Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

S4- Acute Care > Week 6- Patient Positioning/Orthotics/Adaptive Equipment, Integumentary Basics/Burns > Flashcards

Week 6- Patient Positioning/Orthotics/Adaptive Equipment, Integumentary Basics/Burns Flashcards

1
Q

PART 1: PATIENT POSITIONING/ORTHOTICS,ADAPTIVE EQUIPMENT

A

PART 1: PATIENT POSITIONING/ORTHOTICS,ADAPTIVE EQUIPMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 3 of the most commonly used cervical collars?

A
  • Philadelphia
  • Aspen
  • Miami J
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • ___________ collar is good at restricting flexion/extension but doesn’t do as good of a job with rotation.
  • _______ and __________ collars are good at restricting motion in every plane.
A
  • Philadelphia

- Aspen and Miami J

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

______________ collars limit at both the lower cervical and upper thoracic area.

A

Cervicothoracic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A ________ is the most restrictive and involves pins going into the skull to restrict cervical and upper thoracic movement.

A

Halo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 3 hyperextension orthoses that help prevent flexion?

A
  • Jewett
  • CASH
  • HE Brace w/ neck support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

______ orthoses (_____) work like a body cast to control spinal posture.

A

thoracolumbar sacral orthoses (TLSO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 3 LE orthotics used?

A
  • Walking boot
  • AFO
  • Knee Splints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

With knee splints, where should the dial be?

A

Right at the joint line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are hip abductor wedges used for?

A

Used for total hip so they are reminded to not cross their legs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

With arm slings, it is important to support the _____.

A

hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are sock butlers and arm butlers used for?

A

Used for patients who need to get on compressive garments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the goals of patient positioning? (3)

A 
Patient comfort
Skin hygiene (reduce risk of pressure sores)
Joint mobility (reduce risk of joint contractures)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  • Avoid _______ positioning.
  • Educate patient on ________ relief.
  • ________ schedule for individuals unable to reposition themselves.
A
  • static
  • pressure
  • turning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pillows do’s and dont’s?

A

DO
-float heels, elevate UE, use for sidelying, prevent hip ER in supine
DO NOT
-place under knees, keep neck flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Specialty beds are often used for high-risk patients, be sure that during mobility it is __________ inflated. Return it to setting after mobility is over.

A

-maximally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do pressure relief beds do?

A

Changes pressure points throughout the bed on a continual basis to prevent pressure sores.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  • _____ cushions provide the least pressure relief but the most postural support.
  • ______ cushions provide moderate pressure relief and moderate postural stability.
  • _____ cushions provide the most pressure relief and the least postural stability.
A
  • Foam
  • Gel
  • Air
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A _____-____-_______ chair is used for patients who can’t pressure relief.

A

tilt-in-space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

For diabetic foot ulcers, what is the gold standard for offloading?

A

total contact cast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  • Where are we looking at in the integumentary evaluation?

- What are we looking for in the integumentary evaluation?

A
  • At high-risk areas
  • Under orthotics
  • At surgical sites
  • Location, Color, Temperature, Condition, Edema
  • Look for nonblanching skin
  • Observe skin for pressure areas caused by medical devices (ie, catheters)
  • Ask patient to identify areas of discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How should you position each of these patients?

  • THA
  • TKA
  • TLSO splint after spinal surgery
  • Head trauma on mech vent
A
  • THA: Putting patient back to bed in supine.
  • TKA: Lying supine in bed with head elevated, lots of knee pain.
  • TLSO splint after spinal surgery: Pt seated in bedside chair, complains of pain in anterior part of orthosis.
  • Head trauma on mech vent: Unconscious patient lying in bed hooked up to multiple lines, right neck rotation from mech vent tubing.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PART 2: INTEGUMENTARY AND BURNS

A

PART 2: INTEGUMENTARY AND BURNS

24
Q

The Epidermis:

  • The integumentary system is our _______ organ system!
  • What are the functions of it?
  • How many layers are there?
A
  • largest
  • temperature/moisture regulation, sensation, protection from infection/disease,cosmesis, and interacts with our environment
  • five layers
25
Q

What are the 5 layers of the epidermis and a way to remember them?

