Week 2 VI Interventions Flashcards
what are the considerations for compression
- comfort, cosmesis and tolerance.
- frequency it has to be changes
- can they change at home or in the clinic
- condition of the skin
- vascular status
- ambulation
- patient status
- cost
- has it worked before
TF: decisions with the compression for VI is final
false, it is a changing status based on wound and drainage changes and you work until you find what is right
what is a tube-like (Tubigrip)
least compression and inexpensive, and easy to apply, reapply and remove. It is reusable and comfortable. will stretch with repeated use, and LIGHT COMPRESSION
when is tube -like utilized
with UE and LE issues or at risk of mild edema, sprains, wounds.
how much pressure does tube-like usually give
10-12 mmHg
what is a long stretch
it stretches a long way and wants to return to its resting state (ACE WRAP). can give constant compression but can feel tight at rest.
TF: you do not get more compression with calf muscle contraction with a long stretch
false, you do get more
what kinds of patients is the long stretch good for
ambulatory patients
how do you apply the long wrap
figure 8 or spiral technique, and is hard to do on your own
TF; long stretches do not telescope
false they do which can cause injury and restricted blood flow
TF: we do not need to be cautious with long stretch and patients with AI
false, we do
long stretch is reusable but what is wrong with it
it is quick to stretch and does not have consistent tension
what is a short stretch
short distances, and is applied with consistent tension and spiral layering with about 50% overlap.
TF: short stretch can telescope
yes, so you need to frequently re-wrap
can you use short stretch for people with AI
yes, unless the compression is contraindicated
Short stretch is good for what types of ulcers
AI and VI
when is the lowest compression with a short stretch and highest
at rest, highest with muscle contraction
what is an inelastic dressing
unna boot that is applies with only enough tension to keep it in place. it is 2-3 layers over the whole LE and needs a secondary wrap to keep it from telescoping
how long can you wear an unna boot, but what is a draw back
up to 1 week. stinks because as edema decreases it will telescope, and it can also rub at the anterior ankle
what is a multi-layer wrap
2-4 layers with higher compression of 30-40 mmHg. it is on during both work and rest and with long stretch, can feel tight at rest
when can a multi-layer feel tight at rest
with a long stretch layer
what is the draw back of the multi-layer
money, takes a while to apply, adds bulk, single use
what are some good things with multi-layer? who can wear it? how long?
less telescoping, wear for 1 week, good for ambulatory and non ambulatory
what are stockings
for VI and vein and support health
how often do you need to replace stocking
every 6 months, and you should have 2 pairs so you can wear one and wash the other by hand and air dry
when can you wear stockings
with wound closure and after the edema is resolved
TF: the stockings are 100% effective at prevention
false
what are garments
- farrow wrap is a foot piece and velcro that is easy to don and doff over stockings
- circ -aid is a custom no inelastic velcro bands for VI and lymphedema.
what is LaPlace’s law
compression equals the tension of the # layers x4630 /limb girth x bandage width
how can we use la places law
for adjustments, with graduated or graded compression, and an increase or decrease in tension. you can change the number of layers
how is there normally achieved graded compression
with changes in leg circumference, like the calf vs the ankle
what about bandage width and compression
the smaller, the higher the compression
what is the caution with smaller rolls
at the foot and ankle, you may need fewer layers
Figure 8 wrap has ____ the compression of a spiral wrap
2x
what are some exercises for VI ulcers
ankle pumps, ABCs gastric stretches for ankle ROM heel toe raises in sitting and standing step overs (3-4 inch obstacle) exaggerated heel toe (walking) biking aquatics
what are some things we can educate the patient about
compression
extended standing, siting or crossing the legs
elevation care and replacement of stockings
healthy lifestyle
what is true elevation
above the heart level, and when this is not possible and you are in a dependent position, must have compression
what are the goals for physical therapy interventions with VI
prevent and recognize early s/s refer for screenings and repair treatment by the stage of healing relieve pressure and congestion care for wounds (drainage and protection) compression help patients adjust
what is the general technique for spiral and figure 8
50% overlap and 50% tension
with base of toes to just over gastric (2 fingers at the posterior knee) with smooth and no wrinkles
what about techniques for graduated and graded compression
ankle (30-40mmHg) and proximal calf (18mmHg). ankle circumference with multilayer for higher compression and the leg shape and padding make a difference.
