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84 Cards in this Set
- Front
- Back
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Stroke Risk Factors |
Ethnicity (African American) Age (65 years or older) Family History (Hypertension) Obesity High Blood Pressure Smoking TIA Geographic Location (stroke belt) Diabetis Mellitus Oral Contraceptives Hyperlidemia Prior Stroke Heart Defect Murmur Sleep Apnea Drug and Alcohol abuse |
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Stoke Risk Factors (PREVENTIVE) |
Smoking (Stop smoking) Obesity (Clean up your diet) Stop drinking If Diabetic, effectively manage your insulin Be physically active (exercise) |
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Similarities between Right and Left Hemiaparesis |
Hemianopsia Motor Weakness Sensory Loss Muscle Weakness |
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Most Common Type of Stroke |
Ischemic Stroke: when a blood vessel carrying blood to the brain is blocked by a blood clot, causing blood not to reach the brain. |
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Warning Signs |
Loss of Speech Trouble walking Trouble with balance and coordination Severe Headaches Confusion Difficulty Understanding Numbling, Tingling in face, arm or leg Blurred vision in one or both eyes One side of the face droops |
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Difference between Embolism and Thrombosis |
Embolism occurs when a clot that has formed elsewhere breaks up and travels up the stream. Thrombosis is when a clot forms in one of the arteries supplying the brain causing vascular obstruction at its formation point |
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Stroke Complications |
Seizures due to brain scars Infection due to alteration of swallowing, aspiration, bladder function, immobility Thromboembolism due to immobility and prolonged bed rest DVT (local pain and tenderness may develop in calf. Death |
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Motor Stages of Recovery |
Flaccidity Spasticity Isolated Control Full Recovery |
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What is a stroke |
This results from an interruption in blood flow to the brain, either because a blood vessel is blocked or because of ruptures. |
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Ischemic Strokes |
Characterized by blockages. Lack of blood supply. |
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Hemorrhagic Stroke |
Characterized by ruptures in the blood vessel or an aneurysm. Bleeding in brain.. (vessel bursts) |
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Circle of Willis (contd) |
When a major vessel is slowly shut, the normally small communicating arteries enlarge to accommodate this shut down. However, this system sometimes fail to prevent strokes. Sometimes, the circle of willis also gets damaged by the processes causing the stroke. |
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Left Sided Cerebral Injuries |
Right Hemiparesis Affect right side of body Loss of voluntary movement on right side Language Deficits (Aphasia) Problems with speech articulation (Dysarthria) Blind spots in visual field (usually right side) Slow and cautious personality Memory deficits for recent or past events |
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Right Sided Cerebral Injuries |
Left Hemiparesis Affect left side of body Weakness or paralysis on left side Unilateral neglect Dressing Apraxia Defective vision (temporal half of left eye and nasal half of right eye) Impulsive behavior |
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Muscle Tone |
Flaccidity: Too little resistance or floppiness Spasticity: Too much resistance. Hyperactive reflexes. |
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NOTE! LEFT HEMIS |
The "draw a clock" test is for this group. |
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Motor Stages of Recovery |
Flaccidity (limb paralyzed. Could be permanent) Spasticity (protect arm with ROM exercise) Isolated Control (Volitional) Full Recovery (lowest percentage of people) |
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Differences btw the Hemis |
Right Hemis can dress but have trouble talking. Left Hemis can't dress but talk impulsively. |
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CORE VALUES |
Altruism Dignity Equality Freedom Justice Truth Prudence |
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Altruism |
The unselfish concern for the welfare of others. |
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Dignity |
This emphasizes the importance of valuing the inherent worth and uniqueness of each person. |
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Equality |
This requires that all individuals be perceived as having the same fundamental human rights and opportunities |
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Freedom |
This allows the individual to exercise choice and to demonstrate independence, initiative and self direction. |
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Justice |
Places value on the upholding of such moral and legal principles as fairness, equity, truthfulness and objectivity |
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Truth |
This requires that we be faithful to facts and reality. |
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Prudence |
The ability to govern oneself through the use of reason. |
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Schizoprhrenia |
Brain disorder characterized by periods of psychosis which is the presence of delusions or hallucinations. Progressive decline in daily living skills. |
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Positive symptoms of schizophrenia |
Delusions Hallucinations Disorganized thought |
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Negative symptoms of schizophrenia |
Flattened effect (non verbal expression) Alogia (impoverished speech) Avolition (decreased motivation) Anhedonia (loss of pleasure) Associality (decreased interest in socialization) |
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Main treatment for schizophrenia |
Medication (antipsychotics) |
