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(3) PT in Special Conditions > S1L2: Medical Management, PT Assessment & Intervention > Flashcards

S1L2: Medical Management, PT Assessment & Intervention Flashcards

1
Q

Long term goal vs. Immediate goal

● Prevent infection
● Decrease pain
● Prepare wounds for grafting
● To restore skin integrity, function, and appearance
● Prevent contracture and scarring
● Maintain strength and function

A

All are immediate goal except for: To restore skin integrity, function, and appearance

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2
Q

T/F: Goal for acute: immobilization or positioning until pt is stabilized

A

True

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3
Q

GOAL: To remove dead tissue, prevent infection, and promote revascularization/reepithelialization

A

wound cleansing

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4
Q

used to help reduce the number of bacteria. Excess bacteria may lead to problems in healing

A

topical antibacterial agents

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5
Q

Modified T/F: Acute Mx
a. Includes Fluid replacement, TBSA
b. Proper positioning for optimal joint placement is not part of acute mx as this should be part of the rehabilitation process later on

A

TF

B - Proper positioning for optimal joint placement is part of Acute MX

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6
Q

Common Topical Medications used in Treatment of Burns

1.Enzymatic debriding agent selectively debrides necrotic tissue
2. effective against gram-positive organisms
3. Maintains moist environment

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A
  1. e
  2. d
  3. c
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7
Q

Common Topical Medications used in Treatment of Burns

1.effective against gram-negative or gram-positive organisms
2. Most commonly used anti-bacterial agent;
3. Topical solution with antimicrobial function against gram-positive and gram negative organisms

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A
  1. b
  2. a
  3. c
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8
Q

Common Topical Medications used in Treatment of Burns

  1. Antiseptic germicide
    and astringent
  2. will penetrate only 1-2mm of eschar; useful for surface bacteria; stains black
    3.no antibacterial action

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A
  1. c
  2. c
  3. e
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9
Q

Common Topical Medications used in Treatment of Burns

  1. Bland ointment
  2. effective against Pseudomonas infections
  3. diffuses easily to eschar

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A
  1. d
  2. a
  3. b
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10
Q

Common Topical Medications used in Treatment of Burns

White cream applied with sterile glove 2-4mm directly to wound or impregnated into fine mesh gauze

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

A

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11
Q

Common Topical Medications used in Treatment of Burns

White cream applied directly to wound with thin 1-2mm layer 2x daily; may be left undressed or covered with thin layer of gauze

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

b

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12
Q

Common Topical Medications used in Treatment of Burns

50-gram packet of white powder that is mixed with either 1000mL sterile water or 0.9% sodium chloride soaked gauze

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

c

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13
Q

Common Topical Medications used in Treatment of Burns

Dressings or soaks used every 2 hours; also available as small sticks to cauterize small open areas.

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

c

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14
Q

Common Topical Medications used in Treatment of Burns

Thin layer of ointment applied directly to wound and left open

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

d

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15
Q

Common Topical Medications used in Treatment of Burns

Ointment applies to eschar and covered
with moist occlusive dressing with or
without an antimicrobial agent.

a. Silver Sulfadiazine
b. Mafenide acetate (sulfamylon)
c. Mafenide acetate solution (sulfamylon
5% solution) silver nitrate
d. Bicitracin/ Polysporin
e. Collagenase, accuzyme

A

e

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16
Q

Modified T/F:

A. Open technique refers to applying a topical cream or ointment with
dressings
B. It allows for ongoing inspection of the wound and examination of the healing process.

A

FT

A. With or WITHOUT DRESSINGS (usually without)

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17
Q

T/F: In open technique, topical medication must be reapplied throughout the
day

A

True

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18
Q

Modified T/F:

A. Closed technique refers to applying dressings over a topical agent
B. Open technique is better for interventions like exercises

A

TF

B - Closed technique is Better for interventions like exercises in order to keep the wound closed.

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19
Q

T/F: Purpose of closed technique includes:
○ Hold topical antimicrobial agents on the wound
○ Reduce fluid loss
○ Protect the wound

A

True

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20
Q

In closed technique, dressings are changed [] to [] a day

A

once to twice

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21
Q

Arrange the layers in CLOSED TECHNIQUE from the innermost to outermost

Gauze or elastic bandage
Non-adherent
Cotton padding
Elastic wrap/gauze
Roller gauze

A

○ 1st - Non-adherent
○ 2nd - Cotton padding
○ 3rd - Gauze or elastic bandage
○ 4th - Roller gauze
○ 5th - Elastic wrap

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22
Q

Procedure of putting viable tissue over the area wherein
the burn is extensive/deep

A

Grafting

23
Q

Identify the types of graft

○ Patient’s own skin, taken from an unburned area
○ Permanent coverage of the wound

A

Autograft

24
Q

Identify the types of graft

Taken from cadaver of own species (humans)

A

Homograft/Allograft

25
Q

Identify the types of graft

from Non-human (Pigs, tilapia)

A

Heterografts/Xenografts

26
Q

T/F: ROM is important in all phases of burns d/t contractures or improper
positioning

A

True

27
Q

T/F: you can perform break test MMT in acute conditions

A

False better to perform FMT

28
Q

T/F: You can do sensory testing in acute conditions

A

False, only chronic

29
Q

% TBSA Classification is under what heading?

