GI, Renal, Endocrine, Immuno, Integumentary Disorders Flashcards Preview

COTA Clinical Conditions > GI, Renal, Endocrine, Immuno, Integumentary Disorders > Flashcards

Flashcards in GI, Renal, Endocrine, Immuno, Integumentary Disorders Deck (29):
1

Facial Paralysis
Swallowing Disorders

Incomplete closure of the mouth
Loss of the bolus out of the front of the oral cavity

2

Praxis/Motor Planning
Swallowing Disorders

Inability to effectively chew and coordinate tongue movements to propel bolus toward the base of the tongue

Difficulty forming a bolus with smoother consistencies

3

Sensory Impairment
Swallowing Disorders

Lack of awareness of residual food on the side of mouth that has decreased sensation
Pocketing of food
Spillage of residual food into the airway

4

Clinical Aspiration

Food enters the airway

1. Person clears airway by coughing

2. Silent aspiration
a. bolus enter lungs, person does not react
b. bolus enter lungs, person has respiratory distress w/o a cough
c. person cough too weak to expel bolus

5

GERD

Structures involved include lower esophagus and gastric sphincter

Complications
Heartburn/indigestion, feeling that food is "stuck" in throat, chest pressure/pain, regurgitation after swallowing, increased mucus procution

Intervention
Sleeping w/1+ pillows
Medication
Diet Mod- less spice. smaller, more freq meals
Stress Management

6

Small Bowel Obstruction

2nd to scar tissue. 2nd to radiation of abdomen. result of tumor obstruction

Rehab Issues
Decrease mobility of gross movements that cause traction on the healing scar (bending, stooping, LE self-care).

7

Neurogenic Bowel

Sympathetic nerve impairment, generally occurring in persons with SCI above T6. Causes:

Loss of control of anal sphincter, sensory loss, or flaccidity/hypotonicity resulting in bowel incontinence

Autonomic dysreflexia

8

Autonomic Disreflexia
Prevention/Management

Prevention
Pressure relief training
Intermittent catheterization
Diet
Education

Management
Id stimulus and relieve issue
Medication, if no impact is made

9

Kidney Disease
Risk Factors and Stages

Risk Factors
Diabetes
Hypertension
Lupus

Stage 1- Kidney damage w/normal (90 or above) glomerular filtration rate (GFR)

Stage 2- mild decrease in GFR (60-89)

Stage 3- mod decrease in GFR (30-59)

Stage 4- severe decrease in GFR (15-29)

Stage 5- GFR less than 15; end stage

10

Kidney Disease Impact on Performance Skills

Motor- muscle pain; edema limiting mobility; weakness

Sensory- neuropathy; vision loss

Cognitive- alteration of body image; delusions do to sepsis; dementia

Neurobehvioral- dementia; stroke related

Psychological- anxiety disorder; depression; mood disorder

11

Cancer
Risk Factors, Stages, Treatment

Risk Factors- heredity; smoking/using tobacco products; obesity/high-fat diets; environmental/chemical pollution

Stages
I- tumor
II- localized spread of tumor
III- spread to other organs
IV- inoperable primary lesion

Treatment
Surgery, chemotherapy, radiation, immunotherapy

12

Scleroderma

Rheumatic, connective tissue disease associated with impaired immune response. Two types:

1. Limited
Skin involvment (w/good prognosis)
Linear scleroderma (bands of thicker skin, w/good pronosis)

2. Systemic
Systemic scleroderma of internal organs (life-threatening)
CREST syndrome w/good prognosis

13

Scleroderma Intervention

1. Raynaud's Phenomenom
Keep fingers/toes warm; dress in layers; medication; biofeedback; skin inspection; activity mod to prevent trauma

2. Fibrosis of Skin
Protective gloves (cotton, insulated, mildly compressive); meds

3. Myositis
Cessation of exercise; meds

4. Contractures
Splinting (slow progressive dvlpmnt of contractures)
Use of silicone gel in palms
Electrical/mechanical vibration

5. Facial disfigurement/Body image
"Look good/feel" better programs
Support groups

6. Neurorehabilitation and biomechanical approaches indicated for thoracic spinal lesions

14

HIV/AIDS
HIV Stages and Interventions

Stages
I- Acute infection: flu-like response to initial contact
II- Asymptomatic
III- Symptomatic
IV- AIDS: severely compromised

Complications
Enlarged lymph nodes, fatigue, wt loss, general malaise, fever, diarrhea, lack of energy.
Cognitive Impairment
Affective changes
Sensory changes
Visual impairments
Myelopathy
Peripheral neuropathy
ADL impairments

