TERM 3- MY NOTES FOUNDATIONS OF NURSING CH.39 "Rehabilitation Nursing" Flashcards
0
Q
Rehabilitation nursing is really what holistic nursing is all about. In rehabilitation nursing, we assess and address every aspect of the individual’s needs and care.
A)true
B)false
A
A
1
Q
Rehabilitation Nursing
A
,
2
Q
Rehabilitation is possible to define in a variety of ways. For our purposes, it is the process of restoring the individual to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable. It involves relearning former skills-relearning the activities of daily living (ADLs)-and learning the new skills necessary to adapt and live fully within the context of an altered lifestyle
A)true
B)false
A
A rehabilitation
3
Q
Rehabilitation means adjusting to a new set of needs by innvolving and applying previous knowledge and skills in combination with a variety of new ideas, knowledge, and skills.
A)true
B)false
A
A
4
Q
Rehabilitation has to begin from the very onset of a traumatic event or diagnosis of a chronic illness.
A)true
B)false
A
A
5
Q
According to Ruth Stryker (1977), rehabilitation is a creative process that begins immediately with preventive care and continues throughout the course of the illness and through the restorative phase of care, and involves adaptation of the whole being to a new Life.
A)true
B)false
A
A
6
Q
NEED FOR REHABILITATION
A
,
7
Q
What precipitates the need for rehabilitation is impairment, disability, handicap, functional limitation, or chronic illness, or some combination of these.
A)true
B)false
A
A
8
Q
The World Health Organization (1980) defines these terms as follows:
A
,
9
Q
• Impairment: Any loss or abnormality of psychological, physical, or anatomical structure or function.
A)true
B)false
A
A
10
Q
• __________: Any loss or abnormality of psychological, physical, or anatomical structure or function.
A
• Impairment: Any loss or abnormality of psychological, physical, or anatomical structure or function.
11
Q
• Disability: Any restriction or lack (resulting from an impairment) of an ability to perform an activity in the manner or within the range considered normal for a human being.
A)true
B)false
A
A
12
Q
• ___________: Any restriction or lack (resulting from an impairment) of an ability to perform an activity in the manner or within the range considered normal for a human being.
A
• Disability: Any restriction or lack (resulting from an impairment) of an ability to perform an activity in the manner or within the range considered normal for a human being.
13
Q
• Handicap: A disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individuaL The handicap one individual with a given disability faces may not be a concern or handicap for another individual with the same disability.
A)true
B)false
A
A
14
Q
• _________: A disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individuaL The handicap one individual with a given disability faces may not be a concern or handicap for another individual with the same disability.
A
• Handicap: A disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individuaL The handicap one individual with a given disability faces may not be a concern or handicap for another individual with the same disability.
15
Q
• Functional limitation: Any loss of ability to perform tasks and obligations of usual roles and normal daily life. See discussion later in the chapter regarding functional assessment.
A)true
B)false
A
A
16
Q
• __________: Any loss of ability to perform tasks and obligations of usual roles and normal daily life. See discussion later in the chapter regarding functional assessment.
A
Functional limitations
17
Q
• Chronic illness: An irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care, function, and prevention of further disability.
A)true
B)false
A
A
18
Q
CHRONIC IllNESS AND DISABILITY
A
,
19
Q
Healthy People 2010 Focus Areas Related to Chronic Illness and Disability
A
,
20
Q
-Assess the quality of service • Arthritis, osteoporosis, and chronic back conditions • Cancer • Chronic kidney disease • Diabetes • Disability and secondary conditions • Heart disease and stroke • Human immunodeficiency virus (HIV) • Mental health and mental disorders • Respiratory diseases • Vision and hearing
A
True
21
Q
CHRONICITY
A
,
22
Q
Unlike acute illnesses, which are usually abrupt in onset and self-limiting (the illness is either resolved or death ensues), chronic illnesses have the potential to be either abrupt or insidious in onset and by definition persist for an extended and indefinite period.
A)true
B)false
A
A
23
Q
Theorists have developed many definitions of chronic illness. However, all definitions include one or more of the characteristics first outlined by the Commission on Chronic Illness (1957). These characteristics include any impairment or deviation from normal that has the following features:
- Is permanent
- Leaves a residual disability
- Is caused by a nonreversible pathologic condition
- Requires special training of the patient for rehabilitation
- Requires a long period of supervision, observation, or care
A
True
24
DISABILITY
,
25
The Americans with Disabilities Act (ADA) became law in 1990. This landmark legislation provides protection against discrimination for people with disabilities. Universally accepted, the ADA defines an individual as disabled if he or she has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having sudt an impairment.
A)true
B)false
A
26
One way to look at it is to assert that all individuals are only temporarily able bodied, and that at some point in life we will all experience some form of disability. It is essential to develop this level of awareness to avoid labeling groups of people in ways that risk disenfranchising them.
A)true
B)false
A
27
CROSS-CUlTURAL REHABILITATION
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28
We are called on to engage in genuine collaboration with our patients and colleagues, including those trained in other disciplines and community-level workers, in order to obtain the best possible functional outcome for the patient.
A)true
B)false
A
29
CULTURAL COMPETENCE
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30
Cultural competence acknowledges and incorporates all levels-the importance of culture, the assessment of cross-cultural relations, vigilance toward the dynamics that result from cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally unique needs
A)true
B)false
A
31
The following describes a culturally competent practitioner:
* Has the capacity for cultural self-assessment
* Values diversity, with an awareness, acceptance, and even celebration of differences in life view, health systems, communication styles, and other life-sustaining elements
* Is conscious of the dynamics of difference
* Institutionalizes cultural knowledge
* Adapts to diversity
True
32
People develop cultural proficiency when they hold culture in high regard. The culturally proficient professional recognizes the need to conduct research, disseminate (spread)the results, and develop new approaches that promise to increase culturally competent practice.
A)true
B)false
A
33
Rehabilitation professionals have an ethical responsibility to strive for cultural competence and cultural proficiency.
A)true
B)false
A
34
ISSUES IN REHABILITATION
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35
In rehabilitation, several forces drive the rendering of care. The issues involved include but are not limited to the following:
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36
* Quality of life versus quantity of life: Rehabilitation focuses on continually improving the quality of the person's life, not merely maintaining life itself.
