Scheduled maintenance: Wednesday, February 8 from 10PM to 11PM PST
hello quizlet
Home
Subjects
Expert solutions
Create
Study sets, textbooks, questions
Log in
Sign up
Upgrade to remove ads
Only $35.99/year
Adult Practice Exam 3 -- Henderson & Pifer
Flashcards
Learn
Test
Match
Flashcards
Learn
Test
Match
Terms in this set (81)
characteristics of GBS (more prevalence type)
- males and females affected equally
- age doesn't matter
- recovery lasts 6 months to 2 years
- tied to infections, sometimes surgery
clinical characteristics of GBS
- affects peripheral NS
- immune system attacks myelin
- polyneuritis (multiple nerves inflamed across body)
- sensory changes
presentation of GBS
- extremely rapid progression --> distal to proximal
- usually symmetrical
- initial symptoms LE
- no reflexes
- intense tingling, pain, crawling skin, etc.
- weakest point = 3-4 weeks after
medical tx for GBS
- plasmapheresis (plasma exchange --> don't treat day of)
- immunoglobulin injection (protein)
- interdisciplinary rehab
GBS phases
1. initial/acute
2. plateau
3. recovery
initial/acute phase GBS
- rapid progression
- onset --> when stops getting worse
- continue to decline until about week 3
plateau phase GBS
- not getting worse but no recovery
- days/weeks/months
- highly variable
- no avg length
- possibly getting shorter with txs
recovery phase GBS
- when something happens (some new movement)
- 6 months to 2 years
OT tx acute phase GBS
- splinting and positioning
- use of a switch to push call button
- education on mindful management strategies for pain
- AT/AE to preserve function have
- referrals
OT tx plateau phase GBS
- max A appropriate for ADLs
- compensation to get most from what have left
- positioning, splinting, PROM
- emotional support and education
- sitting EOB briefly
- pain management
OT tx recovery phase
- more remediation to get function back but with compensation to motivate
- fatigue management
- careful not to overexert --> lots of rest and breaks
- occupations and exercises
WB restrictions
NWB: non-WB
TTWB: toe touch WB (90% on unaffected side)
PWB: partial WB (50%)
WBAT: WB as tolerated
FWBAT: full WB as tolerated (?)
anterior hip precautions
- no hip extension past neutral
- no internal or external rotation
- no hip adduction past midline
- no active hip abduction
- no hip flexion past 90d
posterior hip precautions
- no adduction past neutral
- no internal rotation
- no hip flexion past 90d
pros of surgical pathways
- reduced length of stay
- better recovery
- more cost-effective
- multidisciplinary
- pain management included
- good for discharge planning
cons of surgical pathways
- sometimes hard to follow pathway --> we are very individualized
how to complete occupations following hip precautions
- dressing, bathing, toileting most affected
- use AE or DME to compensate for restricted movement
research related to PD
- some not great --> low dose, little task-specific practice
- some pretty great --> client-centered, high dose, Dutch guidelines
signs and symptoms of PD
- resting tremor
- bradykinesia and hypokinesia
- cogwheel rigidity
- postural instability
- freezing gait and festination (shuffling)
- decrease initiation of movement / retropulsive
- cog impairment
- psychosocial concerns
- sleep dysfunction
- sensory disturbances
- autonomic dysfunction
what symptoms have largest impact in PD
- non-motor
medical management of PD
- Levodopa (replaces loss of dopamine)
- on/off periods
- good in mild to mod stages
surgical management of PD
- when med is ineffective
- Ablative Surgeries: permanent lesion in brain
- Deep Brain Stimulation: lesion, implanted stimulater, blocks abnormal brain signals
stages of PD
stages I-V
stage I PD
- unilateral tremor
- small writing (micrographia)
- reduced endurance and increase fatigue
stage II PD
- bilateral motor involvement
- mild rigidity
- able to complete ADL tasks and functional mobility with mods
- IADLs are difficult
- work and driving likely cease
- increased difficulty with simultaneous task
- increased difficulty with executive function
stage III PD
- increased difficulty with balance and functional mobility
- delayed reactions
- increased difficulty with sequential tasks
stage IV PD
- significant deficits in ADLs and functional mobility
- fine motor compromised
- deficits in oral motor function (reduced speech and swallowing)
stage V PD
- severe motor deficits
- dependent in ADLs
- requires w/c for functional mobility
- a lot of time in bed
interventions for PD
- specificity: doing actual task
- saliency: real-life activities
- natural context
- repetition: do outside sessions
- feedback
- cognition and sensory cues
- don't hurry or rush the individual
- LSVT-BIG
different types of shoulder surgical procedures
- hemiarthroplasty: replace ball only
- TSA: ball and socket replaced
- reverse TSA: ball and socket replaced and switched
typical protocols and precautions following shoulder surgeries
highly variable by physician and setting
(will be given any specific ones on exam)
pendulum exercises
- body moves while arm is passive
- circles, side to side, front to back
abduction brace management
- keep pillow in place at all times
- watch for tightness at neck
- watch for active movement
- wear all the time except dressing and bathing
- 30d scaption, slight abduction
occupations with shoulder precautions and brace
- dressing --> adapted techniques
- grooming --> passive movement
- toilet transfer and hygiene --> use legs
- sleeping --> pillow
- bed mobility --> push with other arm
- simple homemaking
NMES
- neuromuscular electrical stimulation
- more in hand therapy
- activate muscles
- machine does movement for them
- not very skilled
FES
- functional electrical stimulation
- client engaged in task or occupation while doing
- do movements coordinated with stim
e-stim terminology
- frequency
- amplitude
- pulse width
frequency e-stim
- number of pulses per second/interval
- strength of contraction
pulse width e-stim
- time of each group of pulses
- longer = more neurons --> larger muscles
- shorter = more comfortable, smaller muscles
amplitude e-stim
- strength of e-stim
- frequently adjusting
- high enough to obtain muscle response while remaining comfortable
pros of e-stim (FES) for neurological injury
- helps with movement
- more occ based
- teach to use at home --> generalization
- cheaper
- motor learning
precautions of e-stim (FES)
- watch intensity levels
- do not want hyper movement
- metal work (joint replacements)
- pacemaker
- Baclofen pumps
- broken skin
- tumors
- watch sensory, language, cog
- skin sensitivities
various forms of e-stim
- FES
- NMES
- TENS
- Bioness
- EMG (Biomove, Neuromove)
- reciprocal EMG
- contralateral control tech
application of electrodes for e-stim
- across skin over muscle desire to impact
- clean and dry skin
- monopolar: one active electrode (muscle), other away from target area but in same region
- bipolar: both over target muscle
OT role back surgeries
- educating on precautions (how to follow for occs)
- AE and adaptive techniques for dressing
- don/doff braces
- joint protection
- home safety and activity mods
primary risk factors for back surgeries
- overuse/degenerative
- stenosis (narrowing of spinal spaces)
- arthritis
- trauma
back surgery complications
also: infection, smoking, co-morbidities, CSF leak, swelling, DVT
laminectomy
- lamina surgically removed
- relieves pressure on spine
microdiscectomy
- minimizes surgical trauma
- shorter recovery time
- less pain and scarring
- minimally invasive
corpectomy
- relieve pain caused when diseased or damaged vertebrae bone blocks and pinches nerve roots
- corrects spinal column deformities
- space filled with donor bone from pelvis, leg, or manufactured cage
spinal fusion
- bone graft with allograft or autograft
- may also be done with recurrent bulging or herniated discs
- anterior or posterior
- minimally invasive option
- usually due to degenerative disc disease
universal back precautions and apply to occs
no BLTs
- bending of the back (flexion, lat flexion, extension)
- lifting (none at first then weight prescribed)
- twisting (lat rotation)
cervical braces
- SOMI (not seen much)
- Miami J
-Philly/Philadephia Collar (bathing equivalent for Miami J)
TLSO
- "clamshell"
- Jewiit
- CASH
thoracic-lumbar-sacral
lumbar braces
- CASH type
- molded
- corset style
primary risk factors for amputations
- trauma (war)
- congenital (UE)
- vascular disease
- diabetes (LE)
- frostbite (northern states)
precautions needed to help/treat clients with amputations
- don't get prosthesis right away (train compensation prior)
- pressure relief and positioning
- shaping of residual limb
- training to use prosthesis (don and doff too)
- skin inspection
- desensitization
- phantom limb pain and sensation
- psychosocial concerns (body image!)
- functional mobility (LE)
advantages of body powered prostheses
- comfortable
- easy to adapt/learn
- reliable
- durable
disadvantages of body powered prostheses
- overuse of specific muscles needed to use
- more difficult to control if higher amputation
- less aesthetically pleasing
advantages of myoelectric prostheses
- cooler/more normal looking
- more pinches and grips
- more precise
disadvantages of myoelectric prostheses
- battery reliant
dvantages and disadvantages to LEx prostheses
- BKA, AKA, hip
- walking vs running foot
- not as many options as UE
sternal precautions
- no chest expansion
- no lifting beyond 5-10lbs
- no pushing or pulling with UE
- avoid isometrics (including Valsalva maneuver)
- no overhead activity (except quick for dressing)
pacemaker precautions
ONLY for side on (usu L)
- no shoudler flexion or abduction past 90d
- no heavy lifting (10lbs)
- sometimes have a sling
- e-stim can affect (microwaves, cell phones)
clinical indicators of cardiac issues
- stress and MH one of biggest but often overlooked or not addressed
- thrombogenic = elevated clotting proteins
OT interventions for Cardiac Rehabilitation phases
phase 1 (acute): reduce anxiety, inc independence and confidence, reduce deconditioning
phase 2 (IRF/SNF/OP): bx'l and lifestyle mods
phase 3 (OP): exercise
phase 4 (ind.): HEP
MET levels
charts
OT role in oncology
...
naming and staging of cancers
- named for tissue in
- TNM staging
- four stages
TNM staging
T = tumor size
N = in the lymph nodes
M = presence of metastases
given 1-5
cancer stages
1: 5cm or less
2: greater than 5cm but no invasion
3: positive regional nodes (invasion) but no metastases
4: pos or neg regional invasion, metastasized
OT tx precautions for working with cancer clients
- neutropenic (labs and vitals)
- cognitive (always assume)
- mental and emotional (support)
- chemo and radiation exposure
early post-diagnosis tx oncology
- activity mods/analysis
- energy conservation
post-operative phase tx oncology
- strengthening
- getting moving
- pain management
rehab phase tx oncology
- focus on going home
- ADLs and IADLs
- lymphedema management
- getting moving
palliative phase tx oncology
- positioning
- doing what they want
- increasing QOL
- pain management
- riding it out (palliative)
- end of life wishes (hospice)
OA characteristics
- age related wear and tear
- breakdown of cartilage
- joint deformities
- can be surgically repaired
- non-systemic
- pain less in mornings; worsens with activity
- pain with activity; rest alleviates
- develops slowly
- occasional secondary inflammation
- crepitus
RA characteristics
- autoimmune
- inflammation of synovial fluid
- joint deformities
- less surgically repaired
- systemic
- pain worse in morning; decreases with activity
- morning pain and stiffness; less throughout day
- develops suddenly
- both sides typically involved
- global fatigue
- exacerbation and remission
fibromyalgia characteristics
- affects muscles and soft tissues
- pain all over body
- widespread fatigue
- cognitive difficulties
Compare & Contrast OT interventions for OA and RA
- frequent short walks
- exercise in pain free range
- splinting (more OA or severe RA)
- joint protection
- med management
precautions for OT interventions with OA, RA, & fibromyalgia
- modify if pain lasts more than 1-2 hours after
- only AROM for exacerbation RA
- no heat on inflamed joints
- generally avoid resistive exercises and exercise media
- cog and physical components for med management
Students also viewed
MS
19 terms
Teaching & Learning; Health Literacy & Cognitive B…
10 terms
Back Surgery Rehabilitation
17 terms
Functional Cognition Exam 1
135 terms
Sets found in the same folder
Adult Practice Exam 2 -- Henderson & Pif…
139 terms
Unit 8: Adult Test 2
67 terms
Unit 9&10 Adult Test 2 (USAHS)
89 terms
Adult Test 2 (USAHS)
89 terms
Other sets by this creator
Functional Cognition Midterm (Boone)
93 terms
Functional Cognition Midterm (Boone)
64 terms
Adult Practice Exam 1 (Henderson & Pifer)
153 terms
Conditions Exam 3 (Gateley)
125 terms
Other Quizlet sets
Exam 6 PN
68 terms
Pathophysiology Chapter 12, Gould's Pathophysiolog…
46 terms
Unit 2 Test(Ch.3-4)
46 terms
Cell Cycle and Apoptosis
29 terms