Acute Care, Bed Mobility, Sleep Positioning

Question 1

When teaching a patient self care in the initial treatment stages and prior to discharge the goal is to promote:

Answer 1

Self responsibility

Question 2

The five acute care steps are:

Answer 2

Find a position of comfort
Apply Ice
Take and Anti-Inflammatory
Follow the PUP Principle
Avoid Known Aggravating Activities

Question 3

The Position of Comfort is trained using the principles of positioning to ensure that the patient is ________ appropriately and that all regions of the body have no ___________ which could aggravate symptoms

Answer 3

Supported

Load or Torsional Force

Question 4

An efficient position of comfort is a position that __________ the pain and allows for a __________ after an upright position is assumed

Answer 4

Decreases or Centralizes Pain

Maintenance of this decrease or centralization of pain

Question 5

Positions of comfort can include ______, ________, __________, or ___________ positions

Answer 5

Sitting
Supine
Sidelying
Reclined

Question 6

To position in a position of comfort these three steps must be taken:

Answer 6

Position in a mid range, loose-packed, tissue tension, pain-free position
Support all areas of suspension, or unsupported areas
Support from proximal to distal

Question 7

This has been shown through clinical studies to be the most effective form of application of a modality if a patient is willing to perform it:

Answer 7

Ice Massage

Question 8

Heat is used more in cases of __________ Ice is used more in cases of ____________

Answer 8

Stiffness

Pain

Question 9

Patients should stop taking asprin or motrin if they experience any _________ or ___________

Answer 9

Stomach Discomfort

Ringing in the Ears

Question 10

Do not recommend asprin or motrin if the patient has any history of _________ or ____________

Answer 10

Ulcers

Bleeding Disorders

Question 11

A patient needs to be instructed that pain is an indication of ___________

Answer 11

Tissue damage

Question 12

A ___________ position is necessary in the initial healing stages to reduce the stress on the damaged tissues.

Answer 12

Non-Weight Bearing

Question 13

A controlled increase of appropriate stress to the damaged tissues can actually _________ healing

Answer 13

Promote

Question 14

The key to using the PUP principle is to train the patient to __________

Answer 14

Listen to their body and heed the warning of pain

Question 15

The patient should _______________ whenever the patient feels an onset of the pain related to the damaged tissues

Answer 15

Return to the position of comfort immediately

Question 16

As ___________ occurs the amount of time one can be upright between rest periods will increase

Answer 16

Healing

Question 17

The therapist needs to help the patient identify the activities which are a part of their routine and can be directly related to ___________

Answer 17

Increased pain or symptoms

Question 18

In situations where the activities that the patient do cannot be avoided the goal is to discuss with the patient how to _____________ until the acute phase of their episode is over

Answer 18

Modify the activity

Question 19

Encourage the patient that it is his/her responsibility to _________. It is the therapist’s responsibility to ________

Answer 19

Get pain free

Facilitate the process.

Question 20

The patient needs to keep accurate records of ________ and ________ so as to assist the therapist in making the right decisions about the course of treatment.

Answer 20

Aggravating activities

The course of the pain

Question 21

Sleeping surfaces should offer _______ and be easily ______

Answer 21

Support

Accessible

Question 22

If it is determined that the patient may need a new mattress, be sure to instruct the patient to:

Answer 22

First sample a firmer surface by making a mat on the floor and sleeping there one or two nights
Sample a softer surface by adding a foam topper to an existing mattress.
Test the mattress at a mattress store once knowing if the mattress needs to be firmer or softer.

Question 23

The patient should test a new mattress for at least _________ or ____________ on each of several new mattresses before deciding on the right mattress

Answer 23

30-45 minutes

A time equal to the length of the time before pain comes at night

Question 24

When testing mattresses the patient should take their own _________

Answer 24

Pillow

Question 25

Down and Down/Feather pillows offer a more ____________ with less _______ allowing the neck to fully relax

Answer 25

Conforming support | Pushing back

Question 26

Foam pillows offer more ___________ for areas such as the ____________

Answer 26

Support | Legs, hips, and arms or for the broad shouldered patient

Question 27

If a patient complains that there are too many pillows, they should be encouraged that:

Answer 27

More pillows are needed during the healing phase and most likely only one or two will be needed when the patient is fully recovered.