* Care versus cure: Because of the suddenness and catastrophic effect of many conditions necessitatting rehabilitation, it is necessary to consider the care of the individual versus the cure of the condition. Many conditions are irreversible; therefore, the focus of care is on adapting and accepting an altered life rather than resolving an illness.
* High cost of interdisciplinary care versus longterm care: Rehabilitation is expensive, mainly because the care is delivered by a team of highly trained professionals. In some cases, we view successful rehabilitation as a person's return to productive employment. Studies of resource allocation have shown that for every dollar we spend on rehabilitation, we save an average of three dollars if the individual is able to live independently and return to the workforce, eliminating the exxpense of a caregiver or residential long-term care. Remember, however, that in some cases a disability means that two people become unemployed the individual with the disability and the caregiver. Rehabilitation in this scenario is successful, and the savings still considerable, if the individual with the disability becomes independent enough to not require a caregiver even though he or she remains unable to return to work.
True
37
The underlying philosophy of rehabilitation is to focus on abilities rather than disabilities, to continually make the most of the abilities that remain intact.
A)true
B)false
A
38
The individual, the family, and the support system are the focus of all rehabilitation efforts. Quality rehabilitation will result in people who are continually striving to reach their highest potential of living independently in today's complex world.
A)true
B)false
A
39
GOAlS OF REHABiliTATION
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40
Rehabilitation is, as mentioned, a goal-oriented (outcome-oriented) process. These goals are personal, and in each case we individualize them to meet the holistic needs of each person we serve. To determine goals, we engage in a collaborative goal-setting process that includes the members of the rehabilitation team, with the individual and the family at the center of the process.
A)true
B)false
A
41
It is appropriate to include the following criteria in all rehabilitation goals:
* The goals maximize the quality of life of the individual.
* The goals address the individual's specific needs.
* The goals assist the individual with adjusting to an altered lifestyle.
* The goals are directed toward promoting wellness and keeping complications to a minimum.
* All goals assist the individual in attaining the highest degree of function and self-sufficiency possible.
* The goals assist the individual with home and community reentry.
True
42
CORNERSTONES OF REHABiliTATION
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Rehabilitation is like a road, the road to recovery following a traumatic, life-changing event. The following building blocks or stepping stones pave the way as we travel along it:
,
44
* Focus on the individual: Center all efforts at rehabilitation around the individual's goals and objectives. When the individual sets or holds goals that are less than realistic, the team works with the individual in reshaping expectations.
* Community reentry: We consider rehabilitation successful if the individual is able to reenter the community tluough participation in social, vocational, and recreational activities.
* Independence: The goals of rehabilitation focus on promoting and maintaining physical and emotional independence.
* Functional ability: We measure progress in rehabilitation in terms of functional outcomes.
* Team approach: We achieve rehabilitation goals through the work of the rehabilitation team members, including the individual and the family.
* Quality of life: Goals focus on improving the quality of life rather than increasing the quantity of life.
* Prevention and wellness: Because many problems calling for rehabilitation are long term, our ·goals focus on preventing complications and maximizing function.
* Change process: All individuals and families who experience a disabling condition or chronic illness experience the change process. The rehabilitation team is responsible for directing the change in as positive a manner as possible.
* Adaptation: Although individuals with disabilities do not always accept their disability, learning to adapt to the circumstances created by the limits of their abilities is a positive method of coping.
* Patient and family education: Knowledge and skills are essential components of the rehabilitation program. Individuals with substantial disability have potential to gain a degree of independence through patient education, which enables them to direct their own care.
True
45
REHABiliTATION TEAM
,
46
Because no one discipline offers the knowledge and expertise necessary to provide all the components of the rehabilitation program, the rehabilitation team is composed of people from multiple disciplines. The team coordinates the comprehensive rehabilitation program for each patient in an individualized manner
A)true
B)false
A
47
MODELS OF TEAM FUNCTIONING
,
48
Primary models of rehabilitation team functioning. One model, primarily of service in the past, is the multidisciplinary rehabilitation team. Characteristic of this model are discipline specific goals, clear boundaries between Disciplines, and outcomes that are the sum of each discipline's efforts. Effective communication is the key to success for this type of team.
A)true
B)false
A
49
The type of team most commonly used today in rehabilitation hospitals is the interdisciplinary rehabilitation team. This type of team collaborates to identify individuals' goals and features a combination of expanded problem solving beyond the boundaries of the individual disciplines together with discipline-specific work toward goal attainment.
A)true
B)false
A
50
A third type of team is the transdisciplinary rehabilitation team. What characterizes this model is the blurring of boundaries between disciplines, as well as crosstraining and flexibility to reduce to a minimum any duplication of effort toward individual goal attainment.
A)true
B)false
A
51
Rehabilitation nurses-diverse in expertise, roles, and work settings-play a critical role in models for rehabilitation.
A)true
B)false
A
52
Rehabilitation Team
,
53
Patient
Key member
Participates in goal setting; takes control of own life
Physiatrist
Rehabilitation physician
Team leader; coordinator of program
Rehabilitation RN
Coordinator, educator
Provides support; promotes independence
Rehabilitation LPN/LVN
Care provider; advocate
Assists in treatment plan and implementation
Physical therapist
Designs exercise program
Provides therapy; assesses needs; provides training
Occupational therapist
Assesses independent living needs
Recommends equipment modifications; adapts equipment
Speech pathologist
Designs rehabilitation communication program
Assists in regaining communication skills; educator
Clinical psychologist
Recreation planner
Activates leisure time; promotes interest in activities
Therapeutic recreation therapist
Emotional evaluator
Assists patient in developing realistic positive attitudes
Chaplain
Consultant
Provides support and guidance
Vocational rehabilitation counselor
Vocational planner
Helps obtain training and employment
True
54
REHABILITATION NURSE
,
55
As a rehabilitation nurse, you need to have a broad knowledge base of the pathophysiology of a wide range of medical-surgical conditions and a -body of highly specialized knowledge and skills regarding rehabilitation
A)true
B)false
A
56
Rehabilitation nurses are obliged to be those who offer encouragement on a regular basis. Your role as a rehabilitation nurse is to put the individual in charge of his or her own care rather than taking charge yourself.
A)true
B)false
A
57
The Association of Rehabilitation Nurses (n.d.) gives the following definition:
Rehabilitation nursing is the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems relative to altered functional ability and lifestyle. The goal of rehabilitation nursing is to assist the individual who has a disability and/or chronic illness in restoring, maintaining, and promoting his or her maximal health. This includes preventing chronic illness and disability.
True
58
It is the rehabilitation nurse who reinforces teaching and training completed by the other disciplines on a 24-hour-a-day, 7-day-a-week basis. One hour of physical therapy is -w. possible to undo, or to reinforce, 23 hours a day. Solid rehabilitation nursing is essential for a successful rehabilitation outcome
A)true
B)false
A
59
Rehabilitation nursing roles include those of educator, caregiver, counselor, care coordinator, case manager, patient advocate, consultant, researcher, administrator or manager, and expert witness.
A)true
B)false
A
60
Your focus will be on enabling the individual to move from a totally dependent state to a level of independence
A)true
B)false
A
61
Extensive family and patient education, modern adaptive equipment, numerous community integration activities, specialized programs, and professional, effective team therapies all combine to help the patients learn to make the most of their lives
A)true
B)false
A
62
All basic nursing measures are essential, such as position changes and maintaining body alignment. This prevents skeletal and muscular deformities (contractures) and pressure ulcers.
A)true
B)false
A
63
Rehabilitation nursing is a challenge that requires knowledge, teamwork, coordination, planning, and patience. To care for people with disabilities, it is important for rehabilitation professionals to learn and stay abreast of current knowledge and techniques.
A)true
B)false
A
64
All rehabilitation nurses are expected to engage in professional role activities appropriate to their education, position, and practice setting.
A)true
B)false
A
65
COMPREHENSIVE REHABILITATION PLAN
,
66
The more comprehensive the rehabilitation program, the better the chances for higher functional outcomes of the people served
A)true
B)false
A
67
According to the Commission on Accreditation of Rehabilitation Facilities (CARF) (a nonprofit, private, international standard-setting and -accreditation body whose mission is to promote and advocate the delivery of quality rehabilitation), it is necessary to initiate an overall individualized comprehensive rehabilitation plan of care within 24 hours of admission and have it ready for review and revision by the team within 3 days of admission. The results of the interdisciplinary admission assessment provide the basis for developing the plan.
A)true
B)false
A
68
Underlying it are individual goals incorporating the unique strengths, needs, abilities, and preferences of the person it serves. This plan will reflect the environment where the person will go upon discharge. It is necessary that goals are measurable, are described in functional or behavvioral terms, have associated time frames for achievement, and list the responsible team member(s).
A)COMPREHENSIVE REHABILITATION PLAN
B)false
A
69
Evaluation conferences and family conferences take place on a regular basis. The active participation of the people served is an integral part of planning and implementing the discharge process.
A)true
B)false
A
70
PATIENT EDUCATION
,
71
Patient education is crucial for the rehabilitation process to be comprehensive. Patient education is an ongoing and integral process by which patients and families build knowledge, skills, and confidence to regain physical and psychosocial functioning following an illness or injury.
A)true
B)false
A
72
The following five-step approach is an -option to guide this process:
1. Assess the patient's and the family's needs, abilities, and concerns.
2. Plan interventions based on these needs, abilities, and concerns.
3. Implement the educational plan.
4. Document the educational process.
5. Evaluate and revise the educational plan.
True
73
Guidelines for patient teaching are available from the following:
* Americans with Disabilities Act
* The Joint Commission
* CARF
* American Nurses Association and Association of Rehabilitation Nurses Nursing Standards of Practice
* Individual facility or unit standards
* Patient Care Partnership (Patient's Bill of Rights)
* State nurse practice acts
* National Health Planning and Resource Development Act
True
74
SCOPE OF INDIVIDUALS REQUIRING REHABILITATION
,
75
Chronic illness and physiologic changes of aging increase the likelihood of physical limitations and disability disproportionately for older people compared with younger adults. However, families continue to care for most older people with disabling conditions; relatively few live in nursing homes.
A)true
B)false
A
76
Whether in the acute stage of an illness or injury or in the community, rehabilitation services for the older person are built around maintaining functional abilities, ensuring safety, promoting effective coping, preventing complications, and modifying the environment for maximum independence.
A)true
B)false
A
77
FAMILY AND FAMILY-CENTERED CARE
,
78
Family and family-centered care is a philosophy that -recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions. It is a philosophy that strives to support families in their natural caregiving roles by building on the parents' unique strengths as individuals. This perspective promotes normal patterns of living at home and in the community and views families and professionals as equals in a partnership committed to excellence at all levels of health care.
A)true
B)false
A
79
The ability and willingness of nurses and health care providers to share knowledge and control of health resources with families, empowering them to act as advocates for themselves and their children, is an integral part of family-centered care.
A)true
B)false
A
80
The key elements of family-centered care include the following:
* Incorporating into policy and practice the recoggnition that the family is the constant in a child's life, whereas the service systems and support personnel within those systems fluctuate
* Facilitating family-professional collaboration at all levels of hospital, home, and community care
* Exchanging complete and unbiased information between families and professionals in a supportive manner at all times
* Encouraging and facilitating family-to-family support and networking
* Appreciating families as families and children as children; recognizing that they possess a wide range of strengths, concerns, emotions, and aspirations beyond their need for specialized health and developmental services and support
True
81
PEDIATRIC REHABILITATION NURSING
,
82
Pediatric rehabilitation nursing is a specialty practice area that also continues to grow within the field of rehabilitation.
A)true
B)false
A
83
Nurses in this field, in a collaborative relationship with the interdisciplinary team, provide a continuum of care so those children can become contributing members of society and function at their maximum potential.
A) Pediatrics
B) False
A
84
Infants, children, and adolescents with a variety of disabling conditions receive specialized care from hospital to home, from clinic to school. Physical, emotional, social, cultural, educational, developmental, and spiritual dimensions are all the subject of consideration in a holistic approach to care. The goal is to cherish and foster the unique qualities of each child.
A) Pediatric nurse
B)false
A
85
The primary difference between rehabilitation of children and rehabilitation of adults is the developmental potential of the child. It is possible for the child or adolescent to receive an injury resulting in disability at any age, with very different consequences for his or her future depending on the age and developmental level at which the trauma occurred.
A)true
B)false
A
86
Children who are born with genetic disorders, who are premature, or whose fetal development is affected by maternal disease, injury, or substance abuse require services focused on habilitation rather then rehabilitation
A)true
B)false
A
87
Whereas rehabilitation refers to the relearning of skills or behaviors lost as a result of disease or injury,
A)true
B))false
A
88
habilitation refers to the process of acquiring skills and behaviors by an individual whose development has been affected by disease or other disabling conditions since birth or very early childhood
A)true
B)false
A
89
In summary, in your roles as leader, advocate, and educator, you will have the power as a pediatric rehabilitation nurse to have a very positive influence on the lives of children with disabilities and chronic conditions, as well as on their families
A)true
B)false
A
90
GERONTOLOGIC REHABILITATION NURSING
,
91
Gerontologic rehabilitation nursing is a specialty practice that focuses on the unique requirements of older adult rehabilitation patients.
A)true
B)false
A
92
The gerontologic rehabilitation nurse (GRN) is knowlledgeable about both techniques of caring for the aged and rehabilitation concepts and principles. This unique type of nursing combines knowledge of both the aging process and rehabilitation practice in the specialized task of caring for the aging adult with a disability or long-term health problem.
A)true
B)false
A
93
Your main goal in gerontologic rehabilitation nursing is to assist older adult patients in achieving their personal optimal level of health and well-being by -providing holistic care in a therapeutic environment
A)true
B)false
A
94
GRNs strive not only to provide rehabilitative care but also to teach prevention. Thus GRNs have an opportunity to function within primary, secondary, and tertiary levels of care, with the universal goal of helping older adult patients to achieve optimum wellness and self-care.
A)true
B)false
A
95
POLYTRAUMA AND REHABILITATION NURSING
,
96
Soldiers wounded in conflicts, including those going on in Iraq and Afghanistan, pose new challenges to today's health care system. These soldiers are experiencing multiple traumas with variable patterns, known as polytrauma-blast related injury (PTBRI), resulting from explosions.
A)true
B)false
A
97
Blast injuries are categorized as primary, secondary, tertiary, or quaternary (miscellaneous) ;
,
98
These injuries fall into the primary injury category ;
Air-filled cavities in the body (ears, lungs, and gastrointestinal tract) and organs enveloped by fluid-filled cavities (brain and spinal cord) are -most susceptible to compression damage from high explosive blasts.
True
99
Airborne debris, bomb fragments, and shrapnel embedded in any body part comprise the secondary injury category.
A)true
B)false
A
100
Any injury the soldier sustains from being thrown as the result of an explosive shock wave or dynamic overpressure is a tertiary injury. Examples include broken bones and traumatic head and spinal cord injuries
A)true
B)false
A
101
Inhalation and exposure to toxic chemicals, traumatic amputations of limbs, and burns are examples of quaternary injuries
A)true
B)false
A
102
POSTTRAUMATIC STRESS DISORDER
,
103
Posttraumatic stress disorder (PTSD) is defined as a psychological reaction to the experience of trauma outside the normal range of human experience
A)true
B)false
A
104
PTSD received acceptance as a psychiatric diagnosis, and other forms of trauma, such as rape and natural disasters, were also identified as causes
A)true
B)false
A
105
There is no definitive treatment modality identified for PTSD, but psychotherapy and pharmacotherapy are the most common forms of treatment of PTSD
A)true
B)false
A
106
DISABLING DISORDERS
,
107
SPINAL CORD INJURIES
,
108
SCis occur mainly as a result of traumatic accidents, and the individuals paralyzed are primarily young males
A)true
B)false
A
109
Injury level and the extent of damage to the spinal cord will largely determine functional disabilities. Functional limitations occur in nearly every aspect of an individual's life following an SCI
A)true
B)false
A
110
The effect of SCI on the individual remains one of the most compelling challenges in the field of rehabilitation. People with SCI often require considerable motivation and reeducation to regain a satisfying quality of life and to ensure community reintegration
A)true
B)false
A
111
A spinal cord injury (SCI) is any injury in which the spinal cord undergoes compression by fracture or displaced vertebrae, bleeding, or edema. Each injury has its unique characteristics, but in general, the higher the injury point, the greater the loss of function.
A)true
B)false
A
112
The body parts and the functions located above the injury point will continue to function as they should. Injury to the spinal cord is irreversible in that the cord is unable to repair itself.
A)true
B)false
A
113
In general, however, the effects of an injured spinal cord include paralysis, loss of normal bowel and bladder function, and loss of sensation. Terminology associated with SCI includes but is not limited to the following:
* Complete injury: No motor or sensory function below the level of injury
* Incomplete injury: Some or all motor or sensory function below the level of injury
* Quadriplegia: Damage to the cervical spine or the neck that involves weakness or paralysis in all four extremities
* Paraplegia: Damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities
* Paresis: A slight paralysis, incomplete loss of muscular power, or weakness of a limb
True
114
It is possible to divide SCis into the following cateegories:
* Cervical cord injury: Level of injury is at cervical spine C2 to C7 and involves paralysis of all exxtremities and trunk, respiratory failure, bladder and bowel disturbance, bradycardia, perspiration, elevated temperature, and headache.
* Thoracic cord injury: Level of injury is at thoracic spine T1 to T12 and involves paralysis of lower extremities. Initially muscles are flaccid (weak, soft, flabby, lacking normal muscle tone) and later become spastic (having spasms or other uncontrolled contractions of the skeletal muscles). Paralysis of bladder, bowel, and sphincters; pain in chest or back; abdominal distention; and loss of sexual function are other potential symptoms.
* Lumbar cord injury: Level of injury is at lumbar spine L1 to L2 with paralysis of lower extremities, bladder, and rectum and loss of sexual function .
True
115
Common medical complications experienced by patients with SCI include but are not limited to postural hypotension, autonomic dysreflexia, heterotopic ossification, and deep-vein thrombosis
A)true
B)false
A
116
C1 to C4-Usually requires respiratory assist (respirator) ond usually requires skilled care.
```
C5 to C8-In general, each level is more independent as progression from C1 to C8 occurs;
1 . Nonombulotory
2. Transfer with assistance
a) C4-5 complete dependent transfer
b) C5·6-7 assistive transfer
3. ADL needs assist
4. C5·6·7 drive with assist
5. Intellectual work or avocation
```
T1to T5
1. Nonombulotory (may have exercise abmbulation with braces)
2. ADL independent
3. Bladder independent care.
Bowel may need help.
