Sim Exams from 5/3 and 5/4

things i have been struggling with (everything from truelearn)

What is level 1 of ACL?

Automatic Actions

ACL Level 1: Automatic Actions

* client may be bedridden, sit with support, or move trunk/limbs only
* activities should reduce the number of stimuli and provide only planned stimulation of the sensory system

What is level 2 of ACLs?

Postural Actions

ACL Level 2: Postural Actions

* client stands, has righting actions, walks, names body parts, steps up/over, and pushes/pulls
* activities should allow for planned gross motor actions

What is level 3 of ACLs?

Manual Actions

ACL Level 3: Manual Actions

* client demonstrates grasp/release, repetitive actions, speaks in short phrases, looks at effects of actions and follows cues to complete the next step
* activities are simple with repetitive actions

What is level 4 of ACLs?

Goal-Directed Actions

ACLs Level 4: Goal-Directed Actions

* client is I in doing routine activities, identifies and sustains goals for 1 hour, locates supplies, learns new structures procedure
* activities promote working with other patients to accomplish a shared goal

What is level 5 of ACLs?

Exploratory Actions

ACLs Level 5: Exploratory Actions

* clients discover how to improve actions through overt trial and error, but demonstrate impulsivity and poor judgement
* activities permit variation and allow results to be easily seen and corrected

What is level 6 of ACLs?

Planned Actions

ALCs Level 6: Planned Actions

* client understands safety precautions, uses information gained by reading, and anticipates consequences
* activities permit variation in the selection and planning of steps

hip precautions: posterolateral approach

* no hip flexion greater than 90 degrees
* no internal rotation
* no adduction (crossing legs or feet)

hip precautions: anterolateral approach

* no external rotation
* adduction (crossing legs or feet)
* no extension

universal design

* design of buildings, products, or environments that can be used by anyone regardless of age, disability, or any other factor
* creates an environment that can be utilized by everyone

assistive technology

any item, piece of equipment, software program, or product system that is used to maintain, or improve functional capabilities

* may also include: any service that directly assists the individual with a disability in the selection, acquisition or use of the assistive technology device

accommodations

* modifications or adjustments to the environment or experience
* may include specialized equipment, modifications to the environment, or adjustment to schedules
* applied to work and educational settings

phases of swallowing: anticipatory phase

* psychological, emotion, and social aspects
* includes the variety of foods offered, presentation of food, seating during meals, mealtime atmosphere, food preferences, and mealtime habits and routines

phases of swallowing: Oral Preparatory Phase

* food is masticated by the teeth and gums
* food is manipulated by the lips, cheek, and tongue to form a bolus of appropriate texture for swallowing

phases of swallowing: oral phase

* swallowing begins when tongue initiates posterior movement of the bolus toward the pharynx
* voluntary action, requiring the client to be alert and involved in the process

phases of swallowing: pharyngeal stage

involuntary portion of the swallowing process

phases of swallowing: esophageal stage

* begins when the bolus enters the esophagus
* strong muscles contract to move the bolus through the esophagus to the stomach

activity card sort: purpose

determine the client’s participation in IADL, leisure, and social activities

activity card sort: task

* client sorts a series of photographs into categories based on the question being posed by the person administering the assessment
* client sorts in 5 categories (never done, not doing as an older adult, do now, do less, and given)

activity card sort: version

multiple versions available (healthy older adults, clients receiving services in a hospital, rehabilitation, or SNF; or clients with altered activity patterns, ie. people experiencing homelessness)

impairments following CVA: posterior cerebral artery

* homonymous hemianopsia
* visual agnosia
* memory impairment
* cortical blindness
* visual spatial impairment

impairments following CVA: systematic hypoperfusion

* coma
* decreased concentration
* memory impairment
* agitation
* vision abnormalities

impairments following CVA: cerebellum

* ipsilateral limb ataxia
* gait ataxia
* impaired / uncoordinated eye movements

types of supervision: clinical supervision

* provides support, training, and evaluation of supervisee’s professional performance and development
* focuses on the development of professional discipline-specific skills, i.e. transfers, MMT, ROM, etc.
* may be provided by a member of the supervisee’s discipline
* often specific to the medical model of clinical

