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Foundations (final)

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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  
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3 general procedures for positioning + draping   1. body mechanics, 2. Lift (do not drag), 3. expose only area necessary  
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Procedures for relieving pressure (primary objective)   disperse pressure over greatest area  
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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)  
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Bridging the gap   support proximal and distal to sensitive area (like a bridge)  
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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  
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95% of pressure ulcers develop on... (5)   1. sacral/coccygeal, 2. greater troch., 3. ischial tuberosity, 4. heel, 5. lateral malleolus  
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Pressure ulcer prevention (6)   1. freq. repositioning, 2. relieve pressure on bony prominences, 3. physical activity, 4. monitor skin, 5. decrease moisture, 6. nutrition  
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Minimum time between checking patient positioned in supine/prone   2hrs  
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Documentation for pressure ulcers   vital signs, stage + location of ulcer, positioning  
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ROM   range of motion (full motion possible at the joint)  
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Passive Range of Motion (PROM)   produced by external force ("relax I'm going to move you")  
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Active Range of Motion (AROM)   produced by active contraction of muscles ("do this")  
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Active Assisted Range of Motion (AAROM)   helped by external force ("So the parts you can. I will help you with the rest")  
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Reliability   repeatability of measures  
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Validity   degree to which your measure represents what you intend to measure  
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Improving reliability with a goniometer   use a consistent position, landmark, device, and therapist  
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What type of ROM would you measure if the muscle is tight?   PROM  
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What type of ROM would you measure if the muscle is weak?   AROM  
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What type of ROM would you measure if the capsule is tight?   PROM (for tightness)  
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What type of ROM would you measure if the patient has nerve damage?   AROM  
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Active Insufficiency   deficit of muscle shortening  
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Passive Insufficiency   deficit of muscle lengthening  
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Contraindication for ROM intervention   disrupt healing, life threatening condition  
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5 elements of pt management   examination, eval, diagnosis, prognosis, intervention  
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end feel: boney   abrupt end with no give  
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end feel: capsular/ligamentous   bending plastic ruler  
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end feel: muscular   stretching a large rubber band  
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end feel: springy   bouncy end feel  
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end feel: empty   unable to reach end feel (due to pain, etc)  
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During ROM measure, stabilize ____   the proximal segment  
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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  
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Created by: cbaweiss
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