4. Driving with hand controls
5. Intellectual work or bench or sedentary work
T6 to T9
1. Limited ambulation with braces
2. ADL independence
3. Bladder independent care; may need help with bowel
4. Driving with hand controls
5. Vocation most likely to desk or bench
TlO to Tl2
1. Functional ambulation
2. Complete ADL independence
3. Bowel and bladder independent care
4. Driving
5. Appropriate work
L1 to L3
1. Functional ambulation
2. Complete ADL independence
3. Bowel and bladder independent care
4. Driving
5. Appropriate work
```
L4 and Below
1 . Full ambulation
2. Complete ADL independence
3. Bowel and bladder control
4. Driving
5. Appropriate work
```
True
117
Postural Hypotension
,
118
Some spinal cord-injured individuals will at times have a marked drop in blood pressure while sitting in a wheelchair. It is common for many quadriplegic patients to have a blood pressure of 90/60 mm Hg (or lower) when sitting as a result of the pooling of the blood in the lower extremities and in the abdominal area. Returning the patient to the horizontal position will usually stop dizziness.
To lessen hypotension, raise the head of the bed 15 to 20 minutes before placing the patient in the wheelchair. Use of elastic stockings (thromboembolic disease [TED] hose) and abdominal binders is also an option.
A)Postural Hypotension
B)Autonomic Dysreflexia
A
119
Autonomic Dysreflexia
,
120
Patients with spinal cord lesions above T5 sometimes experience sudden and extreme elevations in blood pressure caused by a reflex action of the autonomic nervous system. It is the result of some stimulation of the body below the level of the injury, usually a distended bladder from a blocked catheter.
Any stimulation has potential to produce the syndrome, including constipation, diarrhea, sexual activity, pressure ulcers, position changes (from lying to sitting), and even wrinkles in clothing or bed sheets.
A)Autonomic Dysreflexia
B)false
A
121
Treatment for autonomic dysreflexia is to find the source of irritation and remove it. Once the irritation is gone, the blood pressure will return to normal within a few minutes. Raise the patient into a sitting position immediately. This helps reduce the elevated blood pressure before damage occurs.
A)true
B)false
A
122
Heterotopic Ossification
,
123
Heterotopic ossification is the abnormal formation of bone cells in joints. It commonly arises in people with . SCis and occurs below the level of the lesion. The formation of extra bone in these joints usually results in limited range of motion. The most commonly affected joints are the hip and sometimes the knee.
It occurs most frequently 1 to 4 months following injury and rarely occurs after 1 year. Symptoms include localized edema around the area; after several days, you will be able to feel a firm mass in underlying tissue. After several weeks, there is loss of range of motion.
Treatment options involve aggressive range of motion, medications, and occasionally surgery.
A)Heterotopic Ossification
B)DVT
A
124
Deep-Vein Thrombosis
,
125
Patients with spinal injuries have the potential to develop deep-vein thrombosis (DVT) in the lower extremities. DVT is a clotting of blood within vessels of the legs caused by slowing of the circulation or an alteration of the blood vessel walls.
Clinical signs include localized swelling, redness, and heat in the involved area. If these signs are present, aggressive movement to that leg is unwise because it has potential to detach the blood clot, which in turn has potential to lodge in the lung (embolus).
Anticoagulants (blood thinners) prevent DVT.
Passive and active range-of-motion (ROM) exercises are other possible preventive measures.
A)DVT
B)False
A
126
TRAUMATIC BRAIN INJURIES
,
127
Most brain related disabilities, including physical, cognitive, and psychosocial difficulties, call for at least 5 to 10 years of difficult and painful rehabilitation; many require lifelong treatment and attention.
A)true
B)false
A
128
The primary goal of the rehabilitation professional treating the survivor of brain injury is to restore the person to the highest possible level of independent functioning
A)true
B)false
A
129
Head injuries fall into two classifications, either penetrating or closed head injuries. In penetrating InJuries, an object lacerates the scalp, fractures the skull, and injures the soft tissue in its path, thus destroying nerve cells.
A)true
B)false
A
130
In a closed head injury, some application of force causes the brain to collide with an inner surface of the skull. There is often violent twisting action, which causes the upper section of the brain to rotate while the lower end remains securely anchored in a stationary position. This results in widespread damage called shearing (when the brain mass is rotated in the cranial vault)
A)true
B)false
A
131
Brain injuries are classified as mild, moderate, severe, or catastrophic.
A)true
B)false
A
132
Brief or no loss of consciousness characterizes mild brain injury. This type constitutes the majority of head injuries. Neurologic examinations are often normal.
Postconcussive syndrome sometimes persists for months, years, or indefinitely.
Signs and symptoms include fatigue, headache, vertigo, lethargy, irritability, personality changes, cognitive deficits, decreased information processing speed, and memory, understanding , learning, and perceptual difficulties. These symptoms lead to feelings of incompetence, guilt, and frustration. Family members also become impatient and frustrated at times
A)mild brain injury
B)moderate brain injury
A
133
In the moderate brain injury, there is a characteristic period of unconsciousness ranging from 1 to 24 hours.
There are usually cognitive impairments, which include planning, sequencing, judgment, reasoning, and computation skills. Generally there are some psychosocial problems, which include self-centeredness, denial, mood swings, agitation, depression, lethargy, sexual dysfunction, emotional lability, low frustration tolerance, poor judgment, or behavioral outbursts.
A)moderate brain injuries
B)server brain injuries
A
134
Patients with severe brain injuries experience unconsciousness or posttrauma amnesia in excess of 8 days. Cognitive, psychosocial, and behavioral disabilities result .
A)true
B)false
A
135
Catastrophic brain injury features a defining characteristic of a coma lasting several months or longer. These individuals sometimes appear to be awake. However, they generally never regain significant, meaningful communication with their environment.
A)true
B)false
A
136
In rehabilitative assessment of the patient with TBI, expect to see inconsistent performance, anger, and frustration; and ineffective behavior will be changeable (unless it is neurogenic in origin).
Cognitive barriers to rehabilitative recovery include problems in thinking and reasoning (impaired memory), impaired concentration and attention, and impaired informational processing speed. Psychosocially there appears to be a lack of initiative. However, this is a normal consequence of a head injury.