A
  • Stratum Corneum
  • Stratum Lucidium
  • Stratum Granulosum
  • Stratum Spinosum
  • Stratum Basale

(C)ome, (L)ets (G)et a (S)un (B)urn

26
Q
  • What is the function of melanocytes?
  • What is the function of Merkel cells?
  • What is the function of Langerhans’ cells?
A
  • Melanocytes: produce melanin, which gives skin its pigment (also protects from UV skin rays).
  • Merkel cells: specialized mechanoreceptors to provide information about light touch
  • Langerhans’ cells: in deeper epidermal layers and help fight infection by attacking and engulfing foreign material
27
Q

The Dermis:

  • __ layers that are _______ vascularized.
  • _______ produce collagen and elastin.
  • Support structures: hair follicles, sudoriferous glands, sebaceous glands, vasculature, lymphatics.
  • ________ endings!
A
  • 2, highly
  • fibroblasts
  • nerve
28
Q

What are some risk factors for acquiring wounds and wound healing?

A
  • Medications: anti-coagulants, steroids, immunosuppressants
  • Diabetes (chronic blood sugar > 250)
  • Tobacco use
  • Poor nutritional status (especially protein)
  • CV comorbidities
  • Reactive/autoimmune processes
  • Reduced mobility
29
Q

With poor nutritional status, we look at _________ for long term protein nutrition and ________ for short term protein nutrition.

A
  • albumin

- pre-albumin

30
Q
  • What is the cause of decubitus ulcers “bed sores”?

- Where is it usually over?

A
  • Lesion caused by unrelieved pressure resulting in damage to underlying tissue.
  • Usually occur over bony prominences that contact surface.
31
Q
  • The pathogenesis for decubitus ulcers is pressure causes ___________, excessive pressure can lead to tissue ___________.
  • If the pressure is relieved, we see temporary reactive hyperemia and no tissue damage. If it is ____-__________ _________ (Stage I), then damage has begun.
A
  • ischemia, necrosis

- NON-BLANCHABLE ERYTHEMA

32
Q
  • How many stages of decubitus ulcers are there?

- What else are we looking at?

A
  • 4 stages

- looking at color, infection, smell, pain (unless decreased sensation)

33
Q
  • In what stage of decubitus ulcers do we see it reaching past the dermis/epidermis and into the subcutaneous layer?
  • In which layer do we see it reach muscle and bone?
A
  • Stage III

- Stage IV

34
Q

If we see stage IV decubitus ulcer where bone is exposed, we should assume they have what?

A

osteomyelitis

35
Q

In order for wounds to heal, there has to be sufficient circulation, what is one way to measure this?

A

Ankle Brachial Index (ABI)

36
Q

ABI:

  • Diagnostic test of _____.
  • Test of distal LE perfusion performed in radiology or with bedside doppler machine.
  • SBP ______/SBP ______
A
  • PAD

- SBP ankle/SBP UE

37
Q
  • What ABI is normal?
  • What ABI is mild PAD?
  • What ABI is moderate PAD?
  • What ABI is severe PAD?
A
  • 1.0-1.4
  • 0.8-0.9
  • 0.5-0.8
  • <0.5
38
Q

With decubitus ulcers, _________ is key. What are some ways to do this?

A

Prevention

  • bed positioning (reposition high-risk every 2 hours)
  • WC cushioning and unweighting/pressure relief, tilt in space WC if pt unable to perform pressure relief
39
Q

What are the causes of burns in order of prevalence?

A
  • Fire/flame (43%)
  • Scald (34%)
  • Contact (9%)
  • Other (7%)
  • Electrical (4%)
  • Chemical (3%)
40
Q

What are the 4 types of burns?

A
  • Thermal
  • Electrical
  • Chemical
  • UV and Ionizing Radiation
41
Q
  • What type of burns have an entry and exit wound?
  • What type of burns involves contact with hot object, liquid, flame, steam, intense heat?
  • What type of burns involve sunburn, radiation treatment for cancer?
  • What type of burns involves contact with alkili or acid substance.?
A
  • Electrical
  • Thermal
  • UV and Ionizing Radiation
  • Chemical
42
Q
  • How do we categorize burns?

