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PT fundamentals > Week 1 > Flashcards

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
Q

What is moderate assist level of assistance?

A

Patient performs 50-74% of task. Holding gait belt is required. Hands on assist.

26
Q

What is maximum assist level of assistance?

A

Patient performs 25-49% of tasks. Holding gait belt is required. May use an assistive device

27
Q

What is total assist level of assistance?

A

Patient perform 0-24% of tasks. Someone else is providing 75-100%. May use an assistive device

28
Q

If a patient requires a 2 person assist, it is classified as a ____

A

Total assist/dependence

29
Q

What is non-weight bearing status?

A

The foot does not come in contact with the ground

30
Q

What is toe- touch weight bearing status?

A

Normal heel to toe gait pattern, but the affected foot is only used for balance and not to bear weight

31
Q

What is touch-weight bearing status?

A

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
Q

What is partial- weight bearing status?

A

Normal heel to toe gait pattern with no more than 50% weight bearing on the affected limb

33
Q

What is weight bearing as tolerated status?

A

Weight bearing within pain tolerance

34
Q

Transfer procedural tips for the PT

A
  • 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
Q

Transfer procedural tips for the patient

A
  • 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
Q

Transfer procedural tips for the family

A
  • 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
Q

Critical safety elements of transfers

A
  • 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
Q

Reasons for Assistive Devices

A
  • 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
Q

Types of assistive devices

A

Canes, crutches, & walkers

40
Q

Purpose of canes

A

compensate for impaired balance or stability, more functional on stairs or narrow/confined areas.

41
Q

Single point canes provide the ___ support

A

Least

42
Q

Purpose of crutches

A

used in those who need less support and provide more variability in gait pattern and gait speed

43
Q

_____ crutches provide the least support and most flexibility

A

Axillary crutches

44
Q

____ crutches provide less stability than axillary crutches, but more than what a cane can
provide and is good for long term use

A

Forearm crutches

45
Q

Purpose of walkers

A

used in those who need maximal stability and support

46
Q

____ walker provide the most stability, less gait speed allowed

A

Standard walker

47
Q

______ walker provides adequate stability while allowing for improved ease of
mobility

A

Rolling walker

48
Q

_____ —allows for most mobility, seat included, basket for carrying items (can
have 3 or 4 wheels)

A

Rollator

49
Q

_____ allows for one sided support in those suffering from hemiplegia

A

Hemi- walker

50
Q

______ allows for use in those with weight bearing restrictions,
deformities or difficulty griping handle

A

Platform attachment

51
Q

Fitting an AD to the patient

A
  • 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
Q

Choosing an AD for a patient

A
  • 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
Q

Key Wheel Chair Component - Seats

A
  • 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
Q

Key Wheel Chair Component – Armrests

A
  • Can aide in postural support
  • Decrease weight on buttocks
  • Can be fixed or removable
  • Can have different lengths
  • Can have adjustable heights
55
Q

Key Wheel Chair Component – Front Rigging

A
  • 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
Q

Key Wheel Chair Component – Frames

A 
- 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
Q

Key Wheel Chair Component – Drive Wheels

A
  • 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
Q

Key Wheel Chair Component – Casters

A
  • 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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