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RCTX 4254

Terms in this set (118)

PERRLA
Noting eye/pupil reactions within normal limits
Pupil, equal, round, react to light, accommodating
In-house forms include?
Intake Assessment
Attendance forms
Functional skill checklist
Satisfaction surveys
Characteristics of most in-house assessments?
Includes basic demographics; name, birthday, admission date, physician's order, etc.
What are the three things that have a major impact on what is contained in the RTs in-house assessment?
The typical needs/strengths of the population being assessed
The scope of practice of RT's on that specific unit
Potential discharge destinations
Why would a facility use a non-standardized assessment?
Their main goal is to provide the proper assessment for the client so they may need to create their own based off research if a standardized one does not exist.
Why do all RTs (working on the same unit) typically use the same in-house assessment?
This allows continuity and increases the probability that critical information is obtained.
Why may RTs that work on different units (same facility) use different in-house assessments?
One RT may provide unit coverage while the other provides specialized care and works off referrals.
What is the most critical element of design when developing an in-house assessment?
This makes finding critical information easy
What is a checklist in a therapeutic setting & how is it used?
It is an inventory of items or a list of possible actions and is used to augment memory so no critical info is left out.
Why is observing behaviors one of the most important tools a RT possesses?
It is important to be able to focus on relevant behaviors and filter out the ones that aren't needed
What is an RT looking for when conducting a behavioral observation?
Formal identification and analysis of a behavior
What is a questionnaire?
A written set of questions presented to an individual to elicit their feelings, beliefs, perceptions, etc.
Be familiar with the 10 steps of questionnaire development.
Characteristics and needs
Main topics/Appropriate order
Select methods to analyze questionnaire
Draft/write questions
Decide question order
Pay attention to overall design
Draft info sheet to be included
Pretest
Prepare copies
Distribute
What are the procedures required for minimum competencies related to assessment?
Observing behaviors
Interviewing
Assessing functional skills
Administration of specific leisure instruments
Administration of other questionnaires
The lack of specificity is not necessarily a terrible thing, as the ability to ___________ procedures is the critical skill.
FOLLOW
Competencies related to process.
Ability to implement general rules
Evaluating skills
Ensuring the assessment is culturally sensitive
Developing questionnaires
Competencies related to basic knowledge.
Sensory, Cognitive, Social, Physical, Affective, and Leisure assessments
What is clinical reasoning?
The use of technical knowledge, learned facts, personal experiences, and personal judgement to analyze a situation and reach a conclusion
What is ambiguity in relation to this chapter?
When evidence or a situation can logically have two or more explanations
What are the important issues to consider when there is a question of the accuracy of what a client tells you?
Social Desirability: clients answer questions to "look good"
Lack of trust to be open
What is a trait?
Long lasting and enduring; " A client with a mood disorder is likely to show anhedonia"
What is a state?
Short lived emotional responses and physical functions; "client with less sleep is more likely to be irritable"
Levels of category of health (ICF information).
Body Function
Body Structure
Activities and Participation
Environmental Factors
By federal law we must accommodate for ____________ throughout the educational continuum up & through the point of sitting for a state or national credentialing exam.
DISABILITIES
What are the eleven basic rules when writing in a chart?
Record accurate, factual events
Write in a timely manner
Error corrections dated and initialed
Communication for various personnel
Document frequently to show progression of care
Document concise and specifically
Sign and date every entry
Don't document other members actions
Descriptive words
Avoid abbreviations
Write legibly
Be familiar with the 13 categories of descriptive words used in documentation.
Posture
Movement
Helpful words
Mental state
Thought process
Affect
Following directions
Use of time
Choice of activity
Approach to activity
Independence
Social
Social behaviors
What are three primary ways that a therapist initiates contact with a patient?
Unit Coverage
Referral
Prescription
Table on enabling documentation.
PERSON FIRST
DO NOT SENSATIONALIZE
+1 +2
use of one or two people to assist
24 A
24 hour assistance
~
Approximately
WNL
within normal limits
V.S.
vital signs
Verbal order
V.O.
Upper Extremity
UE
ST/M
short term memory
Rx
prescription
ROM
range of motion
r/t
related to
qod
every other day
q4h
every 4 hours
PRN
as necessary
PO
by mouth
Ox3
oriented to perrson, place, and time
NOS
not otherwise specified
LLQ
left lower quadrant
I+O
input and output
ETOH
alcohol
What are signs & how are they used?
warnings that something is wrong; measuring changes throughout treatment
What are the four measurements that are combined to make up vital signs?
Blood pressure
Pulse
Respiration
Rate
Temperature
Common factors that influence blood pressure.
Position of client
Activity
Ingested substance
Time of day
Gender
Pain/Emotions
Edema
The body is not able to get rid of excess fluid appropriately
What are scales & how are they used?
Measures "where" and "how much"
What are the three main types of structures that are used when creating a scale?
Nominal (Yes/No) (gender/title) (non-linear)

Ordinal (Likert scale) (strongly disagree to strongly agree)

Interval (ROM, temperature, distance)
Sighs
periodic deep breathing
Biot's breathing
irregular shallow with period of apnea
Purse lip breathing
controlled expiration with pursed lips
Cheyne-Stokes breathing
alternating between deep and shallow breathing
Kussmal breathing
Slow and deep breaths
Abdominal paradox
Chest expands/abdomen retracts
Thoracic paradox
One side expands while the other retracts
Attitude
Short lived emotional state; binary how often or how many
Belief
emotional acceptance of a statement
Feeling
experience of emotion
Mood
long lasting emotional state
Opinion
expressed point of view
Preference
choice that demonstrates the liking
What are those four separate assessments?
Leisure Attitude Measurement: cognitive, affective, and behavioral
Leisure Interest Measure: physical, outdoor, mechanical, artistic, service, social, cultural, reading
Leisure Motivation Scale: intellectual, social, competence-mastery, stimulus avoidance
Leisure Satisfaction Measure: psychological, educational, social, relaxation, physiological, aesthetic
Why would all four assessments (battery as a whole) be utilized?
To provide a broad measure of client's leisure aptitudes
Why would the assessments be used separately?
To provide statistically valid measure of that aspect of the lifestyle
Functional skills
Abilities or tasks demonstrated by the client that can be observed & measured
Physical domain
Grasps and grips
Coordination
Gait (walking)
Endurance/Activity Intolerance
Cognitive domain
Attention
Awareness
Generalization
Initiation
Memory
Mental flexibility
Orientation
Planning
Problem-solving
Social domain
Social roles
Social patterns
Social skills
Social support
Emotional domain
Feeling
Mood
Affect
What are the different ways recreational therapists collect functional information on a client?
Adaptive behavior scales
What is the FFT?
Functional fitness test; simple and easy to use testing items assessing functional fitness for older adults
Participation
linear; quality of action and amount of efforts
Involvement
multifaceted cognitive and emotional state;
Importance
Pleasure
Interest
Intensity
Centrality
Meaning
CIP
Community Integration Program; an assessment focused on cognitive awareness and functional skills in the environment
4 goals of CIP
1) Application of skills
2) Socialization
3) Problem solving
4) Resource guidance
Community Environment
involves the safety, judgement, and behavior control
Cultural Activities
Theater, Library, etc
Community activities
Grocery store, shopping mall, etc.
Transportation
Involves knowing the different means of travel around their community
Physical Activity
leisure activities that promote fitness
1.) Be able to explain a population and why they would need the CIP.
- Patients admitted to rehabilitation and psychiatric service
- Clients and youth with developmental disabilities
- Geriatric
- Physical disabilities - individuals who use a wheelchair?
Quality assurance is the process of....
keeping track of the quality of work done by the treatment team, identifying aspects to improve, and implementing changes
What are the two most important goals to evaluate the quality of services provided?
Improve care so clients benefit from services
Comply with all standards
What are quality indicators?
Patterns that may indicate POTENTIAL problems based on client's scores on the interdisciplinary assessment
What are quality measures?
Thresholds that were passed indicating there is a problem
LCM
Leisure Competence Measure; measures outcomes related to RT and is used to summarize and categorize information
Leisure Awareness
knowledge and understanding of leisure
Leisure Attitude
Behaviors exhibited and/or feelings demonstrated by the client which suggest attitude toward leisure involvement
Leisure Skills
Skills possessed by the client which affect leisure involvement
Cultural/Social behaviors
Observed in the environment
-Specific cultural/social behaviors exhibited by the client which affect their ability to function effectively in leisure activities
Interpersonal Skills
Client's ability to participate within various types on inter-individual and/or group situations
Community Integration
applying skills in the community
Community Participation
Client's overall leisure participation pattern within the community
Social Contact
type and duration
Should the LCM be utilized as the sole testing tool to measure a client's status?
NOOOO
- Idyll Arbor Leisure Battery may complement it.
RAI
Resident Assessment Instrument; care planning process used in long-term care facilities
What does the federal government have to do with the RAI?
Allows them to track resident care, the type and quality of services, and overall trends
What are the three components of the RAI?
Minimum Data Set
Triggers
Resident Assessment Protocols
1.) What are the important issues to consider when there is a question of the accuracy of what a client tells you? (5)
Unreliability
Nondisclosure
Self-disclosure (lack of)
Deception
Dissimulation
Unreliability
the client may be unable to remember correctly.
Nondisclosure
when information is withheld either through a free, conscious choice or when the client is compelled to withhold information by internal processes such as hallucinations.
Self-disclosure (lack of)
when a client does not wish to reveal information about themselves (sometimes influenced by culture)
Deception
when a client distorts or misrepresents themselves. When the client intentionally deceives the therapist.
Dissimulation
when a client distorts or misrepresents psychological symptoms
Leisure Attitude Measurement
a. Reviews the client's attitude toward leisure on three different levels:
cognitive
affective
behavioral
Leisure Interest Measure
Helps identify the degree to which a client is interested in each of the eight domains of leisure activities.
i. Physical
ii. Outdoor
iii. Mechanical
iv. Artistic
v. Service
vi. Social
vii. Cultural
viii. Reading
Leisure Motivation Scale
a. Measures a client's motivation for participating in leisure activities
b. Four primary motivators identified through research:
Intellectual
Social
Competence-mastery
Stimulus avoidance
Leisure Satisfaction Measure
a. Indicates the degree to which a client perceives his/her general "needs" are being satisfied through leisure.
b. Six subscales of satisfaction measure by this tool.
Psychological
Educational
Social
Relaxation
Physiological
Aesthetic
1.) What are the different ways recreational therapists collect functional information on a client?
Functional assessments incorporate a variety of techniques and strategies including:
a. observation
b. Communication
c. Any use of mechanical measurement tools (stopwatches, measuring tapes etc.)
Attendance
- Counts for how many times or how often a client shows up for an activity. (binary count: "either/or")
Participation
Linear Concept that addresses:
- The quality of actions of a client
- The amount of effort the client puts into an activity
involvment
Multifaceted Cognitive & Emotional state

Six independent subcomponents of involvement
- Importance of the activity
- Pleasure derived from activity
- Interest in activity
- Intensity of, or absorption in, the activity
- Centrality of the activity to the individual's perception of self
Meaning of the activity
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