types of supervision: professional practice supervision

* broader term for clinical supervision
* provides support, training, and evaluation of supervisee’s professional performance and development
* focuses on the development of professional discipline-specific skills
* may be provided by a member of the supervisee’s discipline

types of supervision: functional supervision

* training and oversight provided to address a specific aspect of work or function in professional practice, i.e. driving, splinting
* provided by a supervisor with advanced knowledge, skills, and competence in the area, i.e. splinting by a CHT
* supervises the supervisee’s performance and development of specific skills of competency in only the selected job function, i.e. driving with adaptations specific to driving rehabilitation

types of reimbursement: quality payment program

* provides incentives to providers that meet specific quality measures
* encourages providers to offer high-quality, efficient care

types of reimbursement: managed care program

* health insurance plan that coordinates the provision, quality, and cost of care
* requires approval for specialty services

types of reimbursement: episode payment program

* bundled payment program that modifies the standard fee-for-services payment system with a prospective episode-based bundled payment
* single payment for all care to treat a specific illness, condition, or medical event

types of reimbursement: value-based payment

* links financial incentives to provider’s performance based on defined measures of quality or resource use
* holds health care providers accountable for the cost and quality of care provided

Class I of Cardiovascular Disability: Specific Activity Scale

* clients can perform to completion any activity requiring **less than or equal to** **7 METs**
* possible activities include:
* carrying objects that weigh 80 pounds
* shoveling snow, spade soil
* playing basketball, squish, handball, skiing, jog/walk at 5mph

Class II of Cardiovascular Disability: Specific Activity Scale

* client __can perform to completion__ any activity requiring **less than or equal to 5 METS**
* possible activities include
* garden, rake, weed
* roller skate, dance, walk at 4 mph
* hand wash small items, meal preparation
* clients __cannot__ __perform to completion__ activities requiring **greater than or equal to 7 METs**

Class III of Cardiovascular Disability: Specific Activity Scale

* clients __can perform__ __to completion__ activity requiring **less than or equal to 2 METs**
* possible activities include
* shower without stopping, dressing
* strip and make the bed, clean windows
* walk 2.5 mph, bowl, play golf
* clients __cannot perform to completion__ activities requiring **greater than or equal to 5 METs**

Class IV of Cardiovascular Disability: Specific Activity Scale

* clients cannot perform to completion any activity greater than or equal to 2 METs and cannot carry out activities listed in classes I-III
* possible activities include
* driving an automatic car, writing at a desk
* bathing in a tub, showering while seated

Multiple Errands Test

* evaluates the effect of executive function deficits on everyday functioning using real-world tasks
* it is completed using a performance-based rating scale in real-life contexts
* it is best implemented with clients who have experienced acquired brain injury, specifically frontal lobe impairments

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Katz ADL Scale

* provides a quick ADL assessment
* indicates level of independence or dependence
* indicates type of assistance required
* completed using interview and observations

Functional Assessment of Cancer Therapy

* assesses general QOL
* provides information regarding health status
* completed using a self-administered questionnaire or interview with a rating scale

Brief Fatigue Inventory

* determines the severity of fatigue experienced over the previous 24 hours
* identifies the impact fatigue has on occupational engagement
* completed using a self-administered rating scale

Executive Function Performance Test

* performance-based assessment that evaluates cognitive functioning and level of prompting required for ADL completion
* completed using a 4 independent-living tasks where the client is observed and performance is rated

types of dressings: alginate

* soft and absorbent
* keeps wound free of bacteria
* promotes autolytic debridement
* recommended for
* wounds with heavy exudate that require absorption

types of dressings: transparent film

* enables exchange of oxygen between wound and environment
* does not absorb drainage
* impermeable to water and bacteria
* recommended for
* small, partial-thickness wounds with minimal damage

types of dressings: gauze

* often used as a secondary dressing
* absorbency depends on design
* recommended for
* fresh wounds that are likely to bleed

