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42 Cards in this Set
- Front
- Back
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A position of comfort for a pt may lead to what?
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Development of a soft tissue contracture
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Changing the patient's position every 2 hours may be necessary to prevent what?
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1. Contractures
2. Relieve pressure on skin 3. Subcutaneous circulatory 4. Neural, lymphatic, and other structures |
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Which type of pts are most vulnerable to skin breakdown or contractures?
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1. Elderly
2. Confused 3. Mentally incompetent 4. Very young 5. Comatose 6. Paralyzed 7. Agitated 8. Cardiopulmonary impairment 9. Unable to communicate 10. Decreased or absent sensation |
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What are the reasons for positioning?
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1. Pt will be well supported and stabilized
2. Pt comfort 3. Stretching of pt by using gravity to assist 4. Prevention of skin breakdown and contractures 5. Alignment for efficient functioning for pt and PTA 6. Safety of pt and PTA |
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What should be concentrated on when draping a pt?
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Make sure the pt is:
1. Warm enough 2. Able to perform movements 3. Appropriately covered (modesty) |
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Position of pt should relieve what?
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Stress and strain to:
1. Joints 2. Ligaments 3. Muscles 4. Tendons 5. Connective tissue 6. Nerves |
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How should a pt be positioned when supine?
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1. Support head - avoid excessive flexion
2. Support knees - small support relieves lumbar lordosis 3. Support ankles - relieves pressure on calcaneus, avoid hyperextension of knees 4. Upper extremities - position for comfort (ex: pillow under arm, elevate hand) |
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How should a pt be positioned when prone?
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1. Head - neutral position, or with head turned to left or right
2. Abdomen - pillow under abdomen decreases lumbar lordosis 3. Thorax - pillow under thorax maintains lordosis 4. Ankles - support by towel roll (bolster) relaxes hamstrings and low back, avoid full ankle PF 5. Upper extremities - position along side of body or T-position with hands under head |
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How should a pt be positioned when side lying?
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1. Align head, trunk, pelvis
2. LE's flex at hip and knee, pillow between knees, top leg slightly forward 3. Head supported in neutral on one or two pillows 4. Pillow at chest or back to keep pt from rolling |
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When positioning the LEs you want to avoid excessive...?
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External Rotation
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How should a pt be positioned when they are sitting?
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1. Use chair to stabilize trunk
2. Pillows to back of chair or lean forward onto pillow on treatment table 3. LE's on footstool, WC footrests, or flat on floor 4. Support arms |
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Avoid positioning for more than 30 minutes if position causes what?
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1. Excessive rotation or flex of spine
2. Bilateral or unilateral scapular abduction or forward head 3. Compression of thorax or chest 4. PF of ankles and feet 5. Hip or knee flex or hyperextension of knees 6. Adduction and IR of GH jnt 7. Elbow/wrist/finger flex 8. Hip adduction or IR/ER |
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What does blanching or paleness signal?
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Severe or dangerous pressure
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What is happening when a pt complains of tingling/numbness?
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There is pressure on a nerve.
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What needs to happen if areas of redness or blanching do not return to normal after one hour?
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Monitor pt and avoid position in the future
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Why do pts who are at risk for skin breakdowns or contractures need to be monitored frequently?
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1. They may not tolerate any one position for very long
2. Circulation or respiration may change 3. May have trouble complying with instructions 4. May not sense need to change position 5. May not be able to change position |
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What is the abbreviation for a transfemoral amputation and how should the pt be positioned?
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AK (Above Knee)
1. Avoid prolonged hip flex and abd/add 2. Supine - avoid positioning residual limb on pillow more than a few min/hr 3. Sitting - only about 30 min/hr and no greater than 40 min/hr 4. Keep residual limb in extension when standing or lying 5. Prone lying periodically is recommended |
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What is the abbreviation for a transtibial amputation and how should the pt be positioned?
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BK (below knee)
1. Avoid prolonged hip and knee flexion 2. Supine - avoid positioning residual limb on pillow more than a few min/hr, keep knee extended if elevated 3. Lying or standing - keep hip and knee extended to neutral 4. Prone lying recommended |
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What positions should be avoided for an AE (above elbow) amputee?
