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Adult Intervention

Occupational Therapy for Adult Intervention

What is the prevalence of developmental disabilities? 1-3% of the population
What is the definition of Mental Retardation? significant limitations in intellectual functioning and adaptive behavior as expressed in conceptual, social and practical adaptive skills before age of 18
What are specific diagnostic characteristics occurring with individual’s with Down’s syndrome? Round face, small head, low set ears, flattened nose bridge, short limbs, protruding tongue, dysphagia, hypotonia, MR
What is the prognosis of MR? life long and typically non progressive
Name 7 types of developmental disability MR Down Syndrome Fragile X Autism Epilepsy Spina Bifida CP
What was the previous diagnostic classification for intellectual functioning? IQ (70-75 and below for MR)
What is the current diagnostic classification for intellectual functioning? 2 or more standard deviations from the mean
How are IQ's used with children vs adults? Children - identifies educational level adults - moving away from IQ's and looking at function and adaptive skills
What are the levels of MR and their incidence? Mild - 85% Moderate - 10% Severe 3.5% Profound 1.5%
What are the three types of adaptive behavior? conceptual skills, social skills and practical skills
What are conceptual skills? receptive/expressive language, reading, wirting, money, self directions
What are social skills interperosnal skills, responsibility, self-esteem, rules and laws
What are Practical Skills ADL's, IADL's, safety
Describe MMT Grade 5 Normal - Full ROM against gravity w maximal resistance
Describe MMT Grade 4 Good - Full ROM against gravity with moderate resistance
Describe MMT Grade 4 - Good minus - Full ROM against gravity with less than moderate resistance
Describe MMT Grade 3+ Fair Plus - Full ROM against gravity with minmial resistance before it breaks
Describe MMT Grade 3 - Fair minus - less than full ROM against gravity
Describe MMT Grade 3 Fair - Full ROM against gravity with no added resistance
Describe MMT Grade 2+ Poor Plus - Full ROM in a gravity eliminated plane with minimal resistance, then breaks
Describe MMT Grade 2 Poor - Full ROM in a gravity eliminated plane with no added resistance
Describe MMT Grade 2 - Less than full ROM in a gravity eliminated plane
Describe MMT Grade 1 Trace - Tension is palpated in the muscle or tendon but no motion occurs at the joint
Describe MMT Grade 0 Zero - no tension is palpated in muscle or tendon
What muscle grade is the first to use gravity eliminated plane? 2+
How do you measure obesity? BMI
What BMI is classified as morbid obesity? 40+
What BMI is classified as obese? 30-40
What BMI is classified as overweight? 25-30
What BMI is classified as healthy weight? 18.5-25
What BMI is classified as underweight 18.5 and below
what are some characterizations of obesity? imbalance between energy intake and expenditure significant compromises in health increased health/medical consumption decreased function in areas of occ. perf. premature death
What are three surgical and treatment options? bariatric surgery anti obesity drugs life style changes
In therapy, what should we remember about obese clients? sensitivity, no life environment after surgery, apple shaped clients cant do supine positions because it puts more weight on thoracic cavity
Where can you find a peripheral IV line? forearm vein or femoral vein
What is a PCA Patient controlled Analgesia? patient pushes button to release pain meds thru peripheral IV or epidural catheter in spinal canal above level or surgery or pain
Where can you find the Central Venous Catheter? subclavian or jugular vein
What is the Sorenson? Where is it found? hemodialysis, found in subclavian, jugular, or femoral veins (2 lumen)
What is an A Life? Where is it found? What does it do? Arterial line, found in radial vein, measures BP
What is a CVP - central venous pressure line? Where is it found? what does it do? found in subclavian or interal jugular vein, measures pressure in superior vena cava
What is a Swan-Ganz? What does it do, where is it found? catheter in jugular or subclavian, threads through the heart and monitors heart function
What is an EVD external ventricular drain? Where does it go? What does it do? catheter drilled thru skull into brain. Threaded into lateral ventricles, measures intracranial pressure
What is a Licox? What does it do? Where is it found? measures oxygen partial pressure of brain tissue, inserted into white matter of brain
What is a Hemovac? suctions wounds
What is a Jackson Pratt? drain that looks like an egg. squeeze and it drains.
What is a Duvall? Drain that connects to a wall suction or colection bag
What is a Penrose? looks like a straw
What does an Ortho-pat-system do? reinfuses blood
What is a lumbar drain? catheter placed in subdural space in lumbar area that drains CSF
What is a chest tube? catheter inserted into thorax and removes air and fluid and helps re-expand lungs
What is an NG tube? inserted into nose or sometimes mouth
What is a Peg, G Tube, Peg-J, J Tube? feeding tube that goes directly into stomach or jejunum
What is a nasoenteric tube? Dobbhoff - silk tube threaded to the stomach into the intestine
What is a orotracheal tube? inserted into the trachea via mouth
What is a foley? catheter that goes in urethra into bladder and held in by balloon
What is a suprapubic catheter inserted into abdominal wall above pubic bone into bladder
What is a Flexi Seal? rectal tube that collects feces
What is a Colostomy? surgical creation of an artificial anus on the abdominal wall
What is Telemetry? 5 leads on chest that monitor heart and respiratory rate and rhythm
What is a pulse oximeter? attached to finger and measures oxygen saturation
What are sequential Compression Devices (SCD) pumps blood continuously through legs to avoid DVT
What are Ted Stockings? knee high stockings that supply continuous pressure to legs
What is the first heart beat sound? mitral and tricuspid valves closing
What is the second heart beat sound? aortic and pulmonary valves closing
What is normal BP? 120/80
What HBP? 140+/90+
What is orthostatic hypotension? BP drops, when u get up too fast after being laying down for a while. Dizziness, fainting, etc.
