchair setup?
- seat slope
- back angle
- wheel access
- center of gravity
- front hangar

A
  • front seat to floor ht vs. rear
  • ideally with increased slope, close back angle to vertical position
  • for long term propellers. elbow angle 100-120 deg when hang is at top of wheel
  • further back the axle the more difficult to obtain wheelie and negotiate curbs
  • 70-90 deg –> must have ankle ROM for 90 deg
31
Q

what are considerations when making manual w/c recommendations?

A
  • just because they can propel doesn’t mean they should
  • region (flat vs mountain, accessibility)
  • are they a student? (bus, campus)
  • long term UE propulsion (overuse injuries)
32
Q

when are powered wheelchairs indicated for a pt?

A

when they cannot functionally self propel any level of manual w/c in the home throughout the course of a day

33
Q

using a joystick-like a gas pedal to control movement of a power w/c is ______ control

A

proportional

34
Q

what does your patient need to use proportional control?

A

ability to grade movement
ability to move on/off joystick
faster processing and reaction times

35
Q

switches (mechanical or electronic) to control movement of a power w/c is ______ control

A

non-proportional

36
Q

what motor control does your patient need for non-proportional controls

A

ability to consistently access, activate, and release the switch
veer requires 2 switches at once
amount of force varies for switch type

37
Q

what is the primary use for a powered tilt w/c? secondary?

A

1: pressure reliefs
2: sitting balance, posture control for UE activities

38
Q

what angle does the powered tilt w/c tilt to? what do you need to consider for your patient?

A

~50 deg
fear of tilting

39
Q

what is the primary use for a powered recline w/c? secondary?

A

1: intermittent catheterizations, spasticity, pressure relief that is not effective with tilt alone
2: dressing, cathing, assist with non-traditional transfers

40
Q

what should you take caution with if getting your pt a power recline chair?

A

sacral skin breakdown, breath support, swallowing
can be a problem with extensor spasms/spasticity, can contribute to patients sliding down in chair

41
Q

what is the most effective pressure relief chair?

A

power tilt and power recline

42
Q

what is the primary use for a power elevating legrests (ELRs) w/c? secondary?

A

1: LE edema, loss of knee flexion ROM
2: dressing

43
Q

what must your patient have to get a ELR?

A

adequate hamstring ROM with hips flexed to 90 deg
–> ELRs move LEs from 85deg knee flex to full knee ext

44
Q

what is the primary use for a powered seat elevate w/c? secondary?

A

1: transfers
2: active reach to counters, cabinets, refrigerator, etc

45
Q

powered seat elevate w/c elevate to _____ inches so you must take caution with:

A

12-14”
driving on terrain, inclines at full elevation, funding

46
Q

what is the primary use for a powered anterior tilt w/c? secondary?

A

1: reach
2: come to stand (progressive diagnoses)

47
Q

what are the two angle options for a powered anterior tilt w/c?

A

1: 10 deg ant tilt –> reaching
2: 20 deg ant tilt –> requires knee blocks with LE paralysis

48
Q

what is the primary use for a power stand w/c? secondary?

A

1: medical benefits: spasticity, bone density, LE ROM, digestion
2: participation in ADLs from standing position

49
Q

what are red flags for power stand w/c?

A

poor LE bone density for standing
hip joint dislocation
ROM limitations at hip, knee, ankle

50
Q

smart drive and smoov power assist are the two most popular options for _____ w/c

A

power assist

51
Q

when writing a letter of medical necessity advocating for a pt to get a wheelchair, what must you include/take into account?

A

reviewer likely doesn’t have a medical background
state the obvious
explain why cheaper equipment will not work
how will the recommended equipment assist with mobility, ADLs, posture and positioning, & management of secondary effects

neuromuscular II (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions