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Week 1 Flashcards

Patient handling and positioning, the basics

1
Q

What are the key point relating to positioning?

A

Safety, Comfort, access to bodily regions, prevention of pressure injuries, and facilitate bodily functions

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2
Q

What is safety in positioning?

A

Safety for yourself and the patient. Make sure the environment is safe

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3
Q

What is comfort in positioning?

A

Making sure patients are comfortable. The most comfortable position is not always the most safe.

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4
Q

What is access to body regions in positioning?

A

How does the position grant the PT access to certain body regions that is being worked on

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5
Q

What is prevention of pressure injuries in positioning?

A

ulcerations that come from sustained pressure on a given body tissue. Can cause detrimental effects

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6
Q

What is facilitate bodily functions in positioning?

A

Make sure you’re aware of the physiological changes a position can cause to the bodily function

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7
Q

What are the principles and concepts around positioning?

A

Modesty, Base of support, alignment, precautions

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8
Q

What is modesty in positioning?

A

How we introduce ourselves, how we drape the patient, the reasoning for positioning, & utilization of resources to make the patient comfortable and uphold modesty.

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9
Q

What is base of support in positioning?

A

Everything should be supported and comfortable as it relates to safety

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10
Q

What is alignment in positioning?

A

Symmetry of head & trunk, legs, pelvis/hip rotation

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11
Q

What are precautions in positioning?

A

Taking measures to ensure self and patient safety

Ex: thinking about moving dependent patients every 2 hours

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12
Q

Prolonged positioning can cause…

A

pressure injuries and or contractures.

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13
Q

When prolonged positioning is being used, check the skin ____ and ____ treatment. it makes us considerate of ….

A

Before and after.

Documenting what we find

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14
Q

Red, blanched, prolonged tingling is ____ and should be ____

A

Not appropriate and should be documented for other possible members of the team to see

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15
Q

How long does it take to get a pressure injury?

A

An hour or less

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16
Q

Risk factors of pressure injuries

A
  • Bony prominence
  • Poor sensation
  • Moisture
  • Heat
  • Immobility
  • Poor circulation
  • Nutrition
  • Communication problems
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17
Q

What is body mechanics?

A

The efficient use of one’s body to produce safe motion

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18
Q

Things to do with body mechanics

A
  • Breathe: to avoid valsava: which can put us at risk of passing out or injury
  • Stay close to patient: allows for effective lifting strategies. Helps maintain a wide base of support.
  • Use large muscle groups to provide & produce safe motion
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19
Q

Why is body mechanics important?

A
  • Allows for more efficient lift and/or transfer
  • Decrease threat of potential harm
  • Improves safety for practitioner and patient
  • Maintain control of transfer
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20
Q

What are the levels of assistance?

A
  • independent
  • modified independence
  • supervise
  • minimal assist
  • moderate assist
  • maximum assist
  • total assist/ dependent
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21
Q

What is independent level of assistance?

A

Patient is safe to perform activity alone and requires no assist or monitoring

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22
Q

What is modified independence level of assistance?

A

patient is safe to perform activity alone and requires no assist or monitoring but uses assistive devices 7 extra time

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23
Q

What is supervise level of assistance?

A

Supervision required for safety, set-up, or cueing- gait belt not required. May need an assistive device. Patient can walk with RN staff. There should be NO touching

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24
Q

What is minimal assist level of assistance?

A

Patient performs 75-100% of task. Holding gait belt is required. Hands on assist

25
What is moderate assist level of assistance?
Patient performs 50-74% of task. Holding gait belt is required. Hands on assist.
26
What is maximum assist level of assistance?
Patient performs 25-49% of tasks. Holding gait belt is required. May use an assistive device
27
What is total assist level of assistance?
Patient perform 0-24% of tasks. Someone else is providing 75-100%. May use an assistive device
28
If a patient requires a 2 person assist, it is classified as a ____
Total assist/dependence
29
What is non-weight bearing status?
The foot does not come in contact with the ground
30
What is toe- touch weight bearing status?
Normal heel to toe gait pattern, but the affected foot is only used for balance and not to bear weight
31
What is touch-weight bearing status?
Normal heel to toe gait program, but the affected foot is only allowed to use about 10 lbs of force. (difficult to instruct and enforce)
32
What is partial- weight bearing status?
Normal heel to toe gait pattern with no more than 50% weight bearing on the affected limb
33
What is weight bearing as tolerated status?
Weight bearing within pain tolerance
34
Transfer procedural tips for the PT
- Plan ahead: 1st step. Scan the environment for success materials, what is the patient dealing with functionally - communicate: what we plan to to, to the patient - encourage independence: don't be the one doing all of the work - provide physical support
35
Transfer procedural tips for the patient
- instruct the patient or family 1st, then have them repeat the instructions and answer any questions. - Use momentum to help you - Establish a leader(usually the PT or the patient) & count to start lifting - Use the bed/mat to your advantage - Be willing to ask for help
36
Transfer procedural tips for the family
- Instruct the family first, then have them repeat the instructions and answer any questions - You must teach principles of good body mechanics - Break down new information - Avoid information overload
37
Critical safety elements of transfers
- Pre-position and secure equipment prior to lift (Lock wheelchair, patient chair or patient bed) - Know the patient's abilities - Do you have enough assistance? ( call for help if not) - Gait belt
38
Reasons for Assistive Devices
- Compensate for impaired balance, decreased strength, decreased stability, or pain during weight bearing - To facilitate coordinated movements - Absence of a lower extremity (with or without the prosthesis) - To improve functional mobility - To assist with a restrictive weight bearing status
39
Types of assistive devices
Canes, crutches, & walkers
40
Purpose of canes
compensate for impaired balance or stability, more functional on stairs or narrow/confined areas.
41
Single point canes provide the ___ support
Least
42
Purpose of crutches
used in those who need less support and provide more variability in gait pattern and gait speed
43
_____ crutches provide the least support and most flexibility
Axillary crutches
44
____ crutches provide less stability than axillary crutches, but more than what a cane can provide and is good for long term use
Forearm crutches
45
Purpose of walkers
used in those who need maximal stability and support
46
____ walker provide the most stability, less gait speed allowed
Standard walker
47
______ walker provides adequate stability while allowing for improved ease of mobility
Rolling walker
48
_____ —allows for most mobility, seat included, basket for carrying items (can have 3 or 4 wheels)
Rollator
49
_____ allows for one sided support in those suffering from hemiplegia
Hemi- walker
50
______ allows for use in those with weight bearing restrictions, deformities or difficulty griping handle
Platform attachment
51
Fitting an AD to the patient
- Parallel bars and canes = measure with the crease of the wrist or greater trochanter - Forearm Crutch = hand piece/handle at crease of wrist and forearm piece 1 to 1.5 inches from olecranon with grasp on hand piece - Axillary Crutch = Hand piece is the same & the top axillary piece = 2 finger from top of axilla - Walker = top/hand piece should be at the crease of wrist or at greater trochanter - Platforms = Shoulders level with forearm supported, & hand grip comfortable - ELBOW flexion angle—20-25 degrees
52
Choosing an AD for a patient
- Assess mental and physical abilities - Consider the environment in which the patient will ambulate - What is the expected or desired ambulation activities - What is the prognosis for improvement or regression of the patient’s condition/abilities
53
Key Wheel Chair Component - Seats
- Either flexible (“sling”) or rigid - Cushions can be selected for specific pt. - Need to consider where pressure needs to be offloaded - Backing of seat can be rigid (i.e. 90°), reclined or a tilt-in-space that allows the patient to recline
54
Key Wheel Chair Component – Armrests
- Can aide in postural support - Decrease weight on buttocks - Can be fixed or removable - Can have different lengths - Can have adjustable heights
55
Key Wheel Chair Component – Front Rigging
- Otherwise known as leg-rests or foot-rests ``` - Types: • Swing-away • Removable • Elevating • Calf pad/support • Foot plates ``` - Can have a combination or in isolation
56
Key Wheel Chair Component – Frames
``` - Fixed or Rigid • More sturdy • Supports weight well • Decreased shock absorption • Can be harder to transport, however seat will usually fold over ``` - Folding • Cross-brace design • Better shock absorption • Ease of transport/storage
57
Key Wheel Chair Component – Drive Wheels
- Larger rear wheels and tires (“push-wheels”) • Can range from 18 - 26 in. • Can be “quick release” axle-based to remove • Pushrims = optional handrims on outside of the wheel used to help propel chair • Camber = inward angle of the wheel relative to the vertical position (typically 3°) • Improve stability • Decrease energy costs (easier turning, positioning allows arm to be closer to user’s side) - Wheel Locks = secure the chair for safe transfers
58
Key Wheel Chair Component – Casters
* Smaller wheels at the front of the wheelchair * Positioning affects BoS * Large casters = more stability * Small casters = improved maneuverability • Can vary in size (2-8 in.), but most common size is 5 in.

PT fundamentals (8 decks)

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