week 14 Flashcards
OTA Role in Amputation Care
-client’s education regarding the management and complications
-skin care
- functional activity tolerance
Causes Amputation
- Cancer
- Traumatic cause
- Congenital limb loss
Psychosocial Implications
-adjustment to amputation and choice and use of a prosthesis
Phantom limb sensation and phantom limb pain (PLP)
-OTA should directly ask the client if he or she is experiencing these
phantom sensations or pain
-he pain and sensations may lead the client to think that a
limb is still present when it is not
Types of Prosthetics Socket
the piece of the prosthesis that fits around the residual limb to
attach the prosthesis to the residual limb
Suspension refers to the way the socket is held onto the residual limb.
Terminal device (TD)
Refers to the most distal component of the prosthesis that acts as the hand.
▪ Passive - Cosmetic or Passive Use
▪ Prehensile
-Voluntary opening (VO) device
-Voluntary closing (VC) device
PASSIVE FUNCTIONAL PROSTHESIS
Similar in appearance to the non-affected limb and is
passive (no movement) in nature.
▪Although it does not provide the client with grasping
ability, it can be used to stabilize as a gross assist and
to carry items.
BODY-POWERED PROSTHESIS
▪Consists of a harnessing system and uses the client’s gross body movements to control an excursion on a cable attached to the harness
▪This device is very durable and resistant to many environments and materials and its maintenance cost is low.
▪ Cable tension felt through the harness provides some proprioceptive feedback
MYOELECTRIC PROSTHESIS
-Uses electrical motors to move the TD (hand or hook), wrist, and elbow.
- controls this prosthesis through the use of myoelectric signals
-the prosthesis tends to
be heavier and the repair process is more complicated and time consuming.
HYBRID PROSTHESIS
-Combines the use of body-powered components to operate the elbow and
then uses myoelectric signals to operate a TD
ACTIVITY SPECIFIC PROSTHESIS AND TERMINAL DEVICE
-Used to perform a specific task or activity, activity-specific prostheses are available in a wide number of options.
▪Leisure TDs can include attachments for riding a bike,
Phase 1: Early Management and Wound Healing
-Wound management
-ROM to both affected and non affected joints
- For the UE, it is important to make sure that the client is
avoiding positions of shoulder adduction, shoulder internal
rotation, forearm supination, and elbow flexion.
▪ For the LE, the client should avoid knee flexion, hip flexion, or excessive hip abduction or adduction for prolonged periods
-Limb shrinking and shaping
-Desensitization
Phase 2: Preprosthetic Program, Preparation, Training
▪ Increasing general endurance and stamina
▪ Limb strengthening and ROM
▪ Participation in ADLs
Phase 3: Prosthetic Training
▪ Donning and doffing prosthesis
▪ Controls training
-Proportional control
▪ ADL activity using affected UE as an assist
▪ ADL activity with a LE prosthesis and mobility device
Phase 4: Advanced Prosthetic Training
▪ Incorporating UE prosthesis use into ADLs, IADLs,
work, and leisure
▪ Minimizing compensatory movements and
biomechanical stress to uninvolved limb
▪ Participation in ADL, IADL, work, and leisure activities
with LE prosthesis
Therapy Progression of ICU Patient
-alertness
-transfers
-sitting EOB
Standard adjustable bed
specialized adjustable bed that allows a patient to stand when it is elevated completely
Air-fluidized bed
Warm waterbed.
Indicated for patients who have several infected
lesions or require skin protection and whose position
cannot be altered easily
Anticoagulation
Prevent clots
Urinary Catheters
Indwelling (catheter through the urethra), for
example, Foley catheter, suprapubic catheter
External (males only)
Collection: bag, bottle, or urinal
Purewick (females only)
Oxygen delivery
Modes of delivery
1. Nasal cannula
2. Oronasal mask
3. Nasal catheter
4. Tent
5. Tracheostomy mask or catheter
Ostomy Devices
Opening in abdomen to allow elimination of
feces
Enterostomy: ileostomy and colostomy
Three primary types of collecting devices
Purpose of Traction
Align fracture segments
Soft tissue stretch
Reduce muscle spasms or contractures
Immobilize patient
Types of Traction
Skin
Skeletal
1.Balanced suspension traction
2.Skull
3.External fixation
4.Internal fixation
Patient-Controlled Analgesia
Self-administered, small, predetermined, time
limited, doses of pain medication
Follow IV line precautions.
Objectives of Dialysis Treatment
Prevent infection
Restore normal level of fluids and electrolytes
Control acid–base balance
Remove waste and toxic materials
Assist in or replace normal kidney function
Hemodialysis
Blood is pumped out of your body to an artificial
kidney machine, and returned to your body by tubes
that connect you to the machine
Peritoneal dialysis
Inside lining of your own belly acts as a natural filter
An advantage of peritoneal dialysis is that regular
visits to a dialysis unit are not required, and it can be
carried out at home
Responses to Patient Injuries
-immediately provide or obtain emergency care
-document the incident
-Notify your immediate superior
-File an incident report
-Notify the insurance carrier of the incident
Lacerations
Prevent contamination and control bleeding
Shock
Identify and reduce or remove cause.
Prevent or reduce extent of physiologic state of shock
when possible.
Orthostatic (Postural) Hypotension
Most frequently occurs when one attempts to stand quickly
Seizures
Protect person from injury.
Protect for person’s modesty and privacy
Heat-Related Illnesses
Remove or reduce the cause of the illness and return the
patient to a state of normal homeostasis.
Two primary forms: heat exhaustion and heat stroke
Result from a hot and humid environment, vigorous physical
activity, dehydration, and depleted body electrolytes.
Heat stroke may follow heat exhaustion if the patient is not
treated properly.
Heat Exhaustion
Least threatening to life
Cool the patient and
counteract the effects of
dehydration
Heat Stroke
Medical emergency
because the body can not
cool
First-aid treatment should
be initiated promptly
Insulin-Related Illnesses
Restore the patient to a normal insulin–glucose
state and remove, correct, or compensate for
the cause of the condition.
Important to differentiate between hypoglycemia
and hyperglycemia
Hypoglycemia
Too much systemic
insulin, too little food
intake, or excessive
exercise
Provide some form of
sugar.
Refer to a nutritionist or
nurse educator as
needed
Hyperglycemia
Too little systemic insulin,
intake of too much or
improper food, or
insufficient physical
activity
Can lead to diabetic
coma or death
Medical emergency
Do NOT give sugar.
Autonomic Dysreflexia
(Hyperreflexia)
Determine and remove noxious stimulus and return patient to a level of normal homeostasis.
Causes: urine retention, fecal impaction, open pressure ulcers, tight straps, localized pressure, or exercise
Stroke
Third leading cause of death
Risk of stroke increases with age and is more common in African Americans.
Signs and symptoms manifest differently in men and women.
F.A.S.T.
Cardiac Arrest/Death
Maintain cardiopulmonary system at a level sufficient
to sustain life.
Cardiopulmonary resuscitation (CPR): C-A-B (30 chest compressions prior to two rescue breaths)
Early recognition is based on responsiveness and
abnormal breathing.
Use AED when available after five cycles of CPR are
administered when breathing and pulse are absent