A)true
B)false
A
137
Egocentric (self-centered) behavior is 100% normal in a brain-injured individual, as is depression. Generally, the more the memory improves, the more the patient becomes depressed.
A)true
B)false
A
138
Abstinence from alcohol is a primary injunction for any patient with a brain injury. Alcohol increases the chance of impulse and seizure activity.
A)true
B)false
A
139
Regardless of personality types, any disability, particularly a TBI, is a crisis that threatens many aspects of the patient's and family's life: job income, pleasures, family, community ties, health, and life itself. The fears are very real.
A)true
B)false
A
140
CONCLUSION
,
141
If you become a rehabilitation nurse, count on a career with a few key mandates and rewards: take your responsibility seriously as a professional who has The power to significantly affect the future of those with disabilities. Facilitate the change from resistance to openness, turning inertia into action. Keep your focus on the assets and the successes of people who have disabilities.
A)true
B)false
A
142
Key Points
,
143
* Rehabilitation is the process of maximizing an individual's capabilities or resources to foster optimal independent functioning.
* The patient is the most important team member and is crucial to involve in planning the programs and learning in detail about the disabilities, the ways of accomplishing the goals, and the options available.
* Rehabilitation nursing aims toward preventing complications of disease or trauma and maintaining or restoring function.
* Basic rehabilitation is possible regardless of cause of disability. The rehabilitation team will individualize care by developing goal-directed, comprehensive care plans for each patient.
* A disability has a number of potential effects on both the patient and the family, including behavioral and emotional changes and changes in roles, body image, selfconcept, and family dynamics.
* Use holistic nursing interventions to assist the patient in attaining an optimal level of functioning and well-being.
* A comprehensive rehabilitation plan is multifaceted and properly involves a functional assessment, an evaluation conference, and a family conference.
* Keep the focus of all rehabilitation on the patient's abilities, not on his or her disabilities.
True
144
NCLEC PERP
,
145
1. Rehabilitation of the older adult focuses on which aspect(s)? (Select all that apply.)
1. Maintaining functional abilities
2. Ensuring safety
3. Promoting effective coping
4. Preventing complications
5. Maximizing independence
1,2,3,4,5
146
2. The goal of rehabilitation for older adult patients is to:
1. return to work.
2. teach safe mobility.
3. improve quality of life.
4. reduce cellular destruction.
3
147
3. A 19-year-old patient is seen in the emergency department after a diving accident. She is noted as having a spinal cord injury at the cervical level (C3). Which nursing diagnosis is likely?
1. Ineffective breathing patterns, related to neurogenic
injury
2. Deficient fluid volume, related to osmotic diuresis
3. Acute pain, related to disease process
4. Deficient knowledge, related to disease process
1
148
An 11-year-old boy had a head injury from being struck in the skull by a baseball bat. He awoke in a hospital 3 weeks later. His head injury would be classified as a:
1. mild brain injury.
2. moderate brain injury.
3. severe brain injury.
4. catastrophic brain injury.
3
149
5. A patient has been in the intensive care unit for several days following a head injury. His condition is stable, but today he has shown no signs of improvement. Over the past shift, the patient's father has seemed increasingly
upset over apparently minor concerns. Toward the end of the shift, he yells at the nurse when the intravenous (IV} alarm goes off. The most appropriate response is:
1. "You sound upset."
2. "I am going to get my supervisor for you."
3. "You need a break."
4. "Maybe you had better speak to the physician."
1
150
6. The pediatric rehabilitation nurse:
1. advocates for the child and family.
2. does not burden parents with decision making.
3. realizes that children with disabilities will never be
productive members of society.
4. does not take cultural values of parents into
consideration.
1
151
7. According to the World Health Organization (WHO), the disadvantage for a person that results from an impairment or a disability and limits that person's fulfillment of his or her normal roles is defined as a(n):
1. disability.
2. impairment.
3. handicap.
4. inconvenience.
3
152
8. According to the definition of rehabilitation nursing established by the Association of Rehabilitation Nurses, the major goal of rehabilitation nursing is to assist the
individual in:
1. achieving optimal physical functioning.
2. obtaining therapy services.
3. restoring and maintaining optimal health.
4. identifying funding sources.
3
153
9. Rehabilitation nursing practice requires:
1. specialized knowledge and skills.
2. organized approaches to care.
3. skills in all therapies that are provided.
4. rigid mastery of tasks.
3
154
10. The first step to becoming culturally competent is to:
1. know your own culture.
2. learn about other cultures.
3. practice what you know about other cultures.
4. continue to Learn about other cultures.
1
155
11. Which is a barrier to cultural competence?
1. Respect for the beliefs of others
2. Knowing all members of a cultural group are not necessarily alike
3. Believing that one's own culture is better than others
4. Not treating one group better than another based on culture or race
3
156
12. As part of the rehabilitation treatment team, the nurse is often the first professional to detect the presence of PTSD symptoms because:
1. nurses are more intuitive than other members of the team.
2. nurses are in the unique position of having extended time to talk with patients and hear their concerns, feelings, and needs.
3. nurses are the only members of the team knowledgeable about PTSD.
4. the rehabilitation team has no need to address this
issue.
2
157
13. The classification levels of injuries that occur as a result of exposure to a blast are:
1. primary, secondary, and tertiary.
2. quaternary.
3. miscellaneous injuries.
4. All of the above.
4
158
14. Communication with families of patients with polytraumatic injuries properly includes:
1. clear, accurate, and comprehensive information of their loved ones' injuries.
2. supportive, empathetic, and sensitive manner to giving them the information.
3. reassurance there will be someone available to assist them in dealing with their own stress and anxiety.
4. All of the above
4
159
STUDY GUIDE
,
160
Interdisciplinary rehabilitation team– collaborates to identify an individual’s goals and is characterized by a combination of expanded problem solving beyond discipline boundaries and discipline- specific work
A)true
B)false
A
161
Multidisciplinary rehabilitation team– characterized by discipline-specific goals, clear boundaries between disciplines, and outcomes that are the sum of each discipline’s efforts
A)true
B)false
A
162
Transdisciplinary rehabilitation team– characterized by the blurring of boundaries between disciplines, as well as by cross-training and flexibility to minimize duplication of effort toward goal attainment
A)true
B)false
A
163
The philosophy of rehabilitation nursing is to address every aspect of the individual’s needs (holistic approach). The process is creative and includes adaptation of the whole being to a new life. The focus in rehabilitation is on the patient’s abilities, not the disabilities, and to continually make the most of the abilities that remain intact.
