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99 Cards in this Set

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  • Back
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immobilization
rendering a part incapable of moving
traction
exertion of a pulling force
hypostatic pneumonia
pneumonia caused by statis of secretions due to inactivity,which provides a medium for bacterial growth
isometric exercise
exercise preformed against reisistance
splint
a device that protects an injured part of the body by immobilizing it
over-the-bed frame
rectangular frame to which traction equipment may be attached
trapeze bar
overhead bar that patient can grab
sling
bandage for supporting a part
countertraction force
the weight pulling against the weight of the traction
cast
a stiff plaster of Paris, fiberglass, or polyester dressing used to immoblize
bivalved
cut in half lengthwise
spica cast
-cast encase a portion of the trunk and part or all of both legs with a spreader bar
-a spreader bar is placed between legs to maintain the desired angle at the hip & incorporated into the cast
mole skin
thick, durable form of adhesive material
external fixator
-a metal device
-such as a pin, screw, or tong, that is inserted into or through one or more bones to stablize fragments of a fracture while it heals
kinetic
moving
paresthesia
-feeling of numbness or tingling

-neurovascular sensation
blanch
-to become pale

-used in capillary refill
hemiparesis / hemiplegia
one-sided weakness / one-side paralysis
perfusion
circulation of blood through tissue
hydrotherapy
massage or debridement by moving water
paraplegics
those without use of legs
prosthesis
artificial substitute for a body part
quadriplegics
those without use of both arms & legs
Name the 4 common crutch gaits
-four-point gait
-three-point gait
-two-point gait
-swing-through gait
four-point gait
1 advance LT crutch
2 advance RT foot
3 advance Rt crutch
4 advance LT foot
Sequence
Three-point gait sequence
1 advance both crutches w/ the afftected leg & shift weight to crutches
2 advance unaffected leg & shift on to it
What are the Advantages of a three-point gait

What is the requirement
Adv - allows the affected leg to be paritally or completely free of weight bearing
Req - Full wt bearing on one leg, balance & upper body strength
Two-point gait sequence
1 Advance LT crutch & Rt foot
2 Advance RT crutch & LT foot
What are the Advantages of a two-point gait

What is the requirement
Adv - faster version of the four-point gait, more normal walking pattern (arms & legs moving in oppostion)
Req - Partial wt bearing on both legs, balance
Swing-through gait sequence
1 move both crutches forward
2 move both legs forward beyond or even with crutches
or may keep wt on good foot & move other foot forward & then move good foot forward
kinesiologist
physical therapist
Eg of Ambulatory Aid
1 walker
2 crutches
3 canes
4 wheelchairs
Hoyer lift
- mechanical lift, hydrualic pump, on wheels
- use to move immobile pts from the bed of a stretcher, a chair, or a wheelchair and back again
Name the different bandage techniques
1 Circular turn
2 Spiral turn
3 Spiral reverse turn
4 Figure-of-8 turn
5 Recurrent turn
Name some pressure relief devices
1 foam
2 gel pads
3 sheepskin pads
4 heal and elbow protectors
5 pulsating air pads
6 water mattresses
Why is a continuous passive motion machine ordered
-to retore joint function
-prevents contracture, muscles atrophy, venous stasis, thrombus formation
Name some speciality beds
-Air-fluidized beds
-low air-loss beds
-continuous later-rotaion beds
-CircOlectric bed
Why is continuous lateral-rotaion bed used?

Note* Roto-Rest
decrease the incidence of lung collapse & nosocomial pneuomia, facilitate the normal flow of urine, and reduce the risk for deep vein thrombosis and pulmonary embolism
-encourages venous flow
Why is CircOlectric bed used?
and for whom is it use for?
-supported in a large circular frame w/ the pt secured in a bed frame within the circle (360 deg)
-Burn pt
Why is a low air-loss bed used for?
-Shearing and friction are reduced or eliminated

NOTE: -controls moisture
-& contraindication for pt w/ unstable spine
What are some effects of immobility in CV system?
-venous statis
-increased cardiac workload
-blood pressure alterations
What are some effects of immobility in Resp system?
-statis of secretions
-decreased elastic recoil
-decreased vital capacity
What are some effects of immobility in GI system?
-Anorexia
-Metablolic change to catabolism & negative nitrogen balance
-Decreased peristalsis
What are some effects of immobility in muscular system?
-Decreased muscle mass & muscle tension
-Shortening of muscle
-Loss of Calcium from bone matrix
-decrease in bone weight
What are some effects of immobility in Urinary system?
-Stasis of urine
-Urinary Tract Infection UTI
-Renal (kidney) Stones
What are some effects of immobility in integumentary/skin system?
-Decreased circulation from pressure
-Ischemia and necrosis of tissue
What are some effects of immobility in brain/ psychological?
-Decreased mental activity
-Decreased sensory imput
-Decreased socialization
-Decreased independence
What are some problems or complication with immobility in the CV system?
-Thrombus formation
-Thrombophebitis
-Pulmonary embolus
-Orthostatic hypotension
-Increase pulse rate
What are some problems or complication with immobility in the resp system?
-Hypostatic pneumonia
-Atelectasis
-Decreased gas exchange
What are some problems or complication with immobility in the GI system?
-Weight loss
-Protein deficiency
-Abdominal distention
-Constipation
What are some problems or complication with immobility in the musculoskeletal system?
-Fibrosis of connective tissue
-Atrophy
-Weakness
-Joint contractures
-osteoporosis
-bone pain
What are some problems or complication with immobility in the Urinary system?
-Precipitation of calcium salts
-Frequency
-Dysuria
What are some problems or complication with immobility in the integumentary/skin system?
-Skin breakdown
-Pressure ulcers
What are some problems or complication with immobility in the brain/ psychologcial?
-Boredom
-Anxiety
-Depression
-Loneliness
In the principle of traction:What is the nsg intervention when ropes & weights must be free of friction?
-Keep ropes free of entanglement in the linens
In the principle of traction:What is the nsg intervention when maintaining the correct line of pull
-Keep the pt centered in the bed with the body in good alignment
In the principle of traction:What is the nsg intervention when weight & pull of the traction must be continous & as ordered by the physician?
-Remove or add weights only by physician's order. Do NOT interrupt the pull of traction to provide care
In the principle of traction:What is the nsg intervention when sufficient countertraction must be maintained?
-Keep the pt from sliding down in the bed when in leg or back traction
-Keep the pt in side-arm traction in the center of the bed
When is neurovascular assessment done?
-for every pt who has experienced a fracture, whether treated with a cast or traction
NOTE this procedure done q hr for 24 hrs/ ck for protocol @ hospital
Nuerovascular assessment for skin consist of:
-inspect area distal to the injury
-palpate skin temperature with dorsum (back) of the hand
Nuerovascular assessment for movement consist of:
-have pt move area distal to the injury, or move it passively.
NOTE: there should be NO discomfort
Nuerovascular assessment for sensation consist of:
-Inquire about feelings of Paresthesia
-Check sensation with a paper clip & compare bilaterally
NOTE:Sensation should be the same
Sensation should be the same
Nuerovascular assessment for pulses consist of:
-Palpate pulses distal ot the injury.
-Compare bilaterllay if possible
Nuerovascular assessment for capillary refill consist of:
-With thumbnail, press the nail beds distal to the injury to blanch & judge time for capillary refill to occur after releasing pressure should be within 3 secs, within 5 secs in the elderly
Nuerovascular assessment for pain consist of:
inquire about the degree, location, nature, and frequency of pain, noting any increase in intensity or change in type of pain
While walking upstairs, what are the special maneuvers on cutches?
1 Stand @ foot of stairs w/ wt on good leg & crutch
2 wt crutch handles, and lift good leg up on first step
3 Wt on good leg,& lift injure leg & crutch to step
4 repeat for each step
While walking downstairs, what are the special maneuvers on cutches?
1 Stand @ top of stairs on good leg & crutches
2 Shift wt completely on good leg & put crutches down next step
3 Put wt on crutch handles, transfer injured leg down next step w/ the crutches
4 bring good leg down to that step
5 Repeat for each stair step
While sitting down, what are the special maneuvers on cutches?
1 crutch walk to chair
2 turn around slowly, back to chair & back of legs touch seat of chair
3 transfer both crutches to side of injured leg & grasp both hand grips with one hand
4 then reach back with free hand & grasp the arm of chair
5 Lower self in chair, use support of both crutches & chair
6 Sit back in chair, elevate injure leg No greater than 90 deg of hip
& w/ knee slightly flexed
d/t decrease circulation
While getting up from a chair, what are the special maneuvers on cutches?
1 bring both crutches along the side firmly on the floor of the injured leg & grasp both hand grips firmly. Place other hand on arm of chair & push up
2 upright position, transfer one crutch to the other hand for walking
What are the most common used canes?
-Standard ( one-point)
-Quad ( four-point)
What is the advantage of a quad cane?
-It will stand up by itself
When walking with a cane ensure that:
-Cane has intact rubber tip
-pt uses cane on injured side unless a physician or therapist says to use in on the other side for balance
-Pt does not lean on or bear full wt on affected leg
-handgrips is at hip level & pt's elbow bent @ 15-30 deg when placing wt on cane
-Cane's tip is 6 to 10" to the side & 6" in front of the near foot
-Pt looks full ahead while walking
Wheelchairs are used for pts who are:
Not able to ambulate either independently or with aids, such as crutches or a walker
True or False
Brakes are not in lock when wheelchair is not in motion
False
When are brakes always used in a wheelchair?
-transferring a pt into or out of a wheelchair
-if pt is left stationary
Braces & splints are used for:
-to strengthen & support areas of the body affected by weakness or paralysis such as legs or back
What type of pt are braces & splints used for
-after surgery or trauma to immoblize a part while it heals
Why is a wrist splint often used?
-to relieve or prevent carpal tunnel
-to immoblized a sprained wrist
All braces, slpints & prosthetics have the potential to:
-irritate & injure the tissues
NOTE must be monitor closely
What is a sling used for?
to support & immobilize an injured wrist, elbow, or shoulder.
The sling holds the extremity in an elevated position to avoid what
-edema
-pain
-discomfort
-fatique
If there is no commerical sling at hand what else can you use
-triangle bandage sling may be used to support the injured upper extremity
Why do you not use the spreader bar as a handle for lifting & turning the pt?
-It may be dislodged, ruining the cast & causing pain & possible injury to the pt
Why is it critical that the cast be protected from uneven pressure during the dying period?
- Because the shape of position can be inadvertly change
When is pain best controlled?
-When it is treated before it becomes severe
When is a walker used?
-loss of a function
-weak
-tend to lose their balance
Which device is used first when training a pt to walk following a loss of a function?
-walker (frequent)
-crutches
The correct height for a walker is determined how?

NOTE: walker is adjustable
pt's elbow is bent @ a 15 to 30 deg while standing upright & grasping the handgrips
To use a walker, a pt must have the use of what
-both hands & arms
-at least one leg
NOTE:pt w/ generalize weakness are allowed walkers
Three most commonly used crutches are
1 Axillary
2 Lofstrand (shorter)
3 Canadian (shorter)
Which type of crutch will a Pt who will permanently need crutches for mobility use?
-Lofstrand
-Canadian
Which type of crutch is commonly used for short term need?
-Axillary
Are axillary crutches adjustable?
If so how?
- Yes
- using wings nuts

NOTE: they are safe and easy to use
Why is it critical that crutches be adjusted to proper height & instructing pt to avoid resting body's wt on axillary bar?
-Because it can put pressure on vital nerves and can occlude blood vessels in the axilla, causing temporary or permanent damage, including paralysis
In what position do you measure for the overall length of crutches?
-standing or
-supine position
Describe how to measure the length of crutches in a standing position
-standing measure w/ shoes on, tips at a point 4" to 6" to the side and front of shoes,
-pads should be 1 1/2 to 2" below axilla
Describe how to measure the length of crutches in a supine position
-position tips 6" lateral to pt's heel,
-pads should be 3 to 4 fingers under axilla
Describe how do you measure for the handgrips?
-Adjust handgrips
-elbows flexed 15 to 20 deg when palms are resting on handgrip
Guidelines to be considered when teaching crutch walking are as follow:
-head held up, eyes straight ahead, as normal walking
-crutches slightly ahead of body & to outside of feet
-the hands use to support the body
-back kept straight & pt bends @ hips
-crutches and injured leg uses together except in swinging gait
-smooth even rhythm is used
-proper length w/ heavy rubber suction tips
-the gait use will depend on wt bearing status in lower extremities & pt's abilities