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Adult Rehab > Week 4: Total Joint Replacement and IADLs > Flashcards

Week 4: Total Joint Replacement and IADLs Flashcards

1
Q

Supports joint and can be set to move slowly through designated ROM to promote controlled movement in operated joint

A

Continuous passive motion (CPM) machine

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2
Q

Portable breathing apparatus used to encourage deep breathing and prevent post-op pneumonia

A

Incentive spirometer

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3
Q

Prescribed amount programmed by physician/nurse to allow client to self administer pain medication by pushing button to inject safe amount
When dosages reached limit, machine won’t administer anymore if when button pushed

A

Client-controlled administration IV

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4
Q

Purpose is to assist circulation, prevent edema (swelling), reduce risk of deep vein thrombosis (blood clot)

A

Antiembolus hose

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5
Q

Used post-op to reduce risk of deep vein thrombosis. They’re inflatable, external leggings that provide pneumatic compression of legs

A

Sequential compression devices (SCD)

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6
Q

Use this instead of standard toilet, aids in safe transfer and allows client to observe necessary hip flexion precautions

A

Commode Chairs

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7
Q

Has adjustable backrest that allow reclining position used for clients with hip flexion precautions while sitting

A

Reclining wheelchair

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8
Q

Set up by orthopedic technician, can be used for about 3 days post surgery. Balances weight of elevated leg by weights placed at opposite side of pulley system to support LE in first few postoperative days. Client’s leg can be taken out of device for exercise only

A

Balanced suspension

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9
Q

Large and small triangular foam wedge used when client is supine to maintain LE in abducted position

A

Abduction wedge

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10
Q

During surgery, plastic draining tube is inserted at surgical site to assist in post op draining of blood. Unit should not be disconnected for any activity because this may create blockage in system. Hemovac left in place for 2 days post surgery.

A

Hemovac

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11
Q

OT goal for client?

A

maximize performance skills in daily occupations, with all movement precautions observed during activities, teach client ways and means of performing ADL IADLs safely

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12
Q

Before functional eval is made, what needs to be looked at?

A

look at performance skills and client factors (e.g. UE ROM, muscle strength, sensation, coordination, cognitive skills)
Need to evaluate basic ADLs, IADLs, and functional mobility for clinical reasoning/holistic intervention planning.
During evaluation, be sure to observe and document any signs of pain and fear at rest and during movement

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13
Q

Posterolateral approach (traditional) precautions

A

no adduction, no internal rotation, no flexion greater than 90 degrees

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14
Q

Anterolateral approach precautions

A

no adduction, no external rotation, no excessive hyperextension

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15
Q

T/F: If client sleeps in side lying, sleeping on operated side is recommended if tolerable

A

True

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16
Q

What should client do if they sleep on non operated side?

A

When sleeping on non operated side, client must keep legs abducted with abduction pillow or larger pillows to prevent hip adduction and rotation

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17
Q

Transfer To move from standing to sitting?

A

client should back up the chair, extend operated leg forward, reach back from armrests, and slowly lower to sitting position (for those with hip replacement, be sure not to lean forward when sitting down)

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18
Q

To move from sitting to standing

A

Client extends operated leg and pushes from armrests. Once standing, client can reach for ambulatory aid if it is being used. Client should sit on front edge of chair and lean back

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19
Q

Moving to shower

A

When entering, walker or crutches go first, then operated leg, and then non operated leg

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20
Q

Moving to shower tub

A

Client instructed to back up to the tub chair or bench using walker/crutches for support then client should reach for backrest, extend operated leg and slowly lower to seated position
Legs can then be lifted into tub as client leans back, using leg lifter or bath towel if needed to support operated leg

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21
Q

T/F: For pants and underwear, non operated leg is dressed first by using reacher to bring pants over foot and up knee

A

False. For pants and underwear, operated leg is dressed first by using reacher to bring pants over foot and up knee

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22
Q

When is it safe to shower, typically?

A

7-10 days post surgery

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23
Q 
Prepare/retrieve a simple meal,
Employ safety precautions & exhibit good judgment,
Take medication,
Get emergency aid if needed,
Have a system for managing toileting,
Have a method to allow for rest periods.
A

If a client will be home alone, several basic ADL and IADL skills are needed for safety & independence

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24
Q

Why do a home evaluation?

A
  • help with the transition from a treatment facility to home
  • Assessing a home for safety & accessibility,
  • Offering a way for an OT to assess client functioning at home,
  • Determining a time when caregiver training can occur.
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25
Q

subcapital, transcervical, and basilar fractures, are common in adults over 60 and occur more frequently in women

A

Femoral Neck fractures

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26
Q

______ used when displacement is minimal to moderate and blood supply is intact

A

Hip pinning (application of a compression of screw and plate)

27
Q

the femoral head is surgically removed and replaced by an endoprosthesis.

A

hemiarthroplasty.

28
Q

fractures between the greater and lesser trochanter are extracapsular, or outside the articular capsule of the hip joint, and the blood supply is not affected

A

Intertrochanteric fractures

29
Q

The preferred treatment for these fractures is an ORIF; a nail or compression screw with a sideplate is used.