A

Wound Ax

30
Q

T/F: You should perform cardiopulmonary assessment in burn patients

A

True. Poor cardiopulmonary condition may lead to decreased endurance and lead to difficulty when providing the pt c functional tasks

31
Q

T/F: Anthropometric measurement is not important because edema is not present in any forms of burns

A

False Some forms of burns present c edema

32
Q

T/F: PA & GA won’t be done if condition is still acute

A

True

33
Q

Give 2 Burn Outcome measures

A

○ Burn Specific Health Scale-Brief (BSHS-B)
○ Burns Scar Index (Vancouver Scar Scale)

34
Q

T/F: PTDx includes classification of burn injury, % TBSA and Severity of burn

A

True

35
Q

Risk Factors vs. Barriers

  1. Burn injury occurred at work
  2. In patient rehab
  3. longer stay at hospital
  4. wound issues
  5. neurologic problems
A
  1. R
  2. R
  3. R
  4. B
  5. B
36
Q

Risk Factors vs. Barriers

  1. Preburn psychiatric history
  2. Physical abilities, impaired mobility
  3. Extremity burns
  4. Physical abilities, impaired mobility
  5. Electric etiology
  6. Psychosocial factors
  7. Working conditions (temperature, humidity, and safety)
A
  1. R
  2. B
  3. R
  4. B
  5. R
  6. B
  7. B
37
Q

Initial intervention to prevent contracture formation

A

Positioning

38
Q

SPLINTING
○ General Indications:
■ Facilitate proper []
■ Prevention/reduction of joint []
■ Protecting skin [] or fragile []
■ Assisting desired motions

A

SPLINTING
○ General Indications:
■ Facilitate proper positioning
■ Prevention/reduction of joint contracture
■ Protecting skin grafts or fragile wounds
■ Assisting desired motions

39
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Anterior neck
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Anterior neck
Common deformity: Flexion
Motions to be stressed: Hyperextension

40
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Shoulder-Axilla
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Shoulder-Axilla
Common deformity: Adduction and
internal rotation
Motions to be stressed: Abduction,
flexion, and external rotation

41
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Elbow
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Elbow
Common deformity: Flexion and pronation
Motions to be stressed: Extension and supination

42
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Hand
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Hand
Common deformity: Claw hand (intrinsic minus)
Motions to be stressed:
Wrist extension
MCP flexion,
proximal IP and distal IP extension;
thumb abduction

43
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Hip and Groin
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Hip and Groin
Common deformity: Flex and ADD
Motions to be stressed: All motions esp EXT and ABD

44
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Knee
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Knee
Common deformity: Flex
Motions to be stressed: Ext

45
Q

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Ankle
Common deformity:
Motions to be stressed:

A

POSITIONING STRATEGIES FOR COMMON DEFORMITIES

Ankle
Common deformity: PF
Motions to be stressed: All motions expecially DF

46
Q

T/F: Suggested Approaches

Anterior neck >
Use double mattress
position neck in flexion;
with healing use rigid cervical orthosis

A

False - position neck in EXTENSION

47
Q

Suggested Approaches

SH-Axilla >
Position with shoulder [] and [] (airplane splint)

A

Position with shoulder flexed and abducted (airplane
splint)

48
Q

Suggested Approaches

Elbow >
Splint in []

A

extension

49
Q

T/F: Suggested Approaches

Knee > Anterior knee splint

A

False - posterior

50
Q

T/F: Suggested Approaches

Ankle > Plastic ankle-foot
orthosis with cutout
at Achilles tendon
and ankle positioned
in neutral

A

True

51
Q

T/F: Suggested Approaches

Hip > Hip neutral (zero
degrees of flexion/extension), with slight adduction

A

False - slight degree of ABDuction

52
Q

T/F: Suggested Approaches

Hand >

Wrap fingers separately.

Elevate to decrease edema.

Position in intrinsic plus position

A

True

53
Q

Suggested Approach: Hand

Position of intrinsic plus:
Wrists =
MCP =
Proximal IP =
Distal IP =
Thumb =

A

wrist in extension,
MCP in flexion,
proximal IP and distal IP in extension, thumb in abduction with large web space

(3) PT in Special Conditions (40 decks)

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