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pt care skills__

Module 11- w/c

list the standard measurements of an adult w/c? (seat height, seat depth, seat width only) [table 7-2] seat height (heel-popliteal fold + add 2" for clearance of footrest. avg: 19.5-20.5") seat depth (butt-poplit. fold and subtract 2" to avoid pressure against poplit fold. avg: 16") seat width (widest part + 1.5" to allow for bulky clothing. avg: 18")
list the standard measurements of an adult w/c? (back height, armrest height) [table 7-2] back height (seat 2 floor axilla w/shoulder flexed to 90 degrees. then subtract 4" to allow for final height to be below inferior angles of scap. avg. 16-16.5") armrest height (seat of chair 2 olecranon process with lebow flex 2 90, and add 1". avg: 9")
how do u confirm the fit of a w/c: seat height? leg length? [Procedure 7-1] have pt sit errect w/ pelvis in contact with back seat. u should be able to place 2-3 fingers under thigh easily (2" in from edge of seat). bottom of footrest must be > 2" from floor. *pt should wear shoes as normal, + have cushion in place.
how do u confirm the fit of a w/c: seat depth? [Procedure 7-1] should be able to have 2-3 fingers inbtwn frotn edge of seat and users popliteal fold. make sure they are seated all way back in the w/c.
how do u confirm the fit of a w/c: seat width? [Procedure 7-1] be able to slide u hand inbtwn greater trocs and arm rests. hold hand vertically (like a karate chop)
how do u confirm the fit of a w/c: back height? [Procedure 7-1] should be able to place 4 fingers (hand vertically, like karate chop) btwn armpit and back of chair. inferior angles should be 1 finger breadth above back of chair.
how do u confirm the fit of a w/c: armrest height? [Procedure 7-1] have them place arms on rest, with 4" anterior to back post of arm rest (good pic pg 137). shoulders should be level, trunk erect, back against back w/c, look for "triangle" btwn back of chair, humerus and top of armrest.
what are some things to education pt's family re: w/cs? some pts will need 2perform several sitting pushups/hour, some will need to elevate 1 buttock @ a time, leaning, to relieve pressure. this may cause stress 2 wrist structures (carpal tunnel). alt- shift trunk fwd/back. pt may need 2 be removed p 1-4 hrs
does a cushion/pillow relieve pressure in w/c and elimnate the need to do those? it does not elimnate the need to requently relieve pressure by any of the methods described above.
what sxs should the family be instructed in watching for? decreased circulation sx- ankle edema, color changes in toes/legs/feet, decreased sensory response, loss of hair follicles.
what should ea w/c user be taught? 1. how to operate locks + tighten them when necessary, 2. remove/replace arm rests, 3. swing away/remove/replace front rigging, 4. elevate/lower foot plates.
what else should family be educated in regarding proper use/care of w/c? good body mechanics while pushing/transfering.
what is recommended for general care/cleaning for a w/c? periodic cleaning of exposed metal w/nonabrasive metal polish or automobile wax and cleaning of upholstery with use of an approp fabric cleaner or damp cloth. do NOT immerse chair in water or spray with hose. wipe dry after rain exposure.
what is recommended for maintainence for a w/c lub cross brace center pin every 6 mo. use molybdenum-based grease, not light oil bc it will collect dirt particles. periodcally lub arm rests w/WD 40 or paraffin. wheel bearings greased not oiled (only if removed from wheels). chk wheel spoke tightness
with a power tilt w/c, what degree of tilt do u need for pressure redistribution? 45 degrees! most go back 55 degrees.
whats a potential prob with a power tilt w/c tho? could lead to shearing force for pt.
when do u use a standard/basic w/c? short term is defined as <6mo.
how often should u replace cushions in w/c? who is a candidate for needing a special cushion? every 2 years. pts In chair >4 hrs, impaired- no sensation, orthopedic conditions, post SCI- pelvic obliquity
how does weight of a w/c vary? list exs. temp/standard chair weighs 35-60 lbs, light weight long term chair is 28-35 lbs. K5 ultra light weight is 22-25lbs
whats a disadvantage of the temp/standard w/c? Sling back/sling seat- lead to slump/khypotic posture, IR hip
Created by: tpostrel