Clinical quiz 2

OCTH 216 content weeks 4-12

Symptoms of hypoglycemia?

Symptoms of hyperglycemia?

Guidelines for good body mechanics

Relative positions when lifting off of chair?

• Head is forward

• Neck is extended

• Upper trunk is extended

• Lower trunk is flexed

• Knees are forward

• Ankles are behind knees

• Head goes away from chair

What are posterior total hip (arthroplasty) precautions?

1) No hip flexion of the postsurgical hip beyond 90 degrees (or 70 degrees for more conservative.

2) No internal rotation of the post surgical hip beyond neutral (0 degrees)

3) No adduction of the postsurgical hip beyond neutral (0 degrees)

• Beach ball belly

• When supine, place pillow between legs and against outside of operated leg

• When side lying, sleep on operated leg OR keep leg abducted with pillow and operated leg supported to prevent rotation

What are anterior total hip precautions?

1. Avoid hip extension

2. Avoid external rotation

3. Avoid abduction beyond neutral

• Lit review suggests rate of dislocation after anterolateral THA is low and not improved by adhering to hip precautions

What are traditional sternal precautions?

• No lifting more than 5-10 lbs

• No pushing of pulling through the arms

• No reaching behind the back

• Restriction to using arms when moving from supine to sit, standing up

• May include hugging a cushion to chest or “splinting” when coughing.

-No lifting, pulling, pushing more than 5 lbs

-Don’t push on arms when getting in and out of bed or up from chair

-No elbows above shoulders

-No twisting trunk or deep bending

-Hug a pillow (like a splint) to the chest when coughing or sneezing

-No driving for 4 weeks or until cleared by MD

What are modified sternal precautions?

Move in the tube

• The “in the tube” position limits the lever arm created by the arm and hand, which should decrease stress on the sternum

• Still need to hold cushion or cross arms when coughing as coughing adds a lot of stress

• BUT, recommendations is to look a individual risk factors and taper restrictions as the patient recovers.

What are lumbar spine surgery precautions?

• Often movement may be restricted for 6-8 weeks.

• Avoid activities that flex or rotate the lumbar spine

• Avoid lifting objects weighing more than 5 lbs.

• Hip flexion is allowed

Adaptive equipment

Used to compensate for physical or other limitations, to promote safety, prevent injury, promote independence.

Assistive technology

Technologies that assist people with limitation to perform tasks. An “able-bodied” person may be able to do task without it. Expected to be used over longer period of time .

Therapeutic technology

Occupation enabling technology (OET)

Durable medical equipment

• Durable (can withstand repeated use)

• Used for a medical reason

• Typically only useful to someone who is sick or injured

• Used in your home

• Expected to last at least 3 years

What are LE orthotics used for?

• Used for creating increased stability at a joint, to allow limited mobility at a joint, and to support weight bearing surfaces of the foot

• Bracing devices used to manage orthopedic & neurologic effects on the otherwise intact extremities

• Can be static or dynamic (with articulating portions)

What is the role of an OT in orthosis?

• Consider the functional aspects of the LE orthosis for everyday occupations such as dressing, toileting, bathing, etc.

• Client education regarding the donning and doffing of the LE orthotic device

• Assist the client (or caregiver) in time management aspects of donning/ doffing the LE orthosis

• NOT gait training

What is a TLSO brace?

• Thoracic lumbar sacral orthosis

• Stabilizes the spine for various reason

• Spinal precautions in place: no bending, twisting, lifting objects, no upright (sitting up, standing, HOB up with brace off), no lifting above arms. Depends on surgeon

• Ordered by orthopedic surgeon and made by orthotist

• OT can’t issue or discharge

• OT may train in bed mobility, transfers, donning/ doffing

What is a c-collar?

• Cervical collar to stabilize c spine

• Ordered by orthopedic surgeon/ physician

• OT can’t issue or discharge

• Typical cervical precautions: no twisting, turning, no bending at neck, no lifting, no lifting arms above shoulders, no pushing/ pulling

• OT involved in training in occupations while maintaining precautions

Should adaptive devices be used in hemiplegia dressing?

NO