What is congestive heart failure? heart pump is weak and blood flow is reduced and sometimes pools
What is Atria Fibrillation? heart flutter - atria contract rapidly and may cause heart failure or stroke
What is Tachycardia? fast heart rate
What is angina? chest pain
What is ischemic heart disease? heart isnt getting enough oxygen
What is Atherosclerosis and CAD? clogged arteries, blood cant flow well
What is a Heart Attack (myocardial infarction) blood supply cut off. heart muscle starts to die because it has no oxygen
What is an aneurysm? bulge in artery. wall tears. bleed
What is a DVT? blood clot in deep veins
What is syncope? loss of consciousness because of decreased blood flow to brain
What are cardiovascular disorder symptoms? pain, sob, fatigue, palpitations, light headedness, fainting, swelling, numbness, skin color changes
What are Heart Attach Symptoms? tight chest, dull aching, numbness, tingling of arms, SOB, sweating
What are symptoms of cardiac distresss? chest pain, labored breaking? orthopnea (sob), nausea, diaphoresis (sweating) , fatigue, cerebral signs,
What are cardiac problem risk factors? smoking, high cholesterol, HTN, Diabetes, obesity, lack of exercise
What are some psychosocial considerations of cardiopulmonary diseases? fear, anxiety, depression, denial, hopelessness
What is COPD? obstruction of airway from smoking or heredity
What is atelectasis? lung becomes airless and contracts
What is Pneumothorax? pocket of air in lung that results in collapsing
what is ARDS? Acute Respiratory Distress Syndrome? lung failure due to fluid in lungs
What is a MET? Basal Betabolic Equivalent amount of oxygen needed to provide energy for a certain task
what is 1 MET equivalent to? resting in bed quietly
What are some pulmonary rehab techniques? ADL eval and training breathing techniques UE strength energy conservation work simplification adaptive equipment stress management relaxation techniques
What are some energy conservation ideas? re arrange your environment eliminate unnecessary effort plan ahead prioritize
What are some sternal precautions? avoid pulling or pushing with arms avoid lifting more than 10 lbs avoid reaching over head, behind body and stretching forward avoid arm exercises and machines avoid sexual activity avoid driving avoid wheelchair propulsion
What are some safety considerations for using oxygen? no smoking, keep away form open flame, keep away from electrical devices
What is the systole measurement of BP? pressure in arteries as heart contracts
What is the diastole measurement of BP? pressure that is still in the arteries when the heart is between contractions
What is normal heart rate? 60-100 bpm
What is angle in space? angle of the seat back in rleation to the true vertical when the seat and back are rotated counterclockwise as a unit (tilt in space)
What is camber? the amount of angle on the wheels creating flare out at the bottom?
what is the recommendation for camber? 4-6 degrees
What is Pelvic rotation? asymmetrical position of the pelvis with forward position of one side, due to low back rotation, muscle asymmetry or spinal deformity
What is Pelvic Obliquity? uneven level of ASIS's and IT's associated with spinal scoliosis, hip abnormality and pelvic deformity
What is the seat-back angle? angle of the seat surface relative to back surface
What is the typical seat to back angle? 90-10 degrees
What is RESNA? rehab engineering and AT society of north america
What are personal profile factors when selecting a wheel chair? age, stature, developmental status, environment, education and work status or future plans, recreation, needs for AT
What are medical profile factors when selecting a wheelchair? history, physical assessment, diagnosis, skin integrity, blood supply, tone, reflexes, etc
What are goals of seating and positioning in a wheelchair? decrease tone/reflexes dlay or provide corrective forces for defomrity improve function and ADLs accomodate for loss of sensation improve comfort improve self image promote posture tissue protection solid base of support
What are three types of wheelchairs? attendant propelled, manual, power mobility
What does camber to do the measurement of a wheelchair? makes it wider
Why are medical tests performed? to confirm a diagnosis
What are types of tests of structure? x ray ct s can mri ultra sound
What are types of tests of function for the electrical system? EKG - heart EMG - muscle EEG - brain
What are three broad categories of tests of function? electrical, body fluids, physical exam
What is a type of imaging test? PET scan - looks at glucose in cells, tumors, brain function, etc
What is the best way to find out information on patients? taking a good history is the main way of diagnosing along with a good physical exam
What is sensitivity? test picts up the disease from a population of poeple that have it
What is specificity? the test doesnt pick up the disease from a population of people that dont have it
What test would be used to diagnose CVA? EKG, imaging tests, clotting tests
What test would be used to diagnose CAD? EKG, Enzymes, lipids
What test would be used to diagnose CNS Trauma? imaging, CSF, CBC
What test would be used to diagnose burns fluids, electrolyes, culture, sensitivity
What test would be used to diagnose MS? MRI, CSF
What test would be used to diagnose parkinsons dopamine levels
What test would be used to diagnose RA? x rays, esr, ana
What test would be used to diagnose OA? esr, x ray
What test would be used to diagnose diabetes? glucose, urine, hemoglobin
What are 5 types of hip injuries? subcapital, basilar, intertrochanteric, subtrochanteric, transcervical
What are ANTERIOR hip precautions? no external rotation, no extension, no adduction
what are POSTERIOR hip precautions? no internal rotation, no flexion, no adduction
what are some types of adaptive equipment used for hip fractures? sock aid reacher dressing stick leg lifter long handled sponge walker bag elastic shoe laces shoe horn
What does NWB mean? non weight bearing - no weight on leg
What does TTWB mean? toe touch weight bearing- only toe can be placed on ground for balance
What does PWB mean? partial weight bearing - 50% body weight can be placed on leg
What does WBAT mean? weight bearing as tolerated - patient judges based on pain
What does FWB mean? full weight bearing - no limitations
Define SCI Any injury of the neural elements within the spinal canal from either trauma or disease.
