Test I Flashcards

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0
Q

What is a particular tool, systematic observation or instrument that is used to collect data about the patient during the evaluation process?

A

Assessment

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1
Q

What is the process of reviewing data, observing a client and using screening tools to identify the individual’s potential to benefit from further assessment?

A

Screening

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2
Q

What encompasses obtaining, interpreting and synthesizing data to understand the patient, the situation or system factors that may or may not influence the therapeutic intervention?

A

Evaluation

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3
Q

when does discharge planning begin in acute care?

A

At the time of the initial evaluation.

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4
Q

Chart review, interview and occupational profile, specific evaluation measures, interpretations and findings and recommendations for treatment are all part of the ______ process.

A

Evaluation

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5
Q

What type of performance is the OT’s primary focus on in acute care?

A

Cognitive and physiological performance

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6
Q

What is the ultimate goal of acute care?

A

To move the patient home or to another setting as soon as the patient becomes stable.

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7
Q

What is the typical expected time frame for OT evaluations after they are ordered by a physician?

A

Same day or within 24 hours of referral.

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8
Q

How long is a typical acute care eval?

A

30 minutes

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9
Q

What are the benefits of co-evals and co-treats?

A

They reduce the need to compete for time and reduce the client fatigue since they don’t have to perform the same tasks multiple times or answer questions twice.

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10
Q

During what process do OTs typically gain most of their information about their acute care patient?

A

During the patient interview and task oriented assessment

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11
Q

What is the most limiting factor in the acute care setting?

A

time

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12
Q

What is a POC?

A

the medical plan of care

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13
Q

What are the two key measures of homeostasis?

A

lab results and vital signs

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14
Q

List some of the most common lab tests conducted for patients in acute care.

A

Blood cell counts, arterial blood gasses, pH, basic metabolic panel, coagulation panels, d-dimer, urinalysis

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15
Q

At what O2 sat can the OT typically remove a patient’s oxygen during treatment?

A

95% or above

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16
Q

What’s an important test for determining the need for at home O2?

A

6 minute walk test

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17
Q

What is unique about the way cardiopulmonary patients often breathe?

A

Using accessory muscles, such as the scalene muscles over the diaphragm.

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18
Q

For emphysema patients, what’s the most difficult position for breathing?

A

Supine

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19
Q

What should an OT do if their client’s cognition seems impaired?

A

Follow up with a subtest from a standardized assessment.

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20
Q

What kind of body structure/function is a patient’s temperament?

A

Global function (specific mental functions include memory, hearing, vision etc.)

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21
Q

What is a simple way to check a patient’s proprioception?

A

Flex or extend a patient’s finger and while it is out of their view, ask them to identify if the digit is bent or straight.

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22
Q

What’s the best way to check a new patient’s vestibular function?

A

Offer a balance challenge to a patient sitting on the edge of the bed.

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23
Q

If a patient has a dysfunctional body structure, what is the OT’s role in helping the patient with that structure?

A

Teaching the patient to compensate for difficulties with that body structure.

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24
Q

List the common classes of performance patterns

A

roles, habits, rituals, patterns

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25
Q

What is the difference between hypoxemia and hypoxia?

A

Hypoxemia is insufficient oxygenation in the arterial blood (not getting enough into circulation) while hypoxia is the inadequate oxygen in the body tissues (not absorbing enough from blood)

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26
Q

WHAT IS NORMAL HEART RATE?

A

60-100

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27
Q

WHAT IS NORMAL SYSTOLIC PRESSURE?

DIASTOLIC?

A

systolic 90-120

diastolic 60-80

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28
Q

What is hypotension?

A

< 90 systolic

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29
Q

WHAT IS WNL FOR O2 SAT?

A

96-100%

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30
Q

WHAT IS WNL FOR RESP?

A

12-20

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31
Q

What is the function of a bipap?

A

Provides positive inspiratory pressure to decrease the work of breathing.

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32
Q

What is the major purpose of endotracheal tubes?

A

Used to provide an airway

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33
Q

In what case would nasal-tracheal intubation be used?

A

In the case if jaw, neck, mouth or facial trauma.

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34
Q

Where is a tracheostomy inserted?

A

Into the anterior trachea below the vocal cords.

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35
Q

What is the most common reason for tracheostomy placement?

A

For extended vent weaning.

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36
Q

WHAT IS THE FUNCTION OF A CENTRAL LINE?

A

Provides long term vascular access for administering drugs or fluids or taking blood samples. (Placed in the subclavian, jugular, basilic or femoral vein)

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37
Q

Where does a Peripherally Inserted Central Venous Catheter typically terminate?

A

Terminates in the superior vena cava via basilic or cephalon veins.

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38
Q

What are special precautions for patients with temporary pacemakers?

A

Avoid raising arms and anything that could pull on pacemaker leads.

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39
Q

WHAT IS A TYPICAL REQUIREMENT FOR ALL FOUR RAILS TO BE RAISED?

A

Physician’s order

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40
Q

What are the SAFE guidelines for optimal care?

A

Sharpen observation skills, Acquire necessary handling skills, Follow medical guidelines, Enhance the environment.

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41
Q

What are the six elements of the continuum of acute care?

A

Review medical information, observe the patient and environment, initiate patient contact, assess body functions and structures, assess functional activities, intervention.

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42
Q

What are possible benefits of bedrest?

A

Reducing O2 needs, decreasing pain levels, providing needed rest

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43
Q

What is the rate of decreased muscle strength for a person on bedrest?

A

1-3% per day!

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44
Q

What are the common effects of bedrest on the cardiovascular system?

A

Heart rate increases, stroke volume decreases, increased risk of DVTs, and orthostatic hypotension.

45
Q

What are common effects of bedrest on the pulmonary system?

A

Restricted movement of the chest & diaphragm, shallower breathing, increased respiratory rate, impaired cough, hypostatic pneumonia, and atelectasis.

46
Q

What are two disorders that can result from urinary stagnation during bedrest?

A

kidney stones and UTIs

47
Q

What is the term for nearsightedness / objects far away appear blurry?

A

Myopia

48
Q

Where is the focus of light in myopia?

A

In front if the retina.

49
Q

What is the term for farsightedness / seeing distant objects more clearly than close ones?

A

Hyperopia

50
Q

What is a condition in which the eye does not focus light evenly into the retina, making the image look blurry or stretched out.

A

Astigmatism

51
Q

What is the most common symptom of refractive errors?

A

Blurry vision

52
Q

What is defined as the clarity or sharpness of vision?

A

Visual acuity

53
Q

What part of the eye is the white, outermost layer?

A

Sclera

54
Q

What layer covers the iris and allows light into the eye?

A

Cornea

55
Q

What is the clear structure that sits behind the iris and helps to focus images into the retina?

A

Lens

56
Q

What is the name for the layers of blood vessels between the sclera and retina that supply blood for nutrients to the eye and removal of waste?

A

Choroid

57
Q

What part of the eye allows vision of great detail?

A

Macula

58
Q

What spot in the retina contains mostly cones and allows for the greatest acuity?

A

Fovea

59
Q

What are the functions of the central visual field?

A

Analytical vision, denotes form, pattern, color, accuracy, needs light and high concentration.

60
Q

What are the functions of peripheral vision?

A

Awareness, feedback about body in space, denotes movement and obstacles, does not require bright light, important for balance

61
Q

What is ARMD and what are the two common types?

A

Macular degeneration causes loss of central vision; can be wet- blood vessels rupturing in the macula, or dry- causing the macula to atrophy

62
Q

What is the major eye disease that causes cloudiness and yellowing of the lens and blurry vision?

A

Cataracts

63
Q

What is the eye disease characterized by fluid pressure on the optic nerve?

A

Glaucoma

64
Q

What part of the visual field is first to go for patients with glaucoma?

A

Peripheral field

65
Q

What eye disease is called the “silent theif” because it usually goes undetected until it’s too late?

A

Glaucoma

66
Q

What eye problems are caused by leaky blood vessels in the retina?

A

Diabetic retinopathy

67
Q

What form of diabetic retinopathy is caused by micro aneurysms?

A

Mild nonproliferative retinopathy

68
Q

What diabetic retinopathy involves the blockage of some blood vessels as the disease progresses?

A

Moderate nonproliferative retinopathy

69
Q

What diabetic retinopathy involves many blocked blood vessels and a retina that is significantly deprived of blood supply?

A

Severe Nonproliferative Retinopathy

70
Q

What form of diabetic retinopathy consists of the growth of abnormal and fragile new blood vessels?

A

Proliferative Retinopathy

71
Q

Which forms of diabetic retinopathy do not have associated vision changes with changes in glucose levels?

A

Nonproliferative forms of D.R.

72
Q

What is a visual deficit that cannot be corrected with lens, surgery or medication and interferes with daily activities?

A

Low Vision

73
Q

What are 5 areas that can be improved to help clients with low vision?

A

• Maximizing usable vision, • increasing identifiability of objects, • environmental modifications for safety and tasks, • adapting tasks and routines and • maximizing wellness.

74
Q

What is a disease in which visual deficits are accompanied by obscure visual hallucinations?

A

Charles Bonnet syndrome

75
Q

What type of neck injury (commonly associated with car accidents) causes a tear of the posterior longitudinal ligament?

A

Hyper-flexion injury

76
Q

What is the common cause of hyper-extension injuries of the neck, and what is the most vulnerable ligament when those injuries occur?

A

Falls causing a torn anterior longitudinal ligament

77
Q

What is the term for a closed collection of blood which can compress the spinal cord?