A

Intertrochanteric fractures

30
Q

Weight bearing restrictions may be necessary at least 6-8 weeks during healing, but restrictions could be extended

A

Femoral Neck Fractures

31
Q

Weight-bearing restrictions must be observed for up to 4 months during ambulation

A

Intertrochanteric fractures

32
Q

Subtrochanteric fractures

A

1 to 2 inches below the lesser trochanter usually occur because of direct trauma as in falls, motor vehicle accidents, or any other situation in which there is a direct blow to the hip.

33
Q

Fracture Often seen in persons younger than 60 years old

A

Subtrochanteric fractures

34
Q

Skeletal traction followed by an ORIF is the usual treatment; a nail with a long sideplate or a intramedullary rod is used. An intramedullary rod is rod inserted through the central part of the shaft of bone to help maintain proper alignment for bone healing

A

Subtrochanteric fractures

35
Q

T/F: Pain originates from the bone, synovial membrane, or fibrous capsule and from muscle spasm.

A

True

36
Q

When movement of the hip causes pain and limited mobility, the muscles shorten, which can result in …

A

hip position of flexion, adduction, and internal rotation that causes a painful limp.

37
Q

two mechanical components to this type of endoprosthesis/hip joint replacement

A
  • A high density polyethylene socket is fitted into the acetabulum and a metallic prosthesis replaces the femoral head and neck
  • Methylmethacrylate or acrylic cement fixes the components to the bone.
38
Q

….the client will be unstable in external rotation, adduction, and extension of the operated hip and usually must observe precautions to prevent these movements for 6 to 12 weeks.

A

anterolateral approach

39
Q

the client will be unable to flex hip and not internally rotate or adduct for 6 to 12 weeks

A

posterolateral approach

40
Q

T/F: Most surgeons do not restrict weight bearing postoperatively when cement fixation is used.

A

True

41
Q

Major problem with total hip replacement?

A

is the loss of fixation at the prosthesis interface with the remaining bone.

42
Q

T/F:Total joint surface replacements are a variation of the total hip replacement using a metallic shell to cap the surface of the femur and the acetabular cavity receives a plastic cup. No weight bearing restrictions apply

A

True

43
Q

Total or partial? _____ knee replacement is indicated when two or more compartments of the knee are damaged.

A

Total

44
Q

Total or partial? ____ knee replacement is indicated if there is medial or lateral compartmental damage between the femur and the tibia

A

Partial

45
Q

Some complications of both joints replaced?

A

dislocation, degeneration of parts, fracture of bone next to implanted parts, loosening of parts, and infection of the hip or knee after surgery

46
Q

Clients with a chronic orthopedic disability often experience…

A

Clients with a chronic orthopedic disability often experience disease of a body part, fear, joint deformity, anxiety, pain, decreased functional ability, change in body image

47
Q

T/F: The occupational therapist must address the psychosocial issues resulting from this loss while focusing on maximizing the clients ability to participate in areas of occupation that are meaningful

A

True

48
Q

____ is responsible for evaluation and intervention in the areas of musculoskeletal status, lower extremity sensation, pain, skin integrity and mobility. May start therapy right after surgery.

A

The physical therapist

49
Q

_____ is responsible for physical care of client during hospitalization. Including surgical procedure and positioning of body

A

Nursing Staff

50
Q

____ must inform the team of medical status and ordering medications and services

A

physician

51
Q

___ consults with each client to ensure that adequate and appropriate nutrition is received to aid the healing process.

A

Dietician

52
Q

____ ensures that each client is being discharged to the appropriate living situation or facility and often to ensure the availability of durable medical equipment recommended by PT and OT

A

Case coordinator

53
Q

____ community resources for equipment and living accomodations

A

OT

54
Q

____- must address the psychosocial issues resulting from this loss while focusing on maximizing the clients ability to participate in areas of occupation that are meaningful

A

OT

55
Q

2 fears of elderly after hip surgery?

A

fear of dependence and relocation trauma.

56
Q

Increased awareness of weak side
Improved weightbearing
Decreased fear
Greater indepedence

A

Goals Accomplished in Weaksided Transfers

57
Q

primarily in educating the client who has undergone joint replacement or fixation of a fracture about adaptive techniques for ADLs and IADLs with limited mobility while maintaining any joint precautions for movement or weight bearing.

A

OTs role in hip placement rehab

58
Q

OT often provide education classes for people at risk for fractures and those planning joint replacement. Topics include…

A

Topics include home modifications, safe transfer techniques, use of public transportation, community mobility tips

59
Q

Commode chair for anterolateral approach?

A

For anterolateral approach, will have enough hip mobility to use standard toilet seat

60
Q

For what procedure? Recommended client does not sleep on operated side. Pillow can be placed between legs if person is side lying or lies on non operated side

A

Total Knee replacement.

61
Q

When to use ADL Transfer with Transfer Board

A

with a person who cannot bear weight through lower extremities

62
Q

T/F: ADL transfer board, Be sure wheelchair breaks are locked and caster wheels are positioned backward to increase base of support

A

FALSE. FORWARD

63
Q

T/F: • Position wheelchair casters backwards EXCEPT when utilizing a transfer board

A

True

Adult Rehab (16 decks)

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