Question 28

If a patient complains that they move all night they should be taught how to

Answer 28

Move in bed with the supports and pillows as an exercise, such as log rolling and bed mobility exercise

Question 29

During training for sleep emphasize the the importance of the principle of ___________ and discuss the difference between a __________

Answer 29

Unloading | Support and a fulcrum

Question 30

A support is:

Answer 30

A towel, pillow, piece of foam, or any other structure or object which can be placed externally to the body and be used to unload the weight of a particular body part from proximal tissues.

Question 31

A support should not alter the ___________, just unload the weight of a body part and reduce the stress of associated structures

Answer 31

Alignment.

Question 32

A fulcrum is:

Answer 32

A pillow, towel, piece of foam, or any other structure which alters the alignment of the body to emphasize a movement in one direction or another.

Question 33

A fulcrum may be useful if placed on a particular part of the body to __________

Answer 33

Increase range of motion

Question 34

To make the use of a fulcrum more specific you should consider the _________ and _________ of the fulcrum

Answer 34

Specificity | Placement

Question 35

For kinesthetic comparative training the patient is put into their existing preferred position ________ and ______

Answer 35

First and after treatment

Question 36

The patient is placed into a new position and asked to ____________ then they are put into their original position and asked to ____________

Answer 36

Note proprioceptive and kinesthetic changes | Verbally describe the changes

Question 37

The physiological principle behind KCT technique is _________

Answer 37

Accommodation.

Question 38

It is more effective to use KCT to teach a new position because the patient will recognize the ______

Answer 38

Differences

Question 39

The three principles of positioning are:

Answer 39

Position in a mid-range, loose-pack, tissue tension, pain-free position Support all areas of suspension, or unsupported areas Support from proximal to distal.

Question 40

When laying in side-lying a _______ is placed under the waist to keep the __________ in a loose packed position

Answer 40

Folded towel | Lumbar spine

Question 41

Pillows are used to reduce the force of __________ in the cervical spine

Answer 41

Lateral shear

Question 42

When positioning in side lying too much weight on the lower shoulder is often a sign that there is insufficient support at the ___________

Answer 42

Head and neck.

Question 43

When laying in supine pillows should support from the ____________ down to the __________ if possible to support the lumbar spine and pelvis

Answer 43

Ischial Tuberosities | Ankles

Question 44

A ___________ can be used instead of a pillow when laying in supine to support the head during exercise classes or beach lounging

Answer 44

Scrunched towel.

Question 45

The 11 acute care exercises and 1 bonus exercise are:

Answer 45

``` Log rolling Functional Hip Release Diaphragmatic Exercise Hands and Knees Supine over Prop Pelvic clock Lateral shear in side-lying Prone knee bend, unilateral and bilateral Prone press up segmentally Extension in standing Extension with distraction and flexion with distraction Bonus: bracing ```

Question 46

__________ is used to train mobility in bed and should be practiced every night before going to sleep to encourage an automatic, appropriate rolling response while sleeping

Answer 46

Functional rolling.

Question 47

__________ is a feldenkrais based exercise that focuses on motor control and results in increased ROM as well as better awareness of the hip joint

Answer 47

Functional Hip Release

Question 48

Hands and knees is modified to focus on isolated segments of dysfunction through __________

Answer 48

Weight shift.

Question 49

These two exercises can be performed over a prop to progress the supine over prop exercise

Answer 49

Diaphragmatic breathing or pelvic clock.

Question 50

This exercise should be taught very early on in the course of treatment

Answer 50

Basic Bracing

Question 51

Always reinforce the ________________ of the patient for their home program

Answer 51

Self responsibility role.

Question 52

The patient should be taught to ___________ to assume hook lying when they are in the acute stage of their condition

Answer 52

Press their feet into the table

Question 53

Principles of mobility in bed are there to encourage patients to improve their______

Answer 53

ACE

Question 54

The five activities taught to an acute patient for bed mobility include:

Answer 54

``` Assisted Rolling Self Assisted Bridging Up From Sidelying Up From Supine Up From Prone ```

Question 55

In assisted rolling the leg on the ______ side of the roll is pressed into the mat

Answer 55

same

Question 56

in assisted rolling the leg on the _______ side of the roll is brought to the chest to push into for the roll

Answer 56

opposite

Question 57

The hand on the ________ side as the raised leg is used to assist rolling and is placed on the _______ of the raised knee

Answer 57

same, outside

Question 58

When rolling from sidelying to supine the patient places the ______ hand on the _________ of the knee

Answer 58

upper hand, medial side of the knee

Question 59

When self assisting bridging the patient _______ his or her thighs and pushes ______ while squeezing the ______

Answer 59

tractions, out, gluts