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Other treatment for schizophrenia |
Repititive Transcranial Stimulation Electroconvulsive Therapy |
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Impact on Occupational Performance |
Lack of self care. Impaired motor functioning. Impaired visual processing.Most sufferers do not live or work independently. Cognitive impairments persist. Social support, financial assistance and work opportunities are beneficial to the client. |
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Call 911 for a psychotic patient |
no back data |
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What do you do for a Deep Vein Thrombosis? (DVT) |
Blood Thinners Early Mobilization of patient might prevent it Surgery Thrombolysis procedure |
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Symptoms of a DVT |
Local pain and tenderness Swelling Slight increase in temperature |
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Stroke Complications |
Seizures Infection Thromboembolism |
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Impact of Stroke |
Deficits in motor and communication skills Impaired sensation Inefection & depression Cognitive impairment |
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Congestive Heart Failure |
Chronic non-curable condition where the heart does not beat strongly enough to maintain adequate blood flow to all systems in the body, causing organs to be oxygen deprived. It can be caused by infections or conditions such as a heart attack, that weakens the muscle. |
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Coronary Artery Disease or Coronary Heart Disease (CHD) |
Plaque made of cholesterol, fat, calcium and other substances sticks to the inner lining of arteries. Over time, plaque narrows the arteries of the heart leading to CAD. Caused by lifestyle choices and genetics. |
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Warning signs of a Heart Attack |
Chest pain or discomfort Shortness of breath Pain in other areas of the upper body Breaking out in a cold sweat Nausea Light headedness |
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Coronary Artery Bypass Grafting |
Surgery that improves blood flow to the heart. Surgeons use this surgery to treat people that have CHD |
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Sternal Precautions after open heart surgery |
Protect your sternum (hug pillow to chest) Use your legs to sit and stand Be careful getting in and out of bed Do not lift anything heavier than 5 pounds Do not drive while you are healing No pushing or pulling with your arms Do not reach behind your back Do not put your arms overhead |
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Symptoms for Cardio PUlmonary Disease |
Dyspnea (labored breathing) Fatigue Depression Difficulty Focusing Anxiety Light headedness |
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Common Precautions |
No heavy lifting Keep heart rate less or equal to 110bpm NO activities at MET rate higher than 6 Keep oxygen on at all times Maintain low salt diet Record daily weight Follow recommended medication schedule |
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Most severe respiratory issue |
Chronic Obstructive Pulmonary Disease (Cyanosis, SOB, persistent coughing, whistling) |
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Diabetes Type 1 |
Occurs in children. Complete insulin deficiency and requires insulin replacement for survival. Onset is abrupt. Insulin must be taken everyday. |
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Diabetes Type 2 |
Onset in adults. The body does not make enough insulin or doesn't respond to insulin properly (insulin resistance). Usually occurs in adults and those that are overweight. |
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Diabetes is Systemic |
Affects entire system: Periodontal Disease Diabetic Foot Autonomic Neuropathy Diabetic Nephropathy & Retinopathy Cerebrovascular & Cardiovascular Disease |
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Superficial Burn Injury |
Only the epidermal layer is burned. Redness and Pain Wound is dry and doesn't form blisters Sensitive to air and light touch Heals in 3 to 6 days |
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Partial Thickness Burn Injury |
Destroys epidermal layer and dermal layer Some portion of dermis remains intact Large thick walled blisters Deep red to waxy white in color Leaks body fluid Moist to touch Sensitive to pressure Soft and elastic to touch Heals in 7 to 20 days Leaves a residual scar |
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Full Thickness Burn Injury |
Destroys entire epidermal and dermal layers Extends down to subcutaneous fat Black, Cherry, Red, Tan or Pearly White Small Fragile thin walled blisters Dry, Leathery and hard in texture Nerve endings are destroyed Sensitive to deep pressure Healing time is based on donor sites Leaves residual scar Severe risk of contractures |
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Rule of Nines |
Convenient and rapid method used at the scene of accident to estimate extent of burn. |
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Rule of Nines for adults |
Each Arm is 9% Head is 9% Front 18% Back 18% Each Leg 18% Neck 1% |
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Rule of Nines for children |
Arm 9% Head and Neck 18% Leg 14% Front 18% Back 18% |
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Criteria for getting admitted for a burn |
Partial Thickness burns > TBSA 10% Burns involving face, hands, feet, genitalia, perineum and major joints Full Thickness burns in any age group Electrical burns, including lightning Chemical burns Inhalation Injury Burn Injuries in patients with complicating preexisting medical conditions Burned children in hospitals without qualified personnel or equipment Burn injury in patients requiring special social, emotional or long term intervention Burns with concomitant additional trauma in which burn injury poses the greatest risk of morbidity |
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Allograft |
Donor skin taken from another person |
