Ch. 34 & 45 Quiz

moving a body part away from the mid-line of the body

abduction

moving a body part towards the mid-line of the body

adduction

the act of walking

ambulation

the decrease in size or wasting away of tissue

atrophy

restricting a person to bed and limiting activity for health reasons

bed rest

decreased motion and stiffness of a joint caused by shortening of a muscle

contracture

the loss of muscle strength from inactivity

deconditioning

bending the toes and foot up at the ankle

dorsiflexion

straightening a body part

extension

turning the joint outward

external rotation

bending a body part

flexion

the foot falls down at the ankle; also known as permanent plantar flexion

footdrop

excessive straightening of a body part

hyperextension

turning the joint inward

internal rotation

touching an opposite finger with the thumb

opposition

postural hypotension

orthostatic hypotension

a device used to support a muscle, promote a certain motion, or correct a deformity

orthotic

the food is bent; bending the foot **down** at the ankle

plantar flexion

abnormally low BP when the person suddenly stands up

postural hypotension

turning the joint downward

pronation

the movement of a joint to the extent possible without causing pain

range of motion (ROM)

turning the joint

rotation

turning the joint upwards

supination

a brief loss of consciousness; **fainting**

syncope

the activities usually done during a normal day in a person’s life

activities of daily living (ADLs)

any lost, absent, or impaired physical or mental function

disability

an artificial replacement for a missing body part

prosthesis

the process of restoring the person to their highest possible level of physical, psychological, social, and economic function

rehabilitation

a NA with special training in restorative nursing and rehabilitation skills

restorative aide

care that helps persons regain health and strength for safe and independent living

restorative nursing care

all

exercise and activity are important for which body systems?

care plan and assignment sheet

includes the person’s activity level and needed exercises

promoting exercise and activity in all persons to the extent possible

your role in assisting the nurse and health team is to…

improve independence, attain highest level of function possible, prevent loss of function

the goal of rehabilitation activities and exercise may include (3):

do not force them to exercise or take part in activities. stay calm and ask nurse for help. follow the care plan

persons with dementia may resist exercise and activity and bcuz they don’t understand what’s happening, they may fear harm. if they become agitated and combative or cry out for help, what do you do?

reduce oxygen needs, reduce pain, reduce swelling, promote healing

4 common reasons to order bed rest are to:

strict or complete bed rest

in this type of bedrest, everything is done for the pt…all ADLs are done in bed

bed rest

in this type of bedrest, the pt. performs some ADLs like self-feeding, oral hygiene, bathing, shaving, hair care

bed rest with commode privileges

in this type of bedrest, the commode is used at bedside for elimination

bed rest BRP

in this type of bedrest, bathroom is used for definitions

pressure injuries, constipation, fecal impaction, urinary tract infections, kidney stones, blood clots, pneumonia

7 possible complications from bed rest and lack of exercise

contracture, atrophy, postural/orthostatic hypotension

3 musculo-skeletal problems that may occur from bed rest and lack of exercise and activity:

fingers, wrists, elbows, toes, ankles, knees, hips, neck, spine

common sites of contracture:

deformed and stiff

if a pt. has a contracture, the site is…

dizzy, weak, spots before the eyes, syncope

possible signs/symptoms of postural hypotension

good alignment, ROM exercises, frequent position changes

good nursing care prevents complications from bed rest…these 3 things are important prevention measures and are part of the care plan

bed boards, foot-boards, trochanter rolls, hip abduction wedge, hand roll/grip, splints, bed cradle

7 supportive devices that are often used to support and maintain a certain position include…

bed boards

* placed under mattress to prevent sagging
* many are hinged in the middle for use with hospital beds to all the head of the bed to be raised
* may be used in home care by pt. with back problems

foot-board

* prevents plantar flexion that can lead to foot drob
* placed so the soles of feet are flush against it
* can also serve as bed cradles by keeping top linens off the feet and toes

trochanter roll

* prevents hips and legs from turning outwards (external rotation)
* bath blanket or towel is folded to the desired length and rolled up tightly
* flat end is placed under pt. from hip to knee and the role is tucked along side the body

hip abduction wedge

keeps the hips abducted (apart)

* placed between pt. legs and is common after hip replacement surgery

hand roll/grip

prevents contracture of the thumb, fingers, and wrist

* foam rubber sponges, rubber balls, and finger cushions are also used

splints

* keeps elbows, wrists, fingers, ankles, or knees in normal position
* usually secured in place with Velcro

bed cradle

keeps the weight of top linens off the feet and toes

* heavy top linens can cause foot drop and pressure injuries

trochanter roll

\

hip abduction wedge

hand grip/roll

splint

bed cradle

complications from bed rest

exercise helps prevent…

trapeze

used for exercises to strengthen arm muscles

* hangs from an over-bed fram
* person grasps the bar with both hands to lift trunk off the bed
* also used to move up and turn in bed

2x day

ROM exercises are usually done…

done by the person

Active ROM are…

moving the joints through their range of motion

PROM involves you…

person does exercises with some help

AAROM exercises means the…

frequent

pt. on bed rest and those who cannot walk, turn, or transfer themselves because of illness or injury need more __________ ROM exercises

5x

how many times are ROM repeated for each joint?

neck

shoulder

elbow

forearm

wrist

thumb

fingers

hip

knee

ankle

foot

toes

bedrest, illness, surgery, injury

4 reasons a person may be weak and unsteady and need assistance ambulating

P.T.

who teaches the pt. how to use the device

weakness on 1 side for the body

canes are used for…

* provide balance and support
* single-tip and 4-point are common
* 4-point gives more support but is harder to move

strong

which side of the body is the cane held?

6-10 inches

a cane should be held ___________ to the side of and in front of the strong foot

more

a walker gives __________ support than a cane

independence

baskets, pouches, and trays attach to the walker for needed items to free up the hands to grip the walker. this allows for more __________

injury, surgery, deformity, contractures

4 reasons for crutches or orthotic devices (may be temporary or permanent)

1 leg or when 1 or both legs need to regain strength

crutches are used when the pt. cannot use…

get caught between crutches and underarms…can hang forward + block the pt.’s view of the feet and crutch tips

it is important for persons using crutches to where clothes that fit well because…

braces, AFOs

other orthotic devices:

braces

* support weak body parts
* prevent or correct deformities
* prevent joint movement
* applied over ankle, knee, or back

AFOs

* worn with a shoes
* secured with a velcro strap

foot, after a stroke

AFOs are common for…

skin breakdown

you should keep skin and bony points under orthotics clean and dry to prevent…

redness or signs of skin break down and complaints of pain/discomfort

when taking off a brace or AFO, you should report these things immediately

acute disabilities

* short course with complete recovery
* ex: fractures

chronic problem

* has a long course
* problem is controlled, not cured, with treatment
* ex: arthritis and paralysis

P.T., O.T., S.T.

these people are part of the rehabilitation department:

prevent/reduce degree of disability, improve abilities to highest level of independence possible, help the pt. adjust to the disability

goals of rehabilitation include:

when the pt. first seeks out healthcare

when in the pt.’s healthcare experience does rehabilitation start?