types of dressings: hydrogel sheet

* maintains a moist wound environment
* offers pain relief
* recommended for
* partial or full-thickness wounds

professional development: community of practice

support network for people who share a common role

professional development: practice scholar community

an academic-practice scholar community to promote scholarship of best practice

professional development: continuing competency

demonstration of specified levels of knowledge, skills, or ability throughout a career

professional development: mentorship

process by which an individual guides or is guided by another professional

types of groups: task-oriented group

* provides an end product or a service
* the task for each group provides a shared experience where participants reflect on the relationship between behavior, thinking, and feeling

types of groups: egocentric cooperative group

* a form of developmental group
* group interactions occur as a developmental sequence necessary for adaptation
* requires more interaction and responsibility

types of groups: parallel group

* a form of developmental group
* group interactions occurs as developmental sequence necessary for adaptation
* no interaction is required between members

types of groups: thematic group

* group members focus on a common theme that has been experiences among members
* addresses coping skills

pediatric reflexes: rooting reflex

* age appears
* birth
* integration age
* 3-4 months
* retention signs
* sucking thumb; poor eating habits; speech challenges; swallowing and chewing deficits; oral hypersensitivity

pediatric reflexes: moro reflex

* age appears
* birth
* integration age
* 2-4 months
* retention signs
* hypersensitivity to one of the sensory systems; poor reactions to sensory input; allergies; lowered immunity; fatigue; challenges with change

pediatric reflexes: asymmetric tonic neck reflex (ATNR)

* age appears
* birth
* integration age
* 6 months
* retention signs
* difficulty crossing midline; poor handwriting; gait coordination and balance challenges; visual motor tracking issues; math and reading delays

pediatric reflexes: babinski reflex

* age appears
* birth
* integration age
* 6 months
* retention signs
* challenges with grounding, stability, poor balance, and gross motor coordination

stages of change model: pre contemplation

no intention of taking action within the next 6 onths

stages of change model: contemplation

intends to take action within the next 6 months

stages of change model: preparation

* intends to take action in the next 30 days
* has taken some behavioral steps in this direction

stages of change model: maintenance

behavior changed for more than 6 months

common cardiac medications: anticoagulants (blood thinners)

* decrease the blood’s ability to clot
* prevents clot formation
* used in stroke prevention
* common names: warfarin, Coumadin, heparin

common cardiac medications: anti-platelet agents

* prevents clots by preventing platelets from sticking together
* used to prevent clots after an MI
* used in the treatment of unstable angina and ischemic strokes
* common names: aspirin, plavix

common cardiac medications: beta-blockers

* decrease heart rate and cardiac output
* lower BP
* make heart beat slower and with less force
* used to treat abnormal heart rhythms and chest pain
* used to prevent recurrent heart attacks and lower BP
* common names: atenolol, propranolol

common cardiac medications: vasodilators

* relaxes blood vessels
* increases blood supply and oxygen to the heart while reducing the heart’s workload
* used to each chest pain
* common names: nitroglycerin, minoxidil

child occupational self-assessment

* self-report assessment
* addresses competence and value for daily activities
* derived from MOHO
* appropriate for ages 7-18 years

youth experience survey

* self-report assessment
* addresses developmental experiences resulting from activities aimed to promote positive development
* appropriate for high school ages adolescents

participation and environment measure (assessment)

* parent report assessment
* addresses participation in daily activities and impact of the environment on participation
* appropriate for ages 5-17 years

contextual memory test

* designed to assess awareness of memory capacity, use of strategy, and recall in adults with memory dysfunction
* may be used as a screening tool to determine need for further evaluation
* utilizes a verbal questionnaire and performance task

loewenstein occupational therapy cognitive assessment

* assesses orientation, visual and spatial orientation, visuomotor organization, and thinking operations
* consists of a battery of tests

mini-mental state examination

* provides a short, simple, quantitative measure of cognitive performance
* consists of an oral questionnaire

Basic Metabolic Equivalent for Self-Care Tasks: Met 1-2

* eating while seated
* functional transfers (i.e. bed to chair)
* washing face and hands
* brushing hair
* walking 1 mph

Basic Metabolic Equivalent for Self-Care Tasks: Met 2-3

* seated sponge bath
* standing sponge bath
* dressing and undressing
* seated warm shower
* walking 2-3 mph
* wheelchair propulsion 1.2 mph

Basic Metabolic Equivalent for Self-Care Tasks: Met 3-4

* standing warm shower
* bowel movement
* climbing stairs

Basic Metabolic Equivalent for Self-Care Tasks: Met 4-5

* hot shower
* bowel movement on bedpan

low vision definitions: normal vision

* 20/20 acuity
* able to read standard letter size at a standard distance

low vision definitions: moderately low vision

* 20/80 to 20/160 visual acuity
* must bring the print very close which isn’t comfortable for prolonged use
* use of assistive devices promotes independence

low vision definitions: severely low vision

* 20/200 to 20/400 visual acuity
* must bring print so close that only one eye with the best vision can be used
* reading is slow
* sensory/reading substitution may be used (i.e. audio books)

low vision definitions: profoundly low vision

* 20/500 to 20/1000
* reading is limited to essential materials
* use of adaptive device is necessary

phases of Guillain-Barre Syndrome: initial

* acute phase
* first conclusive symptoms
* begins with weakness in the extremities and progresses proximally until the client is paralyzed
* lasts until the client no longer experiences further decline
* duration: 1-3 weeks

OT Intervention for Initial&Plateau Phase of Guillain Barre

* daily PROM
* positioning
* prevent contracture and deformity through splinting, passive activities and non-strenuous social visits are encouraged
* activity modification
* electronic aids for daily living and assistive technologies

phases of Guillain-Barre Syndrome: plateau

* client is stable and no longer sees further deterioration
* no evidence of physical recovery
* paralysis
* duration: a few weeks

phases of Guillain-Barre Syndrome: recovery

* client slowly begins to recover physical abilities
* 85% recover well spontaneously with some residual deficits
* 10% recover but with significant impairments
* 5% result in dealth
* duration: up to 2 years

OT Intervention for Recovery Phase of Guillain Barre

* activity modification to gradually increase active movement and performance of daily activities as the client recovers
* close monitoring of pain and fatigue
* energy conservation
* work simplification
* joint protection
* conservative use of progressive resistive exercises

food consistencies: level 1

* pureed food
* homogeneous, cohesive, or pudding-like

food consistencies: level 2

* mechanically altered
* cohesive, moist, semi-solid foods that require some chewing
* includes mashed soft fruits and vegetables and ground or minced meats

food consistencies: level 3

* advanced
* soft - solid foods that require more chewing ability
* includes crackers, breads, cooked vegetables, soft fruits and meats

food consistencies: regular

* no food restrictions
* includes some fruits with tough skins, hard or crunchy vegetables, tough meats, and foods that are sticky or dry

liquid consistencies: thin

* consistency of water or juice
* includes baby formula and milk products
* includes soup broth and foods that melt including Jell-O
* most difficult to swallow with immature oral motor skills

liquid consistencies: nectar

* consistency of tomato juice
* includes store-bought yogurt smoothies

liquid consistencies: honey

* liquid slowly drips off spoon
* easier to swallow with immature oral motor skills

perceptual impairments: figure-ground discrimination

allows a person to perceive the foreground from the background in a visual array

perceptual impairments: form-constancy dysfunction

recognition of various forms, shapes, and objects regardless of their position, location, or size

perceptual impairments: prosopagnosia

inability to recognize and identify familiar faces

perceptual impairments: agnosia

impaired visual object recognition using

National Institutes of Health (NIH) Stroke Scale

* standardized prognostic scale
* 10 minutes to administer
* evaluates level of consciousness, language, neglect, visual fields, eye movement, motor strength, ataxia, dysarthria, and sensation. it does not evaluate functional tasks

principles of universal design: equitable use

design does not disadvantage or stigmatize users