case app (GBS & axillary nerve injury)

what type(s) of strength assessment(s) would be recommended upon Edith’s admission to the ICU?

a. MMT of individual muscles

b. MMT of muscle groups

c. functional strength testing

d. a strength screening only

e. all of the above

a. MMT of individual muscles

what would be the optimal bed positioning for Edith when she was admitted into ICU?

a. prone at all times

b. partially side-lying with the bottom arm in ABduction and top arm supported in flexion

c. supine with the knees and hips flexed to 60-70 degrees

d. on her back with the head of the bed elevated to 60 degrees 

e. all of these would be good for Edith 

b. partially side-lying with the bottom arm in ABduction and top arm supported in flexion

what type of device(s) could be mounted to her bed in ICU to allow Edith to move/exercise any proximal muscles that may be functioning?

a. mobile arm supports

b. arm troughs

c. suspension slings

d. an over-bed trapeze

e. a robotic device

c. suspension slings

OT intervention for Edith during the time she is in ICU should focus on _____.

a. daily PROM

b. splinting to support weak muscles and prevent contractures

c. protecting muscles in which the patient is experiencing muscle belly tenderness

d. all of the above

e. a and c only

d. all of the above

once Edith is transferred to the IRF, she exhibits some return of 2-/5 strength in her shoulder, scapular, elbow, and trunk muscles. what device(s) could be utilized to allow her to start engaging in light self care activities such as feeding herself while sitting in bed?

a. an electronic feeding device

b. a suspension sling and a utensil with a built-up handle

c. this activity would still not be possible

d. a suspension sling and a universal cuff

e. a mobile arm support

d. a suspension sling and a universal cuff

when Edith is cleared to sit in her wheelchair, the treatment team should ____ in order to ____.

a. increase her sitting time and the angle (hip joint) at which she is sitting as quick as possible; maximize therapy time

b. increase her sitting time and the angle (hip joint) at which she is sitting gradual and methodically; avoid autonomic dysreflexia

c. increase her sitting time and the angle (hip joint) at which she is sitting gradual and and methodically; manage potential orthostatic hypotension

d. let her sit as long as she wants to each day; keep her satisfied

e. increase her sitting time first and then angle (hip joint) at which she is sitting; engage in ADL

c. increase her sitting time and the angle (hip joint) at which she is sitting gradual and and methodically; manage potential orthostatic hypotension

once Edith has started learning to use a mobile support, the best way to assist her to return to reading her bible would be to ____. 

a. place the bible in a book holder, and have her use a universal cuff with a typing stick in to turn the pages of the bible 

b. sign her up for books on tape 

c. show her religious television shows and teach her to use the remote control 

d. see if her insurance would pay for a kindle electronic reading device 

e. b and c 

a. place the bible in a book holder, and have her use a universal cuff with a typing stick in to turn the pages of the bible 

all facet's of Edith’s inpatient rehab program should be implemented with careful regard for ____.

a. endurance and fatigue

b. muscle belly tenderness

c. pain

d. over-exercising during her progressive resistive exercises (PRE) program

e. all of the above

e. all of the above

which of the following interventions would be most helpful to Edith during her inpatient rehab program?

a. driving rehab

b. gentle PROM

c. progressive resistive exercises

d. grooming and dressing skills training

e. c and d

e. c and d

during the initial consultation with Javier, the OT should do all of the following except _____ 

a. providing him with strategies to dress himself while adhering to his shoulder restrictions 

b. educating Javier and his wife about movements to avoid

c. showing him a few shoulder exercises so he wont get stiff

d. teaching Javier and his wife to don the shoulder immobilizer (sling & swath)

e. how to insure that he will maintain ROM in joints without restrictions

c. showing him a few shoulder exercises so he wont get stiff

when working with Javier once he is cleared for OT intervention at 3 weeks post injury, which type of strength assessment would the OT use? 

a. MMT of individual muscles 

b. manual muscle testing of muscle groups

c. functional strength testing 

d. a strength screening only 

e. a and e

b. manual muscle testing of muscle groups

when Javier returns to OT when he is 3 weeks post-injury, administering ____ will help the OT plan the optimal intervention for him

a. the COPM

b. MMT

c. a sensory assessment

d. all of the above

e. a and c only

d. all of the above

during weeks 3-6, active movement of Javier’s right shoulder moving into flexion (he is not allowed to extend) should always be done _____. how would you teach this to the patient (discussion)?

a. with the shoulder internally rotated

b. with the shoulder in neutral with respect to rotation

c. with the shoulder externally rotated

d. in any of the above positions

e. in either a or b

a. with the shoulder internally rotated

when Javier is cleared for exercise in all motions 6 weeks post injury, his middle deltoid strength is 2-/5. the therapist will utilize ____ to best increase his strength. 

a. AROM 

b. strengthening activities in a supine position 

c. self ROM 

d. all of the above 

e. a and b 

e. a and b