Clinical Skills Test 1-Positioning, Transfers, Body Mechanics

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How do you communicate with a pt?

keep it simple, clear, break it down

How do you reduce a pt's fears/ anxieties?

give as much information as they want = empowerment of their treatment

What are 3 ways to manage a patient care area?

saftey, equipment, monitoring pt

In reguards to managment of pt safty what do you need to consider?

proper way to guard pt, wheelchair components, wet floors, cords, self-saftey

In reguards to equipment what do you need to consider?

Know equipment and how to use it. Plan ahead (i.e. IV line, cath., chest tubes, o2

What do you need to monitor in the patient?

vital signs, change in body position, color, change in behavior

What are the principles of proper lifting?

Loratic curve (protected), keeping PT and pt's COG close and over BOS, eyes up (to keep spine inline, pivot not twist, smooth motion, use leg muscles, lower pt slowly

What are saftey considerations of proper lifting?

asses what you are going to do before doing it, ask for help if you think you might need it, don't hold pt up, slowly lower to ground

What are the proper body mechanics of proper lifting?

COG over BOS

What are some general back care principles?

Avoid lifting for long periods of time, role model for pt, wt. control and exercise

How do you minimize skin breakdown of pt?

make sure circulation is not being cut off( ischemia), no bed sores, rotate positioning of pt.

What are areas prone to tissue damage of skin breakdown? Supine

bony processes (occipute,spinous processes, scapula,saccrum, head of fibula, lateral malleloes, elbows, heels

What areas are prone to tissue damage of skin breakdown? sitting

ischial tuberosity, heels, scapula

What are areas prone to tissue damage of skin breakdown? Prone

petella, ear,sternum, ASIS, top of feet

What are areas prone to tissue damage of skin breakdown? sidelying

ear, g.tubercle, prox. humerous, femorl condyle, lateral melliolus, 5th metatarsal

What are risk factors for developing pressure ulcers?

poor nutrition, prolonged immobility, decreases sensation, paralysis, urine/bowel impariment, anemic, thin, vascual diseases, previous ulcers, cast to tight, prothestic, sheering forces(transfer boards), diabetes, ect.

Interventions for reducing pressure sores?

turning/rotating positions, every 2hrs, properly positioning them no wrinkles in sheets, special beds

List general principles and education of positioning pts. for long term use

pillows foward to take pressure off region, push ups in wheel chair, teach how to inspect themselves

What is FIM Scale?

Fuctional Independance Measure - need to put a number on an activity such as transfers or gait

Describe the FIM scale

1- less than 25%, 2-less than 50% more than 25%. 3-less than 75% but more than 50% effort 4- min. contact assistance, contact guard for stbility 5- supervision, standby, coaxing 6- saftey risk, modified dependent 7- complete independance

What are 2 ways to roll someone to sidelying (be able to describe both)

log rolling and segmental rolling

What does the FIM scale asses?

How much work the pt is doing on a scale 1-7, 1 being the worst

Before transfering a pt what do you need to think about?

1- access the pt, 2- gross screening of pt stength, cognition, following commands

What device can you use to transfer someone who has little lower extermity strength of cannot stand up?

transfer board

If pt can stand, but still needs assistance, what kind of transfer should you consider?

Stand-Pivot transfer -make sure good body mechanics, COG over BOS

Describe the pressure Ulcer Staging system

1- skin intact, reddening 2- partial thickness, skin loss of layers, blisters 3-full thickness, tissue loss extending through dermis into subcutaneous tissue(tunneling), 4-deep tissue destruction infection into subcutaneous fasia and may go to bone, necroti tissue tunneling

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