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Foundations (final)
| Question | Answer |
|---|---|
| Goals of proper positioning (4) | 1. make pt comfortable, 2. prevent pressure sores, 3. provide pt w/ access to environment, 4. position for treatment |
| 3 general procedures for positioning + draping | 1. body mechanics, 2. Lift (do not drag), 3. expose only area necessary |
| Procedures for relieving pressure (primary objective) | disperse pressure over greatest area |
| Procedures for relieving pressure (6) | 1. no direct contact w/ bony prominences, 2. eliminate sheet wrinkles, 3. minimize time w/ head elevated, 4. utilize linen/trapeze for transfers, 5. avoid position w/o support, 6. use "pressure dispersing medium" (pillow) |
| Bridging the gap | support proximal and distal to sensitive area (like a bridge) |
| Effects of bedrest (7) | 1. atrophy, 2. fatigue, 3. reduced cardiac funct., 4. loss of bone, 5. deep vein thrombosis (DVT), 6. orthostatic hypotension, 7. pressure ulcers |
| 95% of pressure ulcers develop on... (5) | 1. sacral/coccygeal, 2. greater troch., 3. ischial tuberosity, 4. heel, 5. lateral malleolus |
| Pressure ulcer prevention (6) | 1. freq. repositioning, 2. relieve pressure on bony prominences, 3. physical activity, 4. monitor skin, 5. decrease moisture, 6. nutrition |
| Minimum time between checking patient positioned in supine/prone | 2hrs |
| Documentation for pressure ulcers | vital signs, stage + location of ulcer, positioning |
| ROM | range of motion (full motion possible at the joint) |
| Passive Range of Motion (PROM) | produced by external force ("relax I'm going to move you") |
| Active Range of Motion (AROM) | produced by active contraction of muscles ("do this") |
| Active Assisted Range of Motion (AAROM) | helped by external force ("So the parts you can. I will help you with the rest") |
| Reliability | repeatability of measures |
| Validity | degree to which your measure represents what you intend to measure |
| Improving reliability with a goniometer | use a consistent position, landmark, device, and therapist |
| What type of ROM would you measure if the muscle is tight? | PROM |
| What type of ROM would you measure if the muscle is weak? | AROM |
| What type of ROM would you measure if the capsule is tight? | PROM (for tightness) |
| What type of ROM would you measure if the patient has nerve damage? | AROM |
| Active Insufficiency | deficit of muscle shortening |
| Passive Insufficiency | deficit of muscle lengthening |
| Contraindication for ROM intervention | disrupt healing, life threatening condition |
| 5 elements of pt management | examination, eval, diagnosis, prognosis, intervention |
| end feel: boney | abrupt end with no give |
| end feel: capsular/ligamentous | bending plastic ruler |
| end feel: muscular | stretching a large rubber band |
| end feel: springy | bouncy end feel |
| end feel: empty | unable to reach end feel (due to pain, etc) |
| During ROM measure, stabilize ____ | the proximal segment |
| Steps of ROM measure | 1. POSITION pt, 2. STABILIZE, 3. assess END FEEL, 4. PALPATE boney landmark, 5. ALIGN goni, 6. record START POSITION, 7. record END POSITION |
Created by:
cbaweiss
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