A

Hematoma

78
Q

What is a rupture of a blood vessel which can cause ischemia or can cause pressure to build up on the cord?

A

Hemmorhage

79
Q

What is the difference between a thrombosis and an embolus?

A

A thrombosis is an occlusion of circulation while an embolus is the occluding factor (usually a blood clot)

80
Q

What is typically collecting in the spinal column if a patient has tuberculosis of the spine?

A

Pus

81
Q

What is the condition in which long “wormy looking” cavities form in the spinal column that cause patchy deficits?

A

Syringomyelia

82
Q

What term refers to any paralysis of upper and lower extremities due to a cervical injury?

A

Tetraplegia

83
Q

What refers to partial or complete paralysis of the lower extremities and trunk due to thoracic, lumbar or sacral injury?

A

Paraplegia

84
Q

What type of spinal cord lesions can leave “sacral sparing” which may involve client retaining perianal sensation or toe flexion?

A

Incomplete lesions

85
Q

How is the neurological level determined?

A

The level is named after the most caudal segment of the spinal cord with normal sensory and motor function in both sides of the body.

86
Q

What are areas of the skin that are innervated by the sensory axons within each segmental nerve root?

A

Dermatomes

87
Q

What are collections of muscle fibers innervated by the motor axons within each segmental nerve root?

A

Myotomes

88
Q

What would the ASIA score be for a paraplegic with a loss of the lower 5 key segments?

A

50 (out of 100)

89
Q

The ASIA impairment scale includes classifications from A meaning _____ to E meaning ______.

A

A is a complete injury

E is a healthy person with normal motor and sensory function

90
Q

What is a common scale of functional independence that ranges from 1-7?

A

FIM score

91
Q

What syndrome could cause motor impairments of the upper extremities but not the lower extremities?

A

Central cord syndrome(which is commonly caused by osteoarthritis)

92
Q

Cervical traction and a halo brace are both ____ methods of spine stabilization.

A

Closed

93
Q

What are some open methods of spine stabilization?

A

Fusions using bone grafts or wiring

94
Q

What are Gardner Wells Tongs?

A

A cervical traction device which is no longer commonly used.

95
Q

What is the typical duration of spinal shock when it occurs?

A

1-6 weeks

96
Q

What are the major symptoms accompanying spinal shock?

A

Areflexia (flaccid paralysis and DTRs decreased)

Sympathetic disturbances (low blood pressure and heart rate, vasodilated, no sweating below the lesion)

97
Q

Why are “raises” and “proning” useful techniques for SCI patients?

A

They prevent pressure sores from developing by allowing blood to circulate through frequent repositioning.

98
Q

What are the major stages of decubitus ulcer formation?

A

(1) redness and skin won’t blanch
(2) penetrates epidermis
(3) penetrates dermis
(4) extends into muscle tissue

99
Q

What are three major types of urinary catheters SCI patients may use?

A

Intermittent catheterization, Foley catheters and external catheters

100
Q

What is the best immediate treatment for a patient with orthostatic hypotension?

A

Tilt patient back and elevate the legs

101
Q

What might you do if your SCI patient complains of a pounding headache, sweats above the level of their lesion and has sudden chills or flushing?

A

Autonomic dysreflexia - try to identify and remove noxious stimulus

102
Q

What’s the best (although painful) treatment for heterotopic ossification?

A

Aggressive passive range of motion

103
Q

What does Ditropan do for the urinary bladder?

A

helps prevent spasms

104
Q

Why do SCI patients need drugs like Benzodiazepines, Dandtrium and Lioresal?

A

To relax muscle spacticity

105
Q

What are the key muscles still available with C1-C3 injuries?

A

Sternocleidomastoid and neck accessory muscles allowing for some head and neck movement

106
Q

What key muscles are spared at C4 injuries and what is the significance of health care protocol for injuries at this level?

A

Upper trapezius and DIAPHRAGM so these patients can be weaned from the ventilator, and also have scapular elevation

107
Q

What key muscles are spared in a C5 SCI and why are they important?

A

Deltoids and biceps - so the patient can flex, extend and abduct at the shoulders, as well as flexing the elbow and supinating the forearm (motions key for feeding, grooming and hygiene)

108
Q

At what level do SCI patients retain the mucle function for a tenodesis grasp?

A

C6

109
Q

What are the key muscles spared at C6?

A

ECRL & ECRB, and clavicular pec major - allowing independence in most self care

110
Q

What muscles are spared at C7 level SCIs?

A

Triceps, flexor carpi radialis, lats, pec major, extensor digitorum - now the patients can actively extend the elbow, and extend the fingers, but cannot flex the fingers

111
Q

What is important about C8, T1 SCIs?

A

Finger flexors and hand intrinsics are intact, patient still lacks trunk control.