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Shoulder flex, add, and IR should not be prolonged
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What positions should be avoided for a BE (below elbow) amputee?
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Shoulder and elbow flex, shoulder add and IR should be cautious about
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How is the UE of a CVA pt often positioned?
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In prolonged:
1. Shoulder add and IR 2. Elbow flex 3. Forearm supination or pronation 4. Wrist/finger/thumb flex 5. Finger/thumb add Slings encourage the position |
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How should a CVA pt's LE's be positioned?
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1. Hip and knee ext
2. Hip abd and IR 3. Ankle DF and eversion |
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What should be avoided in positioning a CVA pt's LE's?
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1. Hip and knee flexion
2. Hip ER 3. Ankle PR and inversion |
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What should be done for RA pts?
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1. Avoid prolonged immobilization
2. Active exercise for uninvolved jnts 3. Gentle exercise of involved jnts unless jnts are inflammed |
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What should be done with burn or skin graft pts?
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1. Avoid prolonged positioning of jnts affected by burn/graft
2. Avoid positions of comfort 3. Need frequent ROM 4. Contracture prevention is key |
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How can prolonged use of rails be used?
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As a form of restraint
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What is another name for a turning frame bed and when would one be used?
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Stryker wedge frame or a Foster frame
Used when skeletal stability and alignment is needed |
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What is an air fluidized support bed and when is it used?
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A bed with 1600 lbs of silicone-coated glass beads in which heated, pressurized air flows through the beads to suspend a polyester cover which supports the pt
Used for: 1. Pts with several infected lesions 2. Pts that need skin protection 3. Pts who's position cant be changed easily 4. Pts with excessive pressure ulcers 5. Recent skin graft pts 6. Pts who require prolonged immobilization 7. Pts at risk for skin problems |
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What does an air fluidized support bed do?
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1. Helps heal ulcers
2. Offers reduced pressure 3. When off, bed is a firm surface for tx |
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What are some disadvantages of an air fluidized support bed?
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1. Bed can be punctured
2. Pt has increased fluid loss 3. Tall and obese pts are uncomfortable 4. Difficult to provide care and transport 5. EXPENSIVE |
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What type of bed oscillates from side to side to reduce pressure on pt's skin? What is it used for?
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Post-trauma mobility beds
Used to maintain seriously injured pts in a stable position |
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Which type of bed has segmented bladders that allows limited escape of air? What type of pt is this bed used for?
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Low air loss therapy bed
Used for: 1. Pts who require prolonged immobilization 2. Pts at high risk for pressure ulcers 3. Obese pts 4. Pts that require frequent elevation of their trunk |
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What is the purpose of ventilators or respirators?
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To maintain air exchange when normal respiration is inhibited or cannot be actively performed by pt
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When are ventilators used?
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When pt has apnea or potential for respiratory distress or failure
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What type of ventilator is used when long-term ventilation assistance is needed? Which type of pts is this used for?
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Volume-cycled ventilator
Used for: 1. Severe COPD pt 2. Post-thoracic surgery 3. Disorders of the CNS 4. Musculoskeltal disorders affecting respiratory system |
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What type of ventilator is primarily used for pts with poliomyelitis?
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Negative Pressure Device
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What type of ventilator is used for short-term ventilation and is it used for?
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Pressure-cycled ventilators
Used for pts with neuromuscular or musculoskeletal distress (provides intermittent positive-pressure breathing) |
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What allows suction of the bronchial tree?
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Endotracheal Tube
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When should the ventilator alarms sound?
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1. If the ventilator tube is disconnected
2. Pt is coughing 3. Tubing is moved 4. There is a change in respiratory pattern |
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What do you call an instrument that is positioned or attached to a pt's finger or ear that measures oxygen saturation and reports pulse rate and oxygen saturation percent of hemoglobin?
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An oximeter
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What do you call a long plastic IV tube inserted into an internal jugular or femoral vein which passes into the pulmonary artery?
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A pulmonary artery catheter
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What does an ABG analysis give information about?
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oxygenation level of blood
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