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Patient_care

Module 6 txr prep

QuestionAnswer
Paresis vs Plegia Paresis- partial or incomplete parylsis; Plegia- paralysis (which is loss of power of voluntary movment in a mm thru injury or disease of its nerve supply)
what three things should you always always consider with txrs? 1. pt 2. enviro. 3. urself!
according to Jamie, what is the most impt thing you can ask the pt? what was there PRIOR LVL OF FUNCTION? (and, can they assist or do the txr on their own- our goal is to make THEM more functional!)
how do u define txr? the safe movment of a pers from 1 surface or location to another or from one posit to another. depending on thier ability, it can be performed either independtly or with various lvls of assistance.
what are some things you consider when assessing the pt? cognitive status: lvl of alertness, CONSENT, FOLLOW DIRECTIONS, WATCH A DEMO? physical status: PAIN lvl, take meds? strong vs weak side, side they get OOB @ home, ortho precautions/WB status, lvl of assist. 3. clothing/equip- need shoes! lines?
what should u consider when assessing enviro? 1. treatment area (clear path?, lighting, IV) and how to best arrange the room, move everything so they can get out on their strong side if able, arrange lines, etc.
what should u consider when assessing YOU? do u have ur equip? wash hands and don PPE (if necessary), review med record, INTRODUCE! decide on the most appropriate activity/txr for them, make sure u explain the txr to the pt so they can assist or just know whats going on!
what parameters should u use when making a clinical decision regarding the approp txr or activity with the pt? 4 (from book): " should u PERG?" 1. Pt.- depending on what they tell u (or family mbrs), 2. Eval (what do u think based off that?) 3. Records (med record/previous PT notes say/suggest/lvl of assist.?) 4. Goals of Rx (what do u want 2 accomplish 4 DC)
define INDEPENDENT according to Txr or Amb assist: pt can perform txr w/out ANY type of verbal or tactile cues or manula assistance
define ASSISTED according to Txr or Amb assist: pt requires physical, oral or tactile cues, directions, instructions to perform the acvtivity safely in an acceptable time frame.
define STANDBY ASSISTANCE (SBA) according to Txr or Amb assist: pt requires verbal or tactile cues/directions/instructions from a person close to them, but NOT TOUCHING.
define CONTACT GUARDING (CGA) according to Txr or Amb assist: caregiver is close to pt with his or her hands ON THE PT OR SAFETY BELT. it is very likely the pt will prequire protection during the performance of the activity.
define MODIFIED INDEPT according to Txr or Amb assist: the pt uses ADAPTIVE OR ASSIST. EQUIP to perform the task INDEPENDENTLY. - ex pt may need to grab bed rail to get up, or furniture, or need txr board. pt may have safety or timliness issues
define MIN A according to Txr or Amb assist: pt can perform 75% or more of the activity
define MOD A according to Txr or Amb assist: pt can perfrom 50-74% of activity
define MAX A according to Txr or Amb assist: pt can only perform 25-49% of activity
define DEPENDENT according to Txr or Amb assist: pt requires TOTAL PHYSICAL assist. to accomplish activity safely.
describe how you u EXECUTE the txr activity? 1. mentally plan and organize. 2. EXPLAIN the procedure to the pt (tell them their role and urs!) 3. demonstrate if able. 4. obtain CONSENT. 5. lock all wheels! 6.start txr/activity!
what should u remember DURING the txr activity? use BRIEF, concise, action oriented instructions (first, lock ur chair; now lift the footrests, move ur hips fwd, place ur good goot closer to the chair and ur bad foot further from the chair) proper body mechanics, maintain safety, ANTICIPATE A FALL!
what should u do AFTER the activity? position! drape! make them comfy (phone, newspaper, etc)
what are some precautions for THA? ADD, IR/ER, FLEX>90. requier the pt to sit in a SEMIRECLINING POSIT, and to maintian abduction when moving side to side or sup to sit.
what are some precautions for LB trauma or discomfort? excessive lumbar rotation, trunk bending/flex. maybe logroll. side lying may be comfortable- pillow btwn legs w/ partially flexed LE.
what are some precautions for SCI? have or need a brace? def logroll! be aware of osteoporosis (esp if theyve have injury for several + months), they could get fx easily esp in LE and vertebral bodies. turning them over or txr could fx!
what are some precautions for burns? avoid creating a SHEAR force. elevate body when moving an area (bridge?)
what are some precautions for Hemiplegia? dont pull on involved or weakened extremities! esp shoulder! prone to dislocation. most pts will experience pain when sidelying or roll over involved shoulder- try to avoid.
Created by: tpostrel