Interventions
Nutrition Education
Alternative medicine techniques
Energy conservation
Positioning
Adapted equipment
Consideration of psychosocial stress

15

Acute Hospitalization
Rehabilitation for Immunological Disease

Early mobilization
Preservation of function
Psychological/emotional support
Positioning
Prevention of long-term disease

16

Inpatient Rehab
Rehabilitation for Immunological Disease

Self-care, basic ADL
IADL
Energy conservation and work simplification
Activity/Exercise tolerance
Achievement/maintenance of quality of life
Role adjustment
Community reintegration

17

Home Care
Rehabilitation for Immunological Disease

Restoration of functional ability
Restoration of activity/exercise tolerance
Community mobility

18

Community-Based Care
Rehabilitation for Immunological Disease

School Related
Transition from home school

Work Related
Participatory as per Americans with Disabilities Act (ADA)

19

Complications of Diabetes

Fatigue
Urinary disturbance
Visual loss, low vision
Peripheral neuropathy
Propensity to develop wounds
Poor general health/increased infections
Hypoglycemia
Hyperglycemic crisis

20

Hypoglycemia

Symptoms include vagueness, dizziness, tachycardia, pallor, weakness, diaphoresis, seizures and/or coma

If person is conscious, immediately provide with carbs in the form of hard candy, fruit juice, or honey.

If unconscious, call for emergency care

21

Hyperglycemic Crisis

Ketoacidosis: signs include dehydration, rapid/weak pulse, and acetone breath

Hyperosmolar coma: signs include stupor, thirst, polyuria, and neurologic abnormalities

Call for emergency services

22

Diabetes Rehab

Preventive exercise
Ed on compliance
Psychological support
Lifestyle adjustment (low vision, safety, physical adaptions)
Peripheral neuropathy (safety, sensory loss ed, skin care/inspection, pain mngmnt, ae)

23

BMI

25-29.9- Overweight
>30- Obese
>40- Morbidly obese

24

Lyme Disease
Symptoms

Early Symptoms
Fatigue
Headache
Fever and chills
Muscle/joint pain
Swollen lymph nodes
Rash- circular, red patch(resembling a bulls-eye) appearing 3d-1mo after bite; in groin, thigh, trunk, armpits

Late Symptoms
Arthritis
Nervous Sys Abnormalities (numbness, pain, Bell's palsy, Meningitis)
Heart rate irregularities

25

Lyme Disease Rehab

Joint pain/swelling- rest; anti-inflammatory med; splinting/wrapping to protect inflamed joints; energy conservation

Nervous Sys Abnormalities
Numbness- safety assessment/intervention; mngmnt of aesthesias perceived as pain; occupation-based act to preserve func

Pain- PAMs; stress mngmnt; adaption of activites

Bell's Palsy- facial splint to prevent long-term asymmetry; electric stimulation of denervated muscles; use of fingers to assist with buccal closure and prevent spillage of bolus

Meningitis- Acute: positioning, splinting, supportive care

Heart Rate Irregularities- work simplification, adapt, mod

26

Decubitus Ulcers Stages

I: redness, edema, superficial epidermis and dermis involved. reversible w/intervention

II: redness, edema, blistering and hardening of tissue; skin is open and inflammation extends to the fat layer with superficial necrosis. partial thickness

III: a full thickness skin lesion extending down to muscle

IV: extends to the bone and includes bone destruction

27

Heat Syndromes
Types, Signs, Symptoms

Heat cramps- norm body temp, nausea, diaphoresis, muscle twitching/spasms, weakness, and/or severe muscle cramps

Heat exhaustion- rapid pulse, decreased b/p, nausea, vomitting, cool pallid skin, mental confusion, headache, and/or giddiness, but no fever

Heat stroke- hot dry red skin, body temp >104, slow deep respiration, tachycardia, dilated pupils, confusion, progressing to seizures and possibly loss of consciousness

28

Heat Syndromes
Interventions

Heat stroke is a medical emergency and hospitalization is req.
1. Immediately call emergency medical services
2. Lower person's temp using ice packs on arterial pressure points
3. Hypothermia blankets, IV, and meds

Heat cramps and heat exhaustion usually don't req hospitalization.
1. Loosen clothing and have person lie in cool place
2. Replace fluids and electrolytes with salt tabs and electrolyte drink
3. Massage muscles if cramps are severe
4. IV and O2 may be need if severe

29

Pain Management for LE Burns

providing vascular support before standing decreases blood pooling in the lower extremity and therefore decreases pain in standing and ambulation.

The client should learn an alternative strategy to manage pain early on in the intervention.