A)true
B)false
A
164
The different needs for rehabilitation are identified by the World Health Organization as impairment, handicap, functional limitation, and chronic illness
A)true
B)false
A
165
```
Examples of focus areas related to chronic illness and dis- ability in Healthy People 2010 include:
• Access to quality health services
• Arthritis, osteoporosis, and chronic back conditions
• Cancer
• Chronic kidney disease
• Heart disease and stroke
• HIV
• Mental health and mental disorders
```
Trur
166
General goals of rehabilitation are to maximize the individual’s quality of life, address specific needs, assist with adjustment to an altered lifestyle, promote wellness and minimize complications, promote attainment of maximum functioning ability, and assist the individual with reentry to the home and community.
A)true
B)false
A
167
The members and roles of the rehabilitation team are as follows:
• Patient–takes control of own life
• Physiatrist–team leader, coordinator
• Rehabilitation RN–provides support, promotes independence
• Rehabilitation LPN/LVN–assists in treatment plan and implementation
• Therapists–provide specific therapy to increase or maintain strength or movement, use adaptive equipment, improve communication skills
• Clinical psychologist–assists in developing realistic positive attitudes
• Chaplain–provides spiritual support and guidance
• Vocational counselor–assists in training and employment
True
168
The rehabilitation nurse is with the patient 24 hours each day and is able to readily evaluate progress and assist with adaptation. Focus is placed on enabling the patient to move from a totally dependent state to a level of independence. All basic nursing measures, such as positioning, hygienic care, and especially therapeutic communication skills, are used in this practice
A)true
B)false
A
169
The comprehensive rehabilitation plan is started within 24 hours of patient admission.
A)true
B)false
A
170
Comprehensive rehabilitation plan reevaluated within 3 days of the admission.
A)true
B)false
A
171
Comprehensive rehabilitation plan is developed based upon the results of an interdisciplinary admission assessment.
A)true
B)false
A
172
Characteristics of chronicity–permanent, leaves a residual disability, a nonreversible pathologic condition, requires special training for rehabilitation and a long period of supervision and care.
A)true
B)false
A
173
The two major disabling conditions are spinal cord and traumatic brain injuries.
A)true
B)false
A
174
Quadriplegia–damage to the cervical spine or neck that involves weakness or paralysis to all four extremities
A)true
B)false
A
175
Paraplegia–damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities
A)true
B)false
A
176
Paresis–slight paralysis, incomplete loss of muscular power, or weakness of a limb
A)true
B)false
A
177
Postural hypotension–drop in blood pressure when the patient is sitting up in a wheelchair. The patient may experience dizziness or lightheadedness.
Nursing intervention–Return patient to bed, elevate head of the bed before getting the patient out of bed, apply TED stockings.
A)true
B)false
A
178
Heterotopic ossification–abnormal formation of bone cells in joints 1 to 4 months after the injury. Symptoms include localized edema, with a firm mass possibly developing, and decreased range of motion.
Nursing intervention–Implement range of motion; administer medications.
A)true
B)false
A
179
The two types of head injuries are penetrating (object lacerates the scalp, fractures the skull, and injures the soft tissue, destroying brain cells) and closed (brain collides with the inner surface of the skull).
A)true
B)false
A
180
Most patients with traumatic brain injuries require physical, cognitive, and psychosocial intervention for many years, if not the remainder of their lives. Emphasis is on attainment of a maximum level of functioning, whether it is a return to an occupation or achievement of basic ADLs.
A)true
B)false
A
181
In a rehabilitative assessment of a patient with a traumatic brain injury, the nurse may expect to see inconsistent performance of activities, anger, depression, and frustration. There may be multiple problems with cognition along with a lack of initiative. Egocentric behavior is normal.
A)true
B)false
A
182
```
Examples of possible nursing diagnoses and outcomes for patients with spinal cord and traumatic brain injuries are:
• Airway clearance, ineffective
• Coping, ineffective
• Injury, risk for
• Infection, risk for
• Intracranial adaptive capacity, decreased
• Mobility, impaired
• Self-care deficit
```
```
Outcomes:
• Provide accurate responses to questions.
• Maintain patent airway.
• Demonstrate an awareness of safety hazards.
• Verbalize feelings.
• Demonstrate ability to perform ADLs.
• Request assistance as appropriate.
• Increase the attention span.
• Demonstrate appropriate behavior.
• Remain injury-free.
• Maintain or improve mobility.
```
True
183
Polytrauma, also known as polytrauma-blast related injury (PT/BRI) is a new health care issue resulting from blast injuries to soldiers involved in military conflicts, such as those in Iraq and Afghanistan.
PTSD is a disorder resulting from experiencing a trauma outside the normal range of human experience, such as war, natural disasters, rape, etc.
a)true
B)false
A
184
```
The cornerstones of rehabilitation are:
• Individually centered
• Community reentry
• Independence
• Functional ability
• Team approach
• Quality of life
• Prevention and wellness
• Change process
• Adaptation
• Patient and family education
```
True
185
Key elements of family-centered care include recognition that the family is a constant, collaboration and communication is crucial, networking and support groups are extremely beneficial, and families have diverse strengths, limitations, concerns, emotions, and needs.
A)true
B)false
A
186
The main difference in the approach to pediatric and gerontologic rehabilitation is that specific developmental principles are used in the determination of goals for patients in these age groups. Children may need to acquire new skills or remaster skills that have been lost. The particular needs of the older adult, such as physical limitations, social relationships, and role changes, are incorporated into the rehabilitation plan.
