Week 1 Lectures Flashcards

1
Q

What does appropriate draping provide?

A
  • Access to areas of the body for examination or treatment.
  • Protection of patient’s modesty and dignity.
  • Patient comfort and warmth.
  • Protection of vulnerable sites.
  • Protection of patient’s clothing.
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2
Q

When exposure of the body is required for examination or intervention, members of some culture may?

A
  • Prefer a same gender health care provider
  • Be embarrassed when dressed in a hospital gown
  • Not want to wear attire previously worn by others
  • Have certain items of clothing that are not to be removed.
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3
Q

What maximizes comfort and dignity?

A
  • Communication
  • Providing privacy
  • Same gender chaperone when appropriate
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4
Q

When covering the patient with linens we want to do what?

A
  • Expose only one area at a time
  • Layer linens to minimize exposure
  • Secure edges
  • Dispose of soiled linens
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5
Q

Summary of draping.

A
  • Consider patient dignity and access for treatment.
  • Employ a confident touch, and secure edges of linens.
  • Any patient may be a survivor of trauma or abuse; watch for signs of discomfort.
  • Be aware of cultural preferences.
  • Provide chaperones when appropriate.
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6
Q

Short term vs long term patient positioning.

A
  • Short term- During a therapy intervention or activity where pt can make minor adjustments
  • Long term- Must remain in a position for an extended period of time and impairments prevent independent adjustment.
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7
Q

Goals for short-term positioning?

A
  • Safety
  • Comfort
  • Therapist Access
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8
Q

Things to consider for short-term positioning?

A
  • Primary (ideal position) vs. alternative.
  • Normal spinal curves

Document alternatives so that people behind you know how it was done exactly

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9
Q

Pillow positioning for patients in:

  • Supine
  • Prone
  • Side-lying
  • Sitting in wheelchar
  • Sitting at table
A

-Supine- Pillow under head and knees
-Prone- Pillow around face hole, under hips, and under lower legs
-Side-lying- Pillow under head and under hips for skinnier people
OR
Pillow under head, between legs, and in between arms as something to hold
-Sitting in wheelchair- Box on ground to support feet if no feet rests
-Sitting at table- Enough pillows to support as a headrest

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10
Q

How long is considered long-term patient positioning?

A

Anything over 30 minutes

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11
Q

Goals for long-term patient positioning?

A

-Safety (open airways/falls)
-Prevention (Ulcers/contractures)
Comfort (spine alignment/pressure)

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12
Q

Steps to preventing pressure ulcers?

A
  • Maximum of 2 hrs in one position in bed.
  • Maximum of 15 minutes in one position while seated because of the smaller area of contact.
  • Reposition more frequently if patient has increased risk factors such as a history of frail skin or cognition issues.
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13
Q

Supine high-risk areas for pressure ulcers?

A

Occipital, shoulders, scapula, elbows, sacrum, heels

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14
Q

Prone high-risk areas for pressure ulcers?

A

Forehead, ear, chin, shoulder, ASIS, anterior knee, dorsum of foot

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15
Q

Side-lying high-risk areas for pressure ulcers?

A

Ear, humeral head, hip (greater trochanter), lateral and medial femoral condyle, lateral and medial malleoli

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16
Q

Wheelchair high–risk areas for pressure ulcers?

A

Scapula (esp inferior angle), elbows, sacrum, ischial tuberosities, heels

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17
Q

If redness is still there after 20 minutes what is likely?

A

Most likely getting breakdown

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18
Q

What contractures are the most common?

A

Flexion contractures

19
Q

How to avoid contractures?

A
  • Avoid positions of comfort

- Reposition frequently

20
Q

How to prevent edema and cardiopulmonary complications?

A
  • Position distal extremities at or above the level of the heart.
  • Vary demand on the heart by including more upright positioning.
  • Vary positions to promote lung drainage.

Keep upright to cause fluid to go back to the center of the body

21
Q

Long-term positioning checklist.

A
  • Clear airway
  • Good spinal alignment
  • Minimized pressure over bony prominences
  • Minimized gravity creating shearing forces
  • Cushioned support surfaces
  • Immobile extremities elevated
  • Joint and soft-tissue contractures prevented
  • Trunk and extremities supported and stabilized
  • Long-term functional positions
  • Positioned to optimize interaction with the environment (line of sight, communication, etc.)
  • Special needs accommodated
22
Q

What is an indicator of pain in comatose patients?

A

Heart rate

23
Q

What is sacral sitting and should it be avoided?

A

Sitting leaned back.

Yes.

24
Q

What does the 90,90,90 position refer to?

A

90 degrees at hip, knees, and ankle while sitting

25
Q

What are positioning devices used for?

A
  • To reduce or eliminate load on the tissues

- Help patient maintain a static position

26
Q

INTRO TO MOBILITY AND TRANSFERS

A

INTRO TO MOBILITY AND TRANSFERS

27
Q

The fundamentals of progressive mobility.

A
  • Dependence to independence
  • As much as possible, as normally as possible
  • Control centrally, direct distally
  • Stability to mobility
28
Q

Difference between external and internal forces?

A

Forces acting on the body that originate from the outside are external forces.

Forces produced by the body are internal forces

29
Q

What are some examples of internal forces?

A

Ligaments and tendons

30
Q

Common types of forces.

A

Gravity

Friction

31
Q

Types of loading and their definition.

A
  • Tension- pulled in a forceful manner
  • Compressive- bone to bone, knee jumping and landing with straight leg
  • Distraction- pulling things apart
  • Shear- two forces going opposite directions
  • Bending- proper lifting techniques, sit to stand
  • Torsion- shearing twist around axis
  • Combined- any load combined together
32
Q

What usually causes injury?

A

Abnormal loading, improper technique

33
Q

What all is used in managing load?

A

Stress and Strain
Pressure
Amount

34
Q

Difference between stress and strain?

A

Stress is the force applied to a given area. Strain is the deformation that occurs as a result of the force

35
Q

What is pressure?

A

Amount of force across a given area. Pressure over a long time can be disasterous

36
Q

What can too little load cause?

A

Osteoporosis

37
Q

Types of loading structures.

A

Spine
Skin
Joints
Bone

38
Q

Difference in subluxation and dislocation?

A

Subluxation can go back in, dislocation comes all the way out of a joint.

39
Q

What is “base of support”?

A

The contact area of an object with its supporting surface

40
Q

What is static stability?

A

Maintaining and controlling body’s orientation in space, usually by keeping center of mass in base of support

41
Q

What is stabilization?

A

Ability to hold one attachment site while allowing the other attachment sire to move.

Stabilization at shoulder while moving humerus

42
Q

What is controlled mobility

A

Occurs when center of mass leaves the base of support then comes back within base of support.

Walking is an example

43
Q

What is an open kinetic chain? Closed kinetic chain?

A

Distal segment is free to move. (sitting on table and kicking leg out)

Distal segment is stabilized and proximal segment moves (push-ups)

44
Q

Guidelines for body mechanics

A
  • Plan ahead
  • Position yourself close to the load
  • Maintain a wide base of support
  • Maintain normal spinal curvature whenever possible
  • Bend the hips and knees
  • Hold objects close
  • Take advantage of high/low tables
  • Always “scrub in/out”
  • Always put a gait belt on your patient.