TBI Management Flashcards
ID all VIII levels of RLA
I: No response
II: Generalized response
III: Localized response
IV: confused, agitated response
V: confused, inappropriate, non-agitated response
VI: confused, appropriate response
VII: automatic appropriate response
VIII: purposeful, appropriate response
Which levels of RLA are in the coma levels?
Level I-III
Which levels are post-traumatic cognitive state RLA
Levles IV and V
Which levels are appropraite behaviour for RLA
Vi- VIII
T or F: RLA LOCF can apply to all brain injuries (acquired and traumatic)
FALSE TRAUMATIC ONLY
What is our goal in RLA I-III
Increase awareness and alertness
Prevent secondary impairments
Secure appropriate WC
What are treatment strategies in RLA I-III
- Education
- Positioning and ROM
- Upright mobility
- sensory regulation and stimulation
T or F: Sensory stimulation is always safe
False - if a patient has elevated ICP you do not want to do sensory stim. Monitor vitals and ICP t/o
What does a sensory stimulation session consist of?
- explanation w/ time to respond
- 1-2 mins b/t stim pres for a total of 15-30 min multiple times a day
- aud, olfactory, gustatory, visual, tactile, kinesthetic, vestibular
What are the treatment strategies for RLA IV
Focus on behaviour + re-orientation w/short attn spans
Participate in meaningful and familiar tasks
Prevent self-harm + stop is agitation increasing
At which stage of RLA is learning possible?
RLA VI
What is the behavioural result of frontal lobe damage
- personality changes w/verbal or physical violence
What is the behavioural result of temporal lobe damage
- frustrated by aphasia and comm deficits
- inability to regulate emotions
- impaired memory = frustration
What is the behavioural result of parietal lobe damage
- inability to interact w/environment appropriately leading to undesirable behaviours
What is the behavioural result of occipital lobe damage
- think people/items are present when they are not
- poor tolerance to task
Keys to success for RLA IV?
- calm controlled environment and consistent
- flexible in planning & t/o session
What are possible behaviours to manage? (list)
Agitation
Confusion
Impulsivity
disinhibition
perseveration
confabulation
decreased insight
apathy/depression
lack of initiation
What can you change in the environment to help w/behaviour management?
Lighting
Number of visitors
Sleep amount
electronic use
What can you do for structure for behaviour management?
- schedule rest breaks
- avoid overload and overstim
- CONSISTENCY IS KEY
List the types of medications used in behaviour management of TBI
- psychostimulants
- antidepressants (SSRI)
- antiparkinsonian (amantadine)
- anticonvulsants
- meds for sleep/wake
- beta blockers for autonomic dysfuntion