A)true
B)false
A
187
Two patients are admitted to a rehabilitation hospital. Both have the same medical condition, but one patient is not able to manage, physically or emotionally, the adaptation that is required. This patient best described as having a
A) Disability
B) Handicap
B
188
The patient experienced a spinal cord injury at the T6 through T9 level. The nurse anticipate that the patient should be able to
A) Ambulate independently
B) Drive with hand controls
B
189
The construction worker sustained an injury to C7 after a fall at a work site. The nurse anticipate that this patient will be
A) Independent in bladder care
B) Non-ambulatory
B
190
The emergency squad brought in the patient following an accident at home. One of the squad members tells the nurse that the patient, according to the spouse, was unconscious for one and a half hours. This head injury is described as
A) Moderate
B) Severe
C) Mild
A
191
Patient has a spinal cord injury above the level of T5. While assessing with hygienic care, the nurse notices that the patient is diaphoretic and shivering, and he states that he has a headache. Upon assessment, it is found that his blood pressure is elevated. Dunbars next action should be to
A) Check for bladder distention
B) Position the patient flat
A
192
The nurse anticipates that the treatment for the patient with a spinal cord injury and deep vein thrombosis will include:( select all that apply)
A) Assessment for postural hypotension
B) Prescription anticoagulants
C) fluid restrictions
A B
193
Key terms
,
194
Commission on accreditation of rehabilitation facilities-a not for profit, private, international standards settings and accreditation body. Its mission is to promote and advocate delivery of quality rehabilitation. It is governed by a board of trustees who are responsible for accreditation decisions.
A)true
B)false
A
195
Comprehensive rehabilitation-An overall individualized plan of care that is initiated within 24 hours of admission and ready for review and revision by the team within three days of admission for each individual; a plan, orderly sequence of services for a disabled individual designed to help the patient realize maximum potential
A)true
B)false
A
196
Disability-Any restriction or lack (resulting from an impairment) Of an ability to perform an activity in the manner or within the range considered normal for human being
A)true
B)false
A
197
Family centered care-Philosophy of care that recognizes the family as a constant in the child's life and holds that system and personnel must support, respect, encourage, and enhanced the strengths and competence of the family
A)true
B)false
A
198
Functional limitation-Any loss or ability to perform task and obligations of usual roles and normal daily life
A)true
B)false
A
199
Handicap-a disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for the particular individual
A)true
B)false
A
200
Impairment- Any loss or abnormality of psychological, physiological, or anatomic structure or function
A)true
B)false
A
201
Which of the following statements define rehabilitation? Select all that apply.
A)The process of restoring the individual to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable
B)Relearning of former skills and learning new skills necessary to adapt and live fully in an altered lifestyle
C)The involvement and application of previous knowledge and skills in combination with a variety of new ideas, knowledge, and skills to adjust to a new set of needs
A B C
202
An irreversible illness that may develop as a "normal" part of aging is a(n):
A)Chronic illness
B)Disability
A
203
The underlying philosophy of rehabilitation is to focus on the:
A)Abilities of the patient
B)Patient's need and wants
A
204
An acute illness is severe and short-term.
A)true
B)false
A
205
A disability can affect people of all ages.
A)true
B)false
A
206
An impairment can affect people of all ages.
A)true
B)false
A
207
According to the World Health Organization, which term is defined as any loss of ability to perform tasks and obligations of usual roles and normal daily life?
A)Functional limitation
B)Chronic illness
A
208
Disability is any restriction or lack of an ability to perform an activity in the manner or within the range considered normal for a human being.
A)true
B)false
A
209
Chronic illness is an irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care, function, and prevention of further disability.
A)true
B)false
A
210
Handicap is a disadvantage for a given individual resulting from an impairment or disability that limits or prevents the fulfillment of a role that is normal for that particular individual.
A)true
B)false
A
211
The primary model of rehabilitation team functioning include the ______ rehabilitation team. (Select all that apply.)
A)Multidisciplinary
B)Interdisciplinary
C)Transdisciplinary
A B C
212
As a nurse caring for a child going through rehabilitation, you know the primary difference between children and adults is the:
A)true
B)false
A
213
A patient was in a car accident that resulted in a spinal cord injury. He has now come to the rehabilitation hospital where you work. The history and physical on the chart states that he is a paraplegic as a result of the spinal cord injury. As the nurse you know that having paraplegia means:
A)Damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities
B)A slight paralysis, incomplete loss of muscular power, or weakness of a limb
A
214
A patient has had a brain injury from a fall while riding her horse. She has been assigned to your care. In report, you were told that she has been unconscious now for 8 days. This is an example of which typed of brain injury?
A)Severe
B)Moderate
A
215
Mild brain injury is characterized by brief or no loss of consciousness.
A)true
B)false
A
216
Moderate brain injury is characterized by a period of unconsciousness ranging from 1 to 24 hours.
A)true
B)false
A
217
A severe brain injury is characterized by unconsciousness or posttrauma amnesia in excess of 8 days. There are cognitive, psychosocial, and behavioral disabilities.
A)true
B)false
A
218
Catastrophic brain injury is characterized by a coma lasting for several months or longer.
A)true
B)false
A
219
A patient suffered a spinal cord injury that has left him a quadriplegic. He has paralysis of the lower and upper extremities but is able to breathe on his own. Which of the following would be appropriate nursing diagnoses for this patient? Select all that apply.
A)Risk for impaired skin integrity related to lack of movement
B)Impaired physical mobility related to injury process
C)Grieving related to loss of functions
D
A B C
220
Rehabilitation nurses have a unique position within the disciplinary team in that they:
A)Are the only team member with the patient on a 24-hour basis
B)Have specialized training to provide continuity of care
A
221
Rehabilitation is expensive but has very good results
A)true
B)false
A
222
All rehabilitation goals shall
- Assist the individual with adjusting to an altered lifestyle
- Assistant individual in attaining the highest degree of function and self-sufficiency possible
- assists the individual to return to home and community
True
223
Comprehensive rehabilitation plan-It is initiated within 24 hours of admission and ready for review and revision by the team within three days of admission for each individual
A)true
B)false
A
224
Family and family centered care-a philosophy that recognizes the pivotal role of the family in the lives of children with disabilities and other chronic conditions
A)true
B)false
A
225
Gerontologic Rehabilitation nursing-The main goal is to assist older adults patients in achieving their personal optimal level of health and well-being by providing holistic care in a therapeutic environment.
A)true
B)false
A
226
PTSD- Previously known as "shell shock" or "war neurosis". Now applies to various forms of traumas including natural disasters and rape
A)true
B)false
A
227
Autonomic dysreflexia- Patients with spinal cord lesions above T5 may experience sudden and extreme elevation in blood pressure caused by a reflex action of the autonomic nervous system. It is produced by stimulation of the body below the level of injury, usually by a distended bladder
A)true
B)false
A