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Autograft |
Surgical transplantation of the patient's own skin from one area to another |
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Burn Shock |
Loss of fluid or plasma portion of the circulating blood volume after a burn. This is a cardiac complication. Treatment for burn shock is fluid resuscitation. |
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Burn Treatment - Emergency Phase |
Give I.V. fluids Debridement - Clean wounds Change dressings Give medication (silver dome) |
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Burn Treatment - Rehab |
Engage in active ROM Make use of splints to prevent contractors Continue wound care to prevent infection Change dressings frequently Compression is 23 hrs daily Massage and Moisturize Fluidotherapy |
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OT Focus for burns |
Big goal is to get patient back to work. Vocational Training. (Patient might not be able to do the previous job they were used to doing). |
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Classification for Rheumatoid Arthritis |
Morning Stiffness Arthritis of three or more joint areas Arthritis of hand joints Symmetric Arthritis Rheumatoid Nodules Serum RF Radiographic Changes |
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Swan Neck Deformity |
Flexor contracture of the MCP joint. Compensatory Hyperextension of the PIP joint. Flexion of the DIP joint. |
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Stages of Inflammatory Joint Disease |
Acute Stage (Limited ROM, fever, weight loss) Subacute Stage (Decreased ROM, stiffness) Chronic Active (Fever subsided, endurance low) Chronic Inactive (Muscle atrophy, potential contracture) |
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Hip Precautions |
Keep legs abducted Turn to back and unaffected hip only Keep operated leg in neutral position Use elevated toilet seat Do NOT adduct legs Do NOT flex hip past 90 degrees Do NOT sit for long periods Do NOT sit forward or elevate leg on footrest |
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Differences between DJD and RA |
RA can begin anytime. DJD begins later in life RA is an autoimmune disease that takes weeks to months. DJD is mechanical wear and tear. RA has morning stiffness that lasts over an hr. DJD morning stiffness lasts less than an hr. RA affects body symmetrically. DJD doesn't RA gets worse from weeks to months DJD gets worse over a long period of time |
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5 stages of healing when a bone has been broken |
Hematoma Formation (Hematoma forms and seals blood vessels) Granular Formation (Increases stability of bone fragments) Callus Formation (Formation of a callus) Bony Union (Ossification and formation of bony union) Remodel |
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From the OT perspective, what is primary focus when dealing with a patient that has RA? |
Joint Protection |
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Boutonniere Deformity |
This is the result of an injury to the tendons that straightens the middle joint of your finger. The result is that the middle joint of the injured finger will not straighten, while the fingertip bends back. |
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Macular Degeneration |
AMD results from loss of function of the macular which is in the center of the retina |
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Glaucoma |
Progressive loss of ganglion cell layer. Caused by intraocular pressure |
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Cataracts
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Opacifications of the crystalline lens of the eye which result in a decreased amount of light reaching the retina
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Differences between the eye disorders |
AMD: loss of central vision distortion of objects Glaucoma: slow loss of peripheral vision poor adaptation to changes in lighting Cataracts: Cloudy, blurry, foggy vision decreased color perception. especially blue hues |
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Glaucoma Treatment |
Relieve pressure |
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Cataract Treatment |
Surgical Removal of the lens |
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Blood Borne |
Hep B Lyme Disease (deer tick) |
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Inpiration of infectious mucus, close contact |
Pertussis
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Food borne, contact with feces |
Salmonelosis Shigellosis (also water borne) |
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Airborne, Sputum |
TB |
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Duchenne Muscular Dystrophy |
Affects only males X linked inherited condition Caused by absence or deficiency of dystrophin Symptoms are delayed motor development, proximal weakness and increased fatigue Waddling gait, enlarged calf muscles, increased falls, inability to run or jump |
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Skin Integrity |
Becomes a risk factor with decreased mobility. Individual is at risk for infection, further tissue damage and loss of joint mobility. Careful skin inspection should be incorporated into one's daily routine. Severe infection's can lead to death if not properly managed. |
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How does deoxygenated blood go through the heart |
De-oxygenated blood enters the right atrium of the heart from the superior and inferior vena cava. Blood leaves the right atrium of the heart through the pulmonic valve, into the pulmonary artery and to the lungs where it is oxygenated. The pulmonary vein empties the oxygen rich blood into the left atrium. The blood then leaves the heart through the aorta to the rest of the body. |
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Treatment for Muscular Dystrophy |
Compensatory strategies. Not rehab |
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Weight Bearing Status |
Non Weight Bearing 0% Toe Touch Weight Bearing 10%-15% Partial Weight Bearing 30%- 50% Weight Bearing as Tolerated Full Weight Bearing 75%-100% |
