TBI Flashcards

Question

What are major areas of concerns for contractures?

Answer 1

* Ankles (PF) * Toes (flexor tone) * Elbows, wrist fingers

Answer 2

Level 1 = no response; Level 2= generalized response * Talk to patient in a normal conversational manner (hearing is the first to come back; don't talk about medical condition in the room) * Provide appropriate stimulation (Alternate periods of time with noise for about 15 minutes) * Change pts position

Answer 3

Level 3 =Localized response * Continue in normal conversation tones. Talk about their interests * Use simple 1-part directions. Use 1 or 2 short sentences * Reallize attention span is very short * Encourage verbalizing (except if on vent) * Provide orientation for the patient * Remember rest periods * Don't expet pt to remember recent events * Provide visual helps

Answer 4

Level 4 = confused/agitated * Remember agitation is not personal (major concern is pt safety: avoid contacts to which pt responds negatively, don't react with anger, don't stay alone with pt if you feel uncomfortable, produce a calm environment, pt will not remember the way they acted) * short, simple directions. allow for delayed responses. talk slow * Don't expect pt to remember instructions (attention span \< 2 min) * Provide orienting information frequently * Prepare pt for tasks * pick tasks pt can complete * Treat pt as adult

Answer 5

Level 5 = confused/inappropriate/nonagitated * pt will perform automatic tasks but supervised * pt still in PTA and can't remember recent events and attention span is 2-3 min for single task. provide ways to support memory * Use gentle cues to orient patient * one-step directions, simple words * attention span is 20-30 min for varied tasks * agitation is caused by too much pressure placed on them * if pt becomes agitated: rest period, change task, calmly ask pt to relax

Answer 6

Level 6 = confused/ appropriate * pt not fully out of PTA, but beginning to remember some new information. recall of past is shallow and inconsistent ( can reduce cueing and start a journal) * 2-step directions and normal language (be concrete and specific; don't use sarcasm or humor- they won't get it) * pt needs a lot emotional support * pt can take responsiblity for perfomance of basic daily tasks w/o supv * pt may acknowledge his or her physical and memory impairments

Answer 7

Level VII = automatic/appropriate * normal conversation; 2-3 step directions * pt will literally interpret what you say (won't get subtle humor) * Expect general day-to day carryover (frequently discuss events to encourage recall; pt can use a memory notebook) * Encourage pt to resume responsiblity for daily routine (ADLs, getting to and from therapy sessions) * Expect denial of future implications of disablilites (pt will feel normal) * Design tasks or situations so that pt can control emotional expression (Behav. Mod)

Answer 8

Level VII= purposeful/appropriate * use normal conversation, complex commands * pt will still take things literally, but will understand with explanation * detailed carryover of daily events (pt should continue to use notebook; memory deficits may be permanent) * pt will carry out daily responsiblities independently * pt will make long range plans and goals * will incorporate present physical and mental abilities and limitations in future planning * pt and staff should engage in mutual planning. consider pt premorbid state * pt tolerance for frustration increased (emotional control still not as good as before, help pt avoid situations that cause anger and stress)