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AT 510 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Contraindications for electrotherapy

A
  1. Demand type cardiac pacemaker
  2. Cardiac arrhythmia
  3. Over the carotid artery
  4. Hypersensitive patients
  5. Pregnancy
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2
Q

Precautions for electrotherapy

A
  1. Check equipment: leads, power cord, electrodes
  2. Change intensities slowly
  3. Always turn down intensity before changing other parameter controls
  4. Avoid concentrations of current (skin cuts, creases in electrode pads, poor contact of electrodes)
  5. Avoid dispersal of current (gel smeared outside the electrode area)
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3
Q

Precautions for Iontophoresis

A
  1. electrode burn

2. adverse drug reaction

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4
Q

Two main types of drugs used for Iontophoresis

A
  1. Lidocaine (pain killer) +

2. Dexamethasone (anti-inflammatory) -

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5
Q

Other drugs used in Iontophoresis

A
  • Magneisum + ( muscle relaxant, vasodilator)
  • Calcium + ( spasmodic conditions, tics)
  • Chlorine - (scar tissue, burns)
  • Actate -
  • Ringer’s solution +/- (decubitus lesions)
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6
Q

CPM Indications

A
  • to reduce blood/fluid accumulation in and around joints following trauma/surgery
  • maintain motion following injury or surgery
  • prevent stiffness following injury or surgery
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7
Q

CPM Contraindications

A
  • if ligaments are insufficient
  • joint stability
  • if fracture fixation has not been attained
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8
Q

CPM Precautions

A
  • may increase wound drainage
  • wound swelling could risk incision healing (swollen incision = milk extra fluid before beginning)
  • do not have circumferential dressings in place when using CPM (can cause abrasions
  • check position often to prevent pressure nerve palsies
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9
Q

CPM Treatment time

A

continuous except for bathroom breaks

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10
Q

CPM Length of Treatment

A

7-10 days, although may be used for 21-30 if needed

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11
Q

CPM Positioning

A

to maintain proper axes of motion

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12
Q

CPM arc of motion

A

establish per surgeon

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13
Q

TENS

A

transcutaneous electrical nerve stimulation

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14
Q

TENS waveform

A
  • monophasic
  • biphasic
  • polyphasic
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15
Q

TENS amplitude

A
  • large myelinated fibers requires less than small diameter unmyelinated fibers
  • distant fibers more current than local fibers of the same size
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16
Q

TENS pulse duration

A
  • 50-200
  • brief for larger diameter myelinated fibers
  • long for small unmyelinated fibers
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17
Q

TENS Frequency

A

1-150 Hz

  • sensory fibers fire at higher frequency, pain fire at lower frequency
  • bombards CNS with different frequency
  • frequency and pulse width are related
  • higher frequency correlates to smaller pulse width
18
Q

TENS accommodation

A
  • negative charge inside the cell
  • slower change in voltage = balanced voltage which we don’t want
  • vary frequency and intensity to minimize accommodation
19
Q

TENS accommodation prevention

A
  • increase voltage faster than the cell can equalize voltage
  • units will have different modes
    • burst
    • modulation
    • SMP
    • continuous
20
Q

TENS use

A
  • electrode pads
  • 2 channels
  • lead wires
  • batteries
  • unit: TENS only, or combo units that have IFC, NMES, and TENS
21
Q

Conventional TENS

A 
Frequency: 40-100Hz
Pulse Width: <200 
Amplitude: between initial perception and discomfort
Duration: indefinite
Time: 2-4x/day, 10-30 mins each session
Best for ACUTE pain
Gate control
22
Q

Low Frequency TENS

A

Frequency: 1-5Hz
Pulse Width: 300-400
Amplitude: produce a visible twitch w/in pain tolerance
Duration: 30-45 mins due to muscle fatigue
Time: 2-3x/day, at least 30 mins per time
Best for Chronic pain
endorphin action
- delayed yet long lasting relief

23
Q

TENS hyperstimulation

A

pulsed biphasic
Frequency: maximum setting
Pulse: maximum setting
Amplitude: pain tolerance
Duration: 15 mins, followed by 2-3 min rest, can repeat 2-3 times
- used when wanting quick and long lasting relief but at a cost of painful application

24
Q

TENS electrode placement

A
  • bracket pain
  • acupuncture points
  • dermatome
  • spinal cord levels
  • skin irritation from pads
  • areas of decreased sensation
25
Q

TENS considerations

A
  • pt. may reduce pain medications to monitor effectiveness
  • not in our scope to change medication, has to be doc
  • 32% placebo effect
  • pain questionnaire
26
Q

TENS contraindications

A
  1. Demand type cardiac pacemaker
  2. Cardiac arrhythmia
  3. Over the carotid artery
  4. Hypersensitive patients
  5. Pregnancy
27
Q

TENS Precautions

A
  • areas of decreased sensation have remote potential for burns
28
Q

TENS Indications

A
  • diseases that damage tissue (cancer, RA)
  • pain is the only problem
  • sympathetically maintained pain (edema, skin changes, temperature changes)
  • myofacial pain
  • pt. looking for secondary gain (psychosocial yellow flags), they get more from being in pain
29
Q

Laser Contraindications

A
  • don’t treat tumors or cancerous lesions
  • pregnancy is a precaution for legal reasons
  • don’t apply over thyroid gland due to selective uptake of energy by iodine
  • do not treat bacterial infections
  • pts. who are on immunosuppressant drugs
  • if pt. starts to feel pain/weakness
  • pt. who are taking medications (retain-a), warned to avoid bright sunlight
30
Q

Laser Precautions

A
  • do not look at the beam or allow pt. to do so
  • have a “danger laser” sign at the treatment room door
  • turn the laser off before removing it from the skin
  • pt./PT should wear protective safety goggles
  • do not treat until 2 weeks after steroid injection
  • be careful over tattoos (dyes my become hot)
  • use care w/children due to sensitive skin
31
Q

Laser Pretest

A

safest to perform a skin test initially with 10-25 joules on the arm or leg
- wait 5 minutes and if no adverse reactions, pt. may be treated.

32
Q

Laser Treatment Acute

A

treated 2-3 times per week

33
Q

Laser Treatment Chronic (subacute)

A

treated 2 times/week initially and then decreased to 1 x per week

34
Q

Laser Initial treatment power

A
  • children 12 and younger should be started at 25J or less
  • pt. w/serious systemic diseases or chronic woulds or pain should also be started at 25J or less
  • healthy adults should be started at 50J or less
35
Q

Laser Treatment Progression

A

each successive treatment should increase power no more than 50% of the previous treatment

36
Q

Laser Maximum Dosage

A

Children: 50J
Adult: 200J

37
Q

Laser signs of appropriate dosage

A
  • warm/tingling sensation
  • improvement in functional capacity
  • decreased tenderness
38
Q

Laser symptoms of Excessive treatment

A
  • pt. fatigue, nausea or headache
  • increased symptom severity
  • muscle spasm in treated area
39
Q

Laser calculation of treatment time

A
  • based upon the pt. category (child, adult)
  • which treatment and progression
  • probe output
  • 0.5in/sec = head speed
40
Q

Laser History

A
  • developed in the 1960s

- promotes healing

41
Q

Laser wavelength

A

best range is 600-900nm

  • below 600nm is dangerous for causing cell damage
  • above 900nm the energy is absorbed so quickly that heating occurs which can damage
42
Q

Laser penetration depth

A

in proper 600-900nm frequency range laser may penetrate to 3-6 cm

AT 510 (3 decks)

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