110 patient care skills

Question 1

Patients with hemiparesis who use a cane on the uninvolved side demonstrate all of the following EXCEPT
- Reduced mediolateral and anteroposterior sway
-Increased walking speed
-Loss of stability
-Increased stance time on the affected leg

Answer 1

loss of stability

Question 2

Which statement is NOT true about assistive devices?
-Assistive devices must always be fit while the patient is supine.
-An incorrect fit will adversely affect a patient’s gait pattern.
-When using a device that is held by just one hand (such as a crutch or cane), generally it should go on the side opposite the affected lower extremity.
-Platform attachments are used when a person can’t bear weight through their wrists and/or hands.

Answer 2

Assistive devices must always be fit while the patient is supine.

Question 3

Your patient is a 79 year-old woman who has just had a right total hip arthroplasy (THA). You are going to gait train her with a walker. What is the best position for guarding this patient as she walks?
-Standing directly behind the patient
-Standing directly in front of the patient
-Standing behind and slightly to the left of the patient
-Standing behind and slightly to the right of the patient

Answer 3

Standing behind and slightly to the right of the patient

Question 4

Sagittal (median)

Answer 4

divides body into
right and left halves. Flexion and
extension

Question 5

Frontal (coronal)

Answer 5

divides the body into
front and back. Abduction and
adduction

Question 6

Transverse (axial, horizontal)

Answer 6

divides
the body into top and bottom.
Rotation

Question 7

PROM

Answer 7

passive - the therapist or another external force moves the body part through the ROM- THERAPIST DOING THE WORK

Question 8

AAROM

Answer 8

active assisted - the therapist assists the movement-BOTH PATIENT AND THERAPIST DOING THE WORK

Question 9

AROM

Answer 9

active - the patient moves the body part without assistance- PATIENT DOES THE WORK

Question 10

RROM

Answer 10

resisted - the movement is resisted- THERAPIST PROVIDES RESISTANT TO INCREASE STRENGTH

Question 11

PROM indicatiors

Answer 11

◦ Pain occurs with active contraction
◦ Paralysis or marked weakness
◦ Active contraction is prohibited
◦ Assess joint movement
◦ Counteract negative effects of immobilization
◦ Provide sensory stimulation and awareness
◦ Reduce stress on cardiopulmonary system
◦ To teach movement

Question 12

range of motion

Answer 12

the amount of movement that occurs at a joint. Range of motion exercises are the movements of each joint and muscle through
it’s available ROM

Question 13

PROM will not (passive range of motion)

Answer 13

◦ Prevent muscle atrophy
◦ Increase strength
◦ Increase endurance
◦ Assist circulation to the
extent a voluntary
muscle contraction
would
◦ Reduce body fat

Question 14

benefits of PROM (passive range of motion)

Answer 14

◦ Maintain joint and soft tissue integrity
◦ Maintain mechanical elasticity of muscle
◦ Minimize effects of formation of
contractures
◦ Assist circulation and vascular dynamics
◦ Decrease venous stasis
◦ Enhance synovial movement for cartilage
nutrition
◦ Decrease or inhibit pain
◦ Assist the healing process following
surgery or injury
◦ Sensory Stimulation

Question 15

What is upright, feet parallel, arms at side of body with palms facing forward called?

Answer 15

Anatomical position

Question 16

What plane divides the body into front and back?

Answer 16

frontal-abduction and adduction

Question 17

What plane divides the body into top and bottom?

Answer 17

transverse- rotation

Question 18

Which ROM includes the therapist assisting ROM along with the patient?

Answer 18

Active-Assisted

Question 19

5. Which ROM includes the therapist or another external force moves the body part
   through the ROM?

Answer 19

PROM

Question 20

T/F PROM can increase strength

Answer 20

false

Question 21

PROM contraindications

Answer 21

◦ During stages of tissue healing
in which motion could inhibit,
retard or stop repair
◦ Dislocation or unhealed fracture
◦ Immediately after surgery if motion
to the part will interrupt the healing
process
◦ If it makes the patient worse
◦ Usually because of muscle guarding
◦ If patient would benefit from
active exercise

Question 22

PROM precations

Answer 22

◦ If it temporarily increases pain
◦ In patients taking medication
for pain or muscle relaxants,
because the patient may not be
able to respond appropriately
and movement may be
performed too vigorously
◦ In the region of marked
osteoporosis or in conditions
where bone fragility is a factor.
◦ When it elicits undesired
muscle tone

Question 23

Normal end feel

Answer 23

full PROM at the joint, and the normal anatomy of the joint stops movement

Question 24

Abnormal end feel

Answer 24

decreased or increased passive joint ROM or when
there is normal PROM but structures other than the
normal anatomy stop joint movement.

Question 25

Normal limiting factors (end feel)

Answer 25

◦ Hard (bony) - an abrupt, hard stop. Bone contacts bone. Passive elbow extension, elbow extension ◦ Soft - when two body surfaces come together. Passive knee flexion ◦ Firm - a springy sensation that has some give when the muscle is stretched. Passive ankle dorsiflexion when the knee is in extension, hip abduction

Question 26

abnormal end feel

Answer 26

◦ Hard – OA-osteoarthritis-pop! ◦ Soft – synovitis, edema-inflammation prevents movement ◦ Firm – capsule, muscle, or ligament shortening/tightness ◦ Empty - patient requests movement be stopped, usually secondary to pain, so there is no end feel; bursitis, inflammation- stopping because it hurts

Question 27

crepetis

Answer 27

noise inside a joint

Question 28

IV Lines

Answer 28

Purpose is to either hydrate the person, administer IV antibiotics, or provide electrolytes for the patient.

Question 29

T/F If the IV pump is not flowing then the nurse should be called

Answer 29

true

Question 30

Arterial line

Answer 30

Inserted into an artery. Used to draw arterial blood, measure arterial blood pressure, deliver medication

Question 31

Swan Ganz Catheter

Answer 31

◦ Pulmonary artery catheterization. Inserted into a large vein (subclavian v., femoral v., internal jugular v.) and moved into the pulmonary artery. Use to monitor cardiac output. ◦ Precautions- Do not get anyone up with femoral line. 70 degree limit in flexion for femoral, Life threatening if pulled out, apply pressure and call for help!. Limit shoulder flexion to under 90 degrees for subcl. Limit cervical motion with jug placement.

Question 32

Hickman

Answer 32

◦ Implanted into a vein for long term placement. Used to administer meds (chemotherapy), blood collection, dialysis ◦ Precautions – limit ipsilateral shoulder movements (same side shoulder movements), BP measurements, no aquatic therapy until healed.

Question 33

Hemovac/ JP Drain

Answer 33

To drain excess fluid and blood from surgical sites. If you notice the bag is full call the nurse to have him or her empty it. When moving pt. have them hold the drain so that it does not hang

Question 34

EKG leads

Answer 34

Monitors heart electrical activity Most are now battery-powered You shouldn’t have to mess with them If for some reason a lead falls off you can either call the nurse or you can replace the lead if you feel comfortable doing so. If a telemetry patient will be leaving the nursing unit, you must notify the nurse.

Question 35

Nasogastric and Feeding Tube

Answer 35

Suctions stomach contents or allows the nurse to feed the pt. Safety pinned to the gown so that it does not come out When hooked to the suction you can either call the nurse to unhook if ordered or you will have to do PT in bed

Question 36

(PEG) Percutaneous Endoscopic Gastrostomy Tube/ feeding tube

Answer 36

Allows pt. to be fed through a skin opening into the stomach

Question 37

PEG Tube/ Percutaneous Endoscopic Gastrostomy Tube—Therapy Precautions

Answer 37

 Head of bed must be 30 degrees. If you need to reposition the patient, Nurse needs to be notified to stop PEG tube feeding otherwise patients can aspirate (food/liquid into lungs) Many patients with PEG tubes also have endotracheal tube

Question 38

Foley Catheter

Answer 38

Drains urine from the bladder. Ensure that the bag stays lower than the pt. waist. Ensure that the bag stays off of the ground. Never pull this line.

Question 39

What is the name of what is inserted into an artery and used to draw arterial blood, measure arterial blood pressure and deliver medication?

Answer 39

Arterial line

Question 40

T/F It is ok to get a patient up to a chair with a femoral Swan-Ganz Catheter.

Answer 40

False

Question 41

_____ drain excess fluid and blood from surgical sites.

Answer 41

JP drain and hemovac

Question 42

____is inserted into the stomach through the nose and suctions stomach contents and can be fed by this.

Answer 42

Nasogastric tube

Question 43

Head of the bed must be elevated 30 degrees with what?

Answer 43

PEG Tubes

Question 44

External Urinary Catheter

Answer 44

Non- Invasive catheter that draws urine away from body

Question 45

Sequential Compression Device (SCDs)

Answer 45

- The sleeve placed over a patient’s legs and applies compression to aid in venous return - Often used on surgical patients

Question 46

Oxygen

Answer 46

Keep pt. at the same rate as he or she was in bed. If you need an extension, let the nurse know.

Question 47

Chest Tube

Answer 47

Drain fluid and or blood from the chest cavity. Do not pull, if the tube displaces the pressure will not meet the needs of the lungs and the lungs will collapse. If the pt. expresses that they are having difficulty breathing, let the nurse know.

Question 48

breathing tube inserted through the nose

Answer 48

Endotracheal tube

Question 49

breathing tube inserted directly into the neck

Answer 49

Tracheostomy

Question 50

Stoma bags

Answer 50

Colostomy, ileostomy bags

Question 51

Colostomy, ileostomy bags

Answer 51

Bag for collection of fecal material from surgically created hole (stoma) in abdomen.