What causes most SCIs? car accidents and falls
Define: tetraplegia any degree of paralysis involving the 4 limbs and trunk musculature
Define: paraplegia paralysis of lower extremities and trunk but not involving UE’s
Define: Autonomic Dysreflexia irritation below level of injury that triggers a “panic” response
What are symptoms of Autonomic Dysreflexia? Headache, stuffy nose, sweating, increased BP Most frequently caused by full bladder/bowel
What is Spasiticty? involuntary muscle contraction below level of injury that results from lack of inhibition in the brain
What is heterotrophic ossification? bone the develops in abnormal anatomical locations. (usually hip and knee, sometimes elbow and shoulder)
What are three physical exam aspects that are predictors of recovery? Sensory and Rectal sensation Motor and Rectal Voluntary contraction ASIA Impairment classification
Elbow Flexion occurs at what SC Level? C5
Wrist Extension occurs at what SC Level? C6
Elbow Extension occurs at what SC Level? C7
Finger Flexion occurs at what SC Level? C8
Finger Adduction occurs at what SC Level? T1
Hip Flexion occurs at what SC Level? L2
Knee Extension occurs at what SC Level? L3
Ankle Dorsiflexion occurs at what SC Level? L4
Long Toe extension occurs at what SC Level? L5
Ankle Plantar Flexion occurs at what SC Level? S1
What SC levels are seen in the arm dermatome? C5, C6, T1
What SC levels are seen in the hand dermatome? C8, C7, C6
Describe ASIA A? COMPLETE – no motor, no sensory, no function in S4, S5
Describe ASIA B? INCOMPLETE – no motor, yes sensory, no function in S4, S5
Describe ASIA C? INCOMPLETE – yes motor, more than half muscles have a grade less than 3
Describe ASIA D? INCOMPLETE – yes motor, more than half muscle have a grade 3 or more
Describe ASIA E? NORMAL – motor and sensory function are normal
Define Sensory Level the most caudal dermatome to have normal sensation on both sides of the body
Define Motor Level the most caudal level where strength is at least 3/5 on body sides of the body and the next level is 5/5.
What is Central Cord Syndrome? damage to the center of the spinal cord
Describe effects of Central Cord Syndrome? UE's more effected, in older populations with stenosis or hyperextension
What is Brown-Sequard? only one side of the SC is damaged
Describe effects of Brown-Sequard? due to stabbing or gun shot wounds decreased motor function and proprioception on same side decreased pain, temp and touch on opposite side
What is Anterior Cord Syndrome? damage to the anterior spinal artery
Describe the effects of Anterior Cord Syndrome? loss of pain temp and touch proprioception is in tact
Describe Conus Medullaris Injury UMN injury
Describe effects of Conus Medullaris Injury cuases hypertonicity, bowel bladder dont release
Describe Cauda Equina Injury LMN injury
Describe effects of Cauda Equina injury hypotonicity, problems with controling bowel and bladder because of low tone
The greatest UE recovery in SCI happens when? within the first 6 months
what percent of SCI's regain a level of function? 40-90%
Which regain more function? Incomplete or complete SCIs? incomplete
What are two types of cervical braces? cervical collar Halo Vest
What are three types of throcaci, Lumbar, Sacral braces? TLSO, LSO and corset
What are acute stage therapeutic considerations? ROM, splinting, education discharge planning
What are rehabilitation phase therapeutic aspects and objectives? assessment, maintain ROM, increase strength and endurance, maximize independence, ADLs, training patient and caretakers, adaptive equipment
What are some complications of SCI? skin integrity osteoporosis orthostatic hypotension autonomic dysreflexia heterotrophic ossicification sexuality
Created by: xmelissa48x
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