- How many degrees of burns are there?

A
  • Thickness and severity of damage to epidermis, dermis, and subcutaneous tissues.
  • 3
43
Q

Superficial Burns (First Degree):

  • Only __________ affected.
  • Red, dry, and painful with no ___________.
  • What are some examples?
  • How long until it heals usually?
  • Does it have long-term damage?
A
  • epidermis
  • blisters
  • sunburn, burn from curling iron
  • 1 week
  • no long-term damage
44
Q

Partial Thickness Burns (Second Degree):

  • _______ and part of _______ damaged.
  • Red, __________, swollen, painful.
  • Skin may appear ____ or shiny.
  • Skin may be ________ or have irregular discoloration.
  • Dressing changes can be painful – pain management.
  • May heal in ___ weeks, or require more advanced management.
  • Can be classified as __________ or _____.
A

epidermis, dermis

  • blistered
  • wet or shiny
  • white
  • 3 weeks
  • superficial or deep
45
Q

Full Thickness Burns (Third Degree):

  • __________ and entire ______ are damaged.
  • Dry, _______ skin.
  • Brown, yellow, white, or black color to skin.
  • ____ pain – nerve endings are gone.
  • Require extensive medical management for healing.
A
  • epidermis and entire dermis
  • leathery
  • no pain
46
Q

Total body surface area for burn injury is calculated using the Rule of ______ (Lund and Browder diagram). Describe the percentages on this diagram for each body part.

A

Rule of Nines

  • Head = 9
  • Chest = 9
  • Abdomen = 9
  • Upper back = 9
  • Lower back = 9
  • Arm (front and back) = 9
  • Front of each leg = 9
  • Back of each leg = 9
  • Groin = 1
47
Q

What are the medical priorities in burn rehabilitation?

A
  • Pain management
  • Electrolyte and fluid management
  • Nutrition
  • Wound care (Antimicrobials, skin substitutes)
  • Infection Prevention
  • Pulmonary status
  • Psychological adjustment support
  • Surgery and skin graft management
48
Q

What are some interventions after burn injury?

A
  • Contracture management and positioning.
  • Splinting.
  • Scar management.
  • Prevent wound infection.
  • Improve mobility and cardiovascular function.
49
Q

Contracture Management:

  • Healing scar is at high risk for ____________ development, which significantly impacts function.
  • __________ is key for acute injury and to manage post-surgical edema. (Initiate positioning program as soon as possible)
  • Consider use of pillows (or no pillow under head), towels, wash cloths.
  • ________ more likely with increased depth of injury.
A
  • contractures
  • positioning
  • splinting
50
Q

Splinting and Burn Injuries:

  • Required with increased burn _______.
  • Collaboration with ___ needed.
  • Goal = promote _______ alignment for optimal function.
A
  • depth
  • OT
  • neutral
51
Q

Scarring is most likely to occur with ___________ burn injuries.

A

full thickness

52
Q

What are the 2 most common scar types?

A
  • Hypertrophic scars: raised above normal skin surface. Occur at time of injury.
  • Keloid scars: grow beyond area of original injury. Grow months/years after injury
53
Q

Scar Management (Compression Garment):

  • Customized to patient, frequent re-assessment.
  • ___-___ mmHg.
  • Goal: scar maturation, protect healing skin, shrink scar.
  • ___ hour/day wear schedule.
  • ___-___ month wear time.
  • Unknown mechanism of action.
  • ? Patient compliance and efficacy.
  • Can be used to protect tissues when grafting is delayed.
A
  • 24-30mmHg
  • 23h/day
  • 6-12 month
54
Q

Scar Management (Silicone Sheets):

  • Applied under compression garments or where garments cannot conform to skin.
  • Comfortable, do not restrict movement.
  • Some studies show reduction in scar with prolonged application/wear time.
  • ___-___ months, >___ hours/day Unknown mechanism of action.
A

-6-12 months, >20h/day

55
Q

What are a few other scar management options?

A
  • Scar massage
  • Injections
  • Surgery
56
Q

When is surgery used?

A

As a last resort if it severely impacts function. Creates a new wound, and the cycle of healing begins again.

S4- Acute Care (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions