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99 Cards in this Set
- Front
- Back
- 3rd side (hint)
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immobilization
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rendering a part incapable of moving
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traction
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exertion of a pulling force
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hypostatic pneumonia
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pneumonia caused by statis of secretions due to inactivity,which provides a medium for bacterial growth
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isometric exercise
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exercise preformed against reisistance
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splint
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a device that protects an injured part of the body by immobilizing it
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over-the-bed frame
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rectangular frame to which traction equipment may be attached
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trapeze bar
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overhead bar that patient can grab
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sling
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bandage for supporting a part
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countertraction force
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the weight pulling against the weight of the traction
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cast
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a stiff plaster of Paris, fiberglass, or polyester dressing used to immoblize
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bivalved
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cut in half lengthwise
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spica cast
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-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 |
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mole skin
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thick, durable form of adhesive material
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external fixator
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-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 |
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kinetic
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moving
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paresthesia
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-feeling of numbness or tingling
-neurovascular sensation |
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blanch
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-to become pale
-used in capillary refill |
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hemiparesis / hemiplegia
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one-sided weakness / one-side paralysis
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perfusion
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circulation of blood through tissue
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hydrotherapy
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massage or debridement by moving water
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paraplegics
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those without use of legs
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prosthesis
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artificial substitute for a body part
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quadriplegics
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those without use of both arms & legs
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Name the 4 common crutch gaits
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-four-point gait
-three-point gait -two-point gait -swing-through gait |
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four-point gait
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1 advance LT crutch
2 advance RT foot 3 advance Rt crutch 4 advance LT foot |
Sequence
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Three-point gait sequence
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1 advance both crutches w/ the afftected leg & shift weight to crutches
2 advance unaffected leg & shift on to it |
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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 |
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Two-point gait sequence
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1 Advance LT crutch & Rt foot
2 Advance RT crutch & LT foot |
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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 |
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Swing-through gait sequence
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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 |
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kinesiologist
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physical therapist
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Eg of Ambulatory Aid
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1 walker
2 crutches 3 canes 4 wheelchairs |
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Hoyer lift
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- 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 |
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Name the different bandage techniques
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1 Circular turn
2 Spiral turn 3 Spiral reverse turn 4 Figure-of-8 turn 5 Recurrent turn |
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Name some pressure relief devices
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1 foam
2 gel pads 3 sheepskin pads 4 heal and elbow protectors 5 pulsating air pads 6 water mattresses |
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Why is a continuous passive motion machine ordered
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-to retore joint function
-prevents contracture, muscles atrophy, venous stasis, thrombus formation |
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Name some speciality beds
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-Air-fluidized beds
-low air-loss beds -continuous later-rotaion beds -CircOlectric bed |
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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 |
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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 |
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Why is a low air-loss bed used for?
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-Shearing and friction are reduced or eliminated
NOTE: -controls moisture -& contraindication for pt w/ unstable spine |
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What are some effects of immobility in CV system?
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-venous statis
-increased cardiac workload -blood pressure alterations |
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What are some effects of immobility in Resp system?
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-statis of secretions
-decreased elastic recoil -decreased vital capacity |
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What are some effects of immobility in GI system?
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-Anorexia
-Metablolic change to catabolism & negative nitrogen balance -Decreased peristalsis |
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What are some effects of immobility in muscular system?
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-Decreased muscle mass & muscle tension
-Shortening of muscle -Loss of Calcium from bone matrix -decrease in bone weight |
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What are some effects of immobility in Urinary system?
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-Stasis of urine
-Urinary Tract Infection UTI -Renal (kidney) Stones |
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What are some effects of immobility in integumentary/skin system?
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-Decreased circulation from pressure
-Ischemia and necrosis of tissue |
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What are some effects of immobility in brain/ psychological?
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-Decreased mental activity
-Decreased sensory imput -Decreased socialization -Decreased independence |
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What are some problems or complication with immobility in the CV system?
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-Thrombus formation
-Thrombophebitis -Pulmonary embolus -Orthostatic hypotension -Increase pulse rate |
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What are some problems or complication with immobility in the resp system?
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-Hypostatic pneumonia
-Atelectasis -Decreased gas exchange |
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What are some problems or complication with immobility in the GI system?
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-Weight loss
-Protein deficiency -Abdominal distention -Constipation |
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What are some problems or complication with immobility in the musculoskeletal system?
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-Fibrosis of connective tissue
-Atrophy -Weakness -Joint contractures -osteoporosis -bone pain |
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What are some problems or complication with immobility in the Urinary system?
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-Precipitation of calcium salts
-Frequency -Dysuria |
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What are some problems or complication with immobility in the integumentary/skin system?
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-Skin breakdown
-Pressure ulcers |
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What are some problems or complication with immobility in the brain/ psychologcial?
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-Boredom
-Anxiety -Depression -Loneliness |
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In the principle of traction:What is the nsg intervention when ropes & weights must be free of friction?
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-Keep ropes free of entanglement in the linens
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In the principle of traction:What is the nsg intervention when maintaining the correct line of pull
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-Keep the pt centered in the bed with the body in good alignment
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In the principle of traction:What is the nsg intervention when weight & pull of the traction must be continous & as ordered by the physician?
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-Remove or add weights only by physician's order. Do NOT interrupt the pull of traction to provide care
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In the principle of traction:What is the nsg intervention when sufficient countertraction must be maintained?
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-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 |
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When is neurovascular assessment done?
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-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 |
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Nuerovascular assessment for skin consist of:
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-inspect area distal to the injury
-palpate skin temperature with dorsum (back) of the hand |
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Nuerovascular assessment for movement consist of:
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-have pt move area distal to the injury, or move it passively.
NOTE: there should be NO discomfort |
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Nuerovascular assessment for sensation consist of:
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-Inquire about feelings of Paresthesia
-Check sensation with a paper clip & compare bilaterally NOTE:Sensation should be the same |
Sensation should be the same
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Nuerovascular assessment for pulses consist of:
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-Palpate pulses distal ot the injury.
-Compare bilaterllay if possible |
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Nuerovascular assessment for capillary refill consist of:
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-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
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Nuerovascular assessment for pain consist of:
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inquire about the degree, location, nature, and frequency of pain, noting any increase in intensity or change in type of pain
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While walking upstairs, what are the special maneuvers on cutches?
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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 |
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While walking downstairs, what are the special maneuvers on cutches?
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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 |
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While sitting down, what are the special maneuvers on cutches?
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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 |
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While getting up from a chair, what are the special maneuvers on cutches?
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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 |
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What are the most common used canes?
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-Standard ( one-point)
-Quad ( four-point) |
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What is the advantage of a quad cane?
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-It will stand up by itself
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When walking with a cane ensure that:
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-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 |
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Wheelchairs are used for pts who are:
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Not able to ambulate either independently or with aids, such as crutches or a walker
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True or False
Brakes are not in lock when wheelchair is not in motion |
False
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When are brakes always used in a wheelchair?
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-transferring a pt into or out of a wheelchair
-if pt is left stationary |
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Braces & splints are used for:
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-to strengthen & support areas of the body affected by weakness or paralysis such as legs or back
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What type of pt are braces & splints used for
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-after surgery or trauma to immoblize a part while it heals
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Why is a wrist splint often used?
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-to relieve or prevent carpal tunnel
-to immoblized a sprained wrist |
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All braces, slpints & prosthetics have the potential to:
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-irritate & injure the tissues
NOTE must be monitor closely |
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What is a sling used for?
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to support & immobilize an injured wrist, elbow, or shoulder.
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The sling holds the extremity in an elevated position to avoid what
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-edema
-pain -discomfort -fatique |
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If there is no commerical sling at hand what else can you use
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-triangle bandage sling may be used to support the injured upper extremity
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Why do you not use the spreader bar as a handle for lifting & turning the pt?
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-It may be dislodged, ruining the cast & causing pain & possible injury to the pt
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Why is it critical that the cast be protected from uneven pressure during the dying period?
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- Because the shape of position can be inadvertly change
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When is pain best controlled?
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-When it is treated before it becomes severe
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When is a walker used?
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-loss of a function
-weak -tend to lose their balance |
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Which device is used first when training a pt to walk following a loss of a function?
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-walker (frequent)
-crutches |
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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
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To use a walker, a pt must have the use of what
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-both hands & arms
-at least one leg NOTE:pt w/ generalize weakness are allowed walkers |
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Three most commonly used crutches are
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1 Axillary
2 Lofstrand (shorter) 3 Canadian (shorter) |
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Which type of crutch will a Pt who will permanently need crutches for mobility use?
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-Lofstrand
-Canadian |
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Which type of crutch is commonly used for short term need?
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-Axillary
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Are axillary crutches adjustable?
If so how? |
- Yes
- using wings nuts NOTE: they are safe and easy to use |
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Why is it critical that crutches be adjusted to proper height & instructing pt to avoid resting body's wt on axillary bar?
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-Because it can put pressure on vital nerves and can occlude blood vessels in the axilla, causing temporary or permanent damage, including paralysis
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In what position do you measure for the overall length of crutches?
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-standing or
-supine position |
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Describe how to measure the length of crutches in a standing position
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-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 |
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Describe how to measure the length of crutches in a supine position
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-position tips 6" lateral to pt's heel,
-pads should be 3 to 4 fingers under axilla |
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Describe how do you measure for the handgrips?
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-Adjust handgrips
-elbows flexed 15 to 20 deg when palms are resting on handgrip |
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Guidelines to be considered when teaching crutch walking are as follow:
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-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 |
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