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Neuro Rehab 2 > TBI - 2b Mod-Severe TBI > Flashcards

TBI - 2b Mod-Severe TBI Flashcards

1
Q

what is the focus of the RLA

A

general pattern w focus on cog and behavior

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2
Q

what type of responses can be expected from RLA 1-3

A

no - generalize - localized

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3
Q

what are the 5 main intervention categories to manage RLA 1-3

A

sensory stim
communcation
cardiopulm
prevention of indirect impairment
family/caregiver ed

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4
Q

how should sensory stim be presented and what should you look for for for RLA 1-3

A

present in highly structured manner

monitor for:
- subtle response (HR, RR, BP)
- motor response (face, posture, head turn, vocalization)

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5
Q

when can communication as an intervention be introduced and how is it utilized across RLA 1-3

A

as begins to respond to commands via eye opening, changes in BP/HR/RR w stim

encourage vocalization/verbal
integrate movement w meaning as start to follow commands

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6
Q

what are appropriate cardiopulm interventions for levels 1-3

A

positioning
bronchopulm hygiene
early mob OOB

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7
Q

what are interventions to prevent indirect impairments in RLA 1-3

A

positioning
ROM
serial casting
- phenol, botox

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8
Q

what are things to educate the family/caregiver on in RLA 1-3

A

stages of disability
POC
ROM, positioning, communication, sensory stim

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9
Q

what type of response can be expected from RLA 4-5

A

confused agitated - confused inappropriate

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10
Q

what are 5 components of managing RLA 4-5

A

manage agitation
behavior modification technique
consequent control
antecedent control
pt/family ed

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11
Q

what are strategies to manage the agitated pt

A

MDs - optimize med status and meds
orient - non threatening and provide info to pt
safety, constant supervision

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12
Q

what is consequent control and how can this be utilized in RLA 4-5

A

consequence immediately following behavior is assumed to have some significant effect on future probability of behavior
- token economy
- positive re-inforcement
- redirection/time out
- shaping

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13
Q

what is antecedent control and how can this be utilized in RLA 4-5

A

stimulus present prior to and during behavior
- can elicit, maintain, modify behavior

can use environment as stim early in treatment (primary means of control)
- how you deliver stim is important

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14
Q

what are things to educate the pt/family on in RLA 4-5

A

focus on family
- explain part of recovery
- teach strategies - consistency, calm behavior

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15
Q

what type of responses can be expected from RLA 5-6

A

confused-inappropriate / confused-appropriate

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16
Q

what are strategies to utilize in managing RLA 5-6 (6)

A
  1. frequent re-orientation but try not to cue continuously
  2. explain what you are doing and why
  3. establish routine and structure -> memory charts, lists
  4. environment control
  5. appropriate amt of supervision vs restraints for safety
  6. avoid mental and physical fatigue (ie allow for rest breaks)
17
Q

what are things to educate the family and pt on in RLA 5-6

A

pt may be moving but lack insight into deficits
- family teaching regarding assisting, wc use, body mechanics (unable to complete tasks (I) w/o cueing)

18
Q

what are safety considerations when managing RLA 5-6

A

PT/OT may co-tx (rehab aide)
don’t leave unit/gym
- risk of elopement

19
Q

what responses can be expected from RLA 7-8

A

automatic appropriate - purposeful appropriate

20
Q

what is the emphasis of pt management of RLA 7-8 and what is an important thing to cut back on to encourage this

A

beginning community re-entry, return to work or school

wean from structure of inpatient rehab

21
Q

what is the main strategy of pt management of RLA 7-8 and what are examples of this

A

progressive build up of cog components
- negotiate obstacles
- use environmental cues
- integrate compensatory strategies during “PT” activities
- low to high level of distraction in environment
- decision making
- problem solving

22
Q

what are things to educate the patient and family on in RLA 7-8

A

community resources
-support groups

23
Q

what type of response can be expected from RLA 8-10

A

purposeful - appropriate

24
Q

what is an important thing to remember when managing patients RLA 8-10

A

pts not at baseline

25
Q

what is the focus of the PT program for RLA 8-10 and what are examples of interventions

A

work on remaining deficits:
- high level balance and coordination deficits
- endurance/work hardening
- remaining ROM/strength deficits from neuro/ortho injuries
- integrate high level problem solving during tasks (public transport, scavenger hunts, community outings)

26
Q

what are primary impairments of neuromuscular BSF (5)

A

abnormal tone
sensory impairments
motor function
- control and learning
postural control (balance)
gait

27
Q

what are primary impairments of cognitive BSF (7)

A

altered level of consciousness
memory loss
altered orientation
attention deficits
impaired insight and safety
impaired problem solving/reasoning
impaired executive function

28
Q

what are primary impairments of behavioral BSF (8)

A

disinhibition
impulsivity
physical/verbal aggressiveness
apathy
lack of concern
sexual inappropriateness
irritability
egocentricity

29
Q

what are primary impairments of communication BSF (6)

A

receptive aphasia
expressive aphasia
dysarthria
auditory deficits
impaired reading comprehension
impaired written expression

30
Q

what are 7 primary impairments of BSF

A

neuromuscular
cognitive
visual
perceptual
behavioral
communication
dysphagia

31
Q

what are 3 secondary BSF impairments

A

musculoskeletal
cardiopulm/vascular
integ

32
Q

what are 4 secondary musculoskeletal BSF impairments

A

soft tissue contractures
heterotrophic ossification
ms atrophy
dec bone density

33
Q

what are 3 secondary cardiopulm/vascular BSF impairments

A

dec endurance
pneumonia
DVT

34
Q

what are 2 secondary integ BSF impairments

A

skin breakdown (ie decubitus ulcers)
infection

35
Q

what systems/functions should PT tests and measures assess (11)

A

circulation/respiratory
integ
MSK
nervous system
reflex integ/ms tone
postural control
vision
perceptual
cognition
behavior
communication

36
Q

what PT tests and measures are included in a screen of the nervous system

A

sensory integrity
- light touch
- deep sensation
- proprioception

motor function
- motor control and learning

Neuro Rehab 2 (48 decks)

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