Week 4 Flashcards
What is a transfer?
A change in position: lying to sitting, sitting to standing, etc
or
A change in location: bed to wheelchair, bed to commode, chair to chair, etc
What should you consider when working with a patient?
- precautions/restrictions: weight bearing precautions, movement restrictions
- pain/anxiety: expect pain post surgery, anxiety from falling or may be afraid they might fall again, therefore they might need encouragement
- medical status: other issues they may have such as diabetes
What should you prepare for in advance to seeing a patient?
- what do I do if something goes wrong: have a backup plan
- resting places in appropriate positions: have a chair in the room/hall
- follow with a wheelchair: usually family members or another staff member
- oxygen equipment: make sure they can still use it when doing
What are 4 things you should remember when working with a patient post surgery?
*** important
- Discuss WB and movement restrictions before starting
- Position yourself on the operated side
- Support the operated leg for a moderate assist
- Cue the patient to stick their leg out before standing/sitting
What should you do after a transfer?
Inform nurse
Ensure patient is comfortable/safe: check pressure points (bone under skin, smooth out surface)
Closing: recap, get feedback, check in, next steps
Document
Oxford orthopedic surgery
Partial knee replacement (usually in the younger population)
TKR orthopedic surgery
Total knee replacement
–> all three parts
ACL repair orthopedic surgery
Anterior cruciate ligament
–> ligament in knee
Hemiarthroplasty orthopedic surgery
half joint in hip
–> usually in younger population
THR orthopedic surgery
Total hip replacement
–> all of the hip
ORIF orthopedic surgery
Open reduction with internal fixation
–> cut you open, put bone back in place, use plate or screw to screw everything back together
BKA orthopedic surgery
Below knee amputation
AKA orthopedic surgery
Above knee amputation
RC repair
Rotator cuff repair
Most common fracture
Neck of femur / Femoral neck fracture
What is a femoral neck fracture
- usually PWB - WB precautions
- NO movement restrictions (they can move it how they want)
- double trauma (patient breaking hip, then surgery following) causing increase in pain they were not prepared for
- other issues that led to it (deconditioned, balance issues, weakness)
- not a same day surgery
What kind of weight bearing is recommended with a hip fracture?
PWB - usually younger patients
WBAT - used cement in replacement
–> sometimes there an extra day
Precautions for posterior THR
1) No hip flexion beyond 90 degrees: don’t bend over (as this prevents dislocation/can pop out the back)
2) No hip adduction past midline: don’t cross your legs
3) No hip internal rotation (avoid twisting your hip)
–> approximately 6-12 weeks
Precautions for anterior THR
- No hip external rotation
- No hip extension
- No bridging
–> approximately 6-12 weeks
Hip and ankle fracture (ORIF/open reduction internal fixation)
Hip ORIF: no hip precautions
Ankle ORIF: will have an aircast or plaster cast
–> usually PWB, toe touch weight bearing (TTWB), or non weight bearing (NWB)
Why would you use an air cast as opposed to a regular cast?
for walking/increased mobility
Can also take foot out
What’s something you need to talk to the nursing staff about?
Pain
–> patient is going to be in pain so you want to coordinate with nurses so they have pain. meds 30 mins before treatment/session
What is Vaso-vagel?
Fainting
- often brief (loss of consciousness)
- occurs when sudden change in HR/BP
- may vomit after
What is delirium?
Acute confusion
Usually due to
1) Infection - coloured discharge at incision site, warmth and redness blistering, general fever
2) Medication
What is DVT?
Deep vein thrombosis - blood clot
- calf pain, excessive swelling, hot to touch, red, tender, pain with dorsiflexion
Pulmonary embolus - blood clot in the lungs
