9/18d Movemet System Screening Lab (Examination, Evaluation, Intervention) Flashcards Preview

Unit 1 > 9/18d Movemet System Screening Lab (Examination, Evaluation, Intervention) > Flashcards

Flashcards in 9/18d Movemet System Screening Lab (Examination, Evaluation, Intervention) Deck (22)
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1
Q

Part 1:

A

History

  1. Obtain the following information:
    - Age
    - Chief Complaint
    - Lab Results
    - Diagnosis (Dx)
    - Past Medical History (PMH)
    - Medications
    - Social
    - Referral
  2. Create a hypothesis about the situation based on medical history and the movement system ornament. Determine the prospective goal and activity for treatment
  3. Plan tests and measures to confirm hypothesis, determine what you need to bring with you
  4. Systems Review of the following: Cardiovascular pulmonary (CVP), Integumentary (Integ), Musculoskeletal (MSK), Neuromuscular (NMS), Communication/Cognition, Pain, SAFETY FIRST
2
Q

Hard stops during the systems review

A

if something is out of range of what you would have expected

  • acute distress = hyperventillating, profuse sweating
  • elevated HR
  • evaluate vitals
3
Q

How do you analyze integument during systems review

A
  • Skin/wounds clean and dry > no > continue with increased safety concerns AND discuss with nursing staff
  • Skin/wounds clean and dry > yes > continue with screen
4
Q

How do you analyze MSK during systems review

A

Ask yourself if there is adequate strength & ROM to get OOB:

  • No, <3 -> Proceed with in-bed activities that are safe OR Get additional help/be prepared to provide assistance
  • Yes, >3, <4 -> Guard closely
  • Yes, strong against gravity -> continue with screen
5
Q

How do you analyze NMS during systems review

A
  1. Adequate Motor control to get and remain OOB?
    - No > Proceed with in-bed activities that are safe OR Get additional help/be prepared to provide assistance
    - Yes, but unsteady at low levels > provide additional support/assistive device
    - Yes > continue with screen
  2. Adequate Sensory info for function?
    - No > provide additional support/assistve device
    - Yes > continue with screen
6
Q

How do you analyze communication/cognition during systems review

A

Alert and grossly oriented?

  • Impaired > Consult with medical team OR continue with increased safety concerns
  • OK > continue with screen
7
Q

How do you analyze pain during systems review

A

pain level?

  • unexpected and incapacitating > consult with medical team
  • Expected and tolerable > continue with screen
8
Q

Common Elements for safety assessment

A
  • Hemodynamics (approp measures)
  • Integument (observation)
  • MSK (define muscles and how)
  • NMS (which tests and how)
  • Communication and Pain (questions and observations)
9
Q

CVP Screening elements

A

BP
RR
HR

10
Q

MSK Screening

A

perform MMT sitting and supine for LE

perform force and motion screening for UE

11
Q

NMS Screening

A

Sitting - ability to maintain posture, reaching (feedfoward), response to push (feedback)
Standing - ability to maintain posture, reaching or weight shift (feedforward), walking
-If warranted by history, light touch and proprioception screens

12
Q

activities most interested in screening?

A
  • rolling
  • lying to sitting
  • sitting
  • sitting to standing
  • walking
13
Q

Basic requirements for rolling

A
  • some amount of LE movement against gravity
  • some amount of 1 UE movement
  • Head and neck control
  • trunk control
14
Q

When do you know it’s safe to proceed with rolling?

A

Rolling

  1. Impaired
    - Control
    - Amount of Movement > examine strength and ROM in limited areas
    - Speed of Movement
    - Symmetry of Movement > examine strength and ROM in limited areas
    - Symptom provocation > examine sub-components of motion for pain
  2. Not Impaired > continue with screen
15
Q

Basic requirements for lying to sit

A
  • Head and neck control
  • UE strength in 1 arm
  • Trunk Strength
  • LE Control
16
Q

When do you know it’s safe to proceed with lying to sit?

A

Lying to Sit

  1. Impaired
    - Control
    - Amount of Movement > examine strength and ROM in limited areas
    - Speed of Movement > May lead to further exam of pain or vitals
    - Symmetry of Movement
    - Symptom provocation > examine sub-components of motion for pain OR measure vitals again
  2. Not Impaired > continue with screen
17
Q

Basic requirements of sitting

A
  • head control
  • trunk control
  • UE Strength (if poor trunk control)
18
Q

Basic requirements of sit to stand

A
  • UE Strength
  • LE Strength
  • Motor Control
19
Q

When do you know it’s safe to proceed with sit to stand?

A

Sit to Stand

  1. Impaired
    - Control > examine???
    - Amount of Movement > examine strength and ROM in limited areas
    - Speed of Movement > May lead to further exam of pain or vitals
    - Symmetry of Movement
    - Symptom provocation > examine sub-components of motion for pain OR measure vitals again
  2. Not Impaired > continue with screen
20
Q

Basic requirements of walking

A
  • LE Strength

- Motor control

21
Q

When do you know it’s safe to proceed with walking?

A

Walking (ITE)

  1. Impaired
    - Control > examine???
    - Amount of Movement > examine strength and ROM in limited areas
    - Speed of Movement > May lead to further exam of pain or vitals
    - Symmetry of Movement > May lead to examination of pain or weakness
    - Symptom provocation > examine sub-components of motion for pain OR measure vitals again
  2. Not Impaired > continue with screen
22
Q

what do you do in a normal acute care case?

A
  • History
  • Plan
  • Screen
  • Re-Plan

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