Skills 110 Finals Written Exam Flashcards

Question

All of the following are factors that affect body temperature except: Drinking hot tea 15 minutes before having body temperature measured Age Time of day Cardiopulmonary disease

Answer 1

cardiopulmonary disease

Answer 2

Pain is always abnormal and can be a valuable indicator of a serious problem.

Answer 3

Arm position is not important when measuring blood pressure.

Answer 4

poor circulation

Answer 5

Pulse 71, BP 117/70, RR 14

Answer 6

1. Infectious agent 2. Reservoir for organism 3. Method of exit 4. Method of transmission 5. Method of entry into a new host 6. Susceptible host

Answer 7

◦ Direct – body to body surface contact ◦ Indirect – contact with an intermediate object

Answer 8

◦ Result of coughing, sneezing, suctioning, etc ◦ Particles can travel about 3’

Answer 9

◦ Small particles can be widely dispersed and suspended in air for long periods of time ◦ About 6’ travel – hence “6 feet rule” for social distancing

Answer 10

* Gloves * Gown maybe * Private room preferred * Dedicated equipment if possible

Answer 11

* Shield, * Mask * Gloves * Gowns often needed * private room prefered

Answer 12

* mask (K2 or N95 mask) * Private room with negative air pressure * Particulate respirator no visitors :(

Answer 13

-gown -gloves -mask and respirator (K2 or N95 mask) no visitors :(

Answer 14

airborne + contact

Answer 15

All of the abover

Answer 16

Infectious agent Reservoir for organism Method of exit Method of transmission Method of entry into a new host Susceptible host

Answer 17

direct and indirect

Answer 18

concept of designing building that is usable by all without the need for adaptation. -----ADA enforced compliance with Standards for Accessible Design

Answer 19

36” clear width for wheelchair 60” clear turning diameter for turning a wheelchair 15” to 48” forward reach 9” to 54” side reach 28” to 34” high table and counter tops 32” to 34” wide for doorways 34” to 38” for handrails 33” to 36” for grab bars

Answer 20

All controls, door handles, etc. operable with a fist 32-34"

Answer 21

◦ 1:20 path of travel maximum slope for outside ramps ◦ For every inch of height, there are 20 inches of ramp length ◦ 1:12 ramps for minimum ramp grade ◦ For every inch of height, there are 12 inches of ramp length ◦ At least 36” wide

Answer 22

Blue square sign with a person in a wheelchair.

Answer 23

Ban discrimination based on disability Remove employment and access barriers Improve opportunities for employment Designate transportation access

Answer 24

Designate transportation access to limited modes of transportation

Answer 25

Creating a building accessible and free of barriers for people of all ages

Answer 26

Toilet grab bars placed horizontally at least 50 inches from the floor ----requirement for grab rails is 33-36"

Answer 27

Availability to neighbor's house

Answer 28

"She is wheelchair bound at this time."

Answer 29

Inhale during exertion

Answer 30

Anterior pelvic tilt

Answer 31

The CoM never changes position.

Answer 32

 Result of prolonged pressure on tissue caught between 2 firm surfaces such as a bony prominence and the seat of a chair  When pressure is applied to an area, the circulation is decreased and the tissues do not receive the amount of oxygen or nutrients that they need.

Answer 33

Back of head, shoulder, elbow, buttocks, heel areas prone to ulcers; prone or supine-----back of the head, shoulder, elbow, ribcage, hip, buttock, leg knees, heel, toe, scapula, sacrum

Answer 34

Necrosis or Necrotic

Answer 35

* Proper positioning * Keep skin dry and clean * Keep bed linens wrinkle free * Frequent skin inspections * Minimize friction/shearing when moving patient * High protein diet * Adequate hydration *Use of pressure reducing devices

Answer 36

"Her inability to move independently makes her more vulnerable to skin breakdown." -might be wrong idk

Answer 37

Shortening or tightening of soft tissue that prevents normal movement

Answer 38

Great trochanter

Answer 39

All of the above.

Answer 40

Circulation or respiratory impairments

Answer 41

1. False 2. True 3. False 4. False 5. True 6. False

Answer 42

◦ Level 4 – Total dependence ◦ Level 3 – Extensive assistance ◦ Level 2 – Limited Assistance ◦ Level 1 – Supervision ◦ Level 0 - Independent

Answer 43

Hoyer, 2 person lift, squat-pivot, use of draw sheet

Answer 44

Used when patient is unable to stand or use a sliding board

Answer 45

Dependent (100%) Maximum assistance (max.) (>50%) Moderate assistance (mod.)(25%-50%) Minimum assistance (min.)(<25%) Contact Guard assistance (CGA) Stand By assistance (SBA) Independent (I, Ind.)

Answer 46

Squat Pivot (less assistance) Standing Pivot Transfers ◦ Dependent, assisted, standby, independent Sitting ◦ Anteroposterior Transfers ◦ Sliding Board Transfers ◦ Dependent, assisted, standby, independent

Answer 47

Straight on ◦ Chair is facing toward the surface they are transferring to ◦ Often used by patient’s with bilateral amputations or SCI ◦ Must have good UE strength and hamstring length

Answer 48

strong side

Answer 49

Guard the patient using clothing or grasping an arm.

Answer 50

The number of repetitions of the transfer being completed

Answer 51

The sliding board is used to assist the patient in coming to stand

Answer 52

Place a stool in front of the wheelchair for him to move onto first.

Answer 53

Seat Width 1. Widest point 2. Hip width 3. Chest width Measure widest point and add 2 inches 4. Seat height – heel to popliteal fold (+ 2”) 5. Seat depth (most accurate in supine) – posterior buttock to popliteal fold (– 2”) 6. Armrest height – seat to olecranon process (+1”) 7. Back height – seat to floor of axilla (-4”)

Answer 54

◦ Does the patient’s posture appear symmetrical? ◦ Is the patient’s position approximately 90-90-90? ◦ Are the patient’s hips fully back in the wheelchair with the knees at or slightly above the level of the hips? ◦ Are the patient’s normal spinal curves being maintained?

Answer 55

◦ Seat width – (or an open hand) with palm toward hips, between hips and sides of wheelchair ◦ Seat depth – horizontal fingers between popliteal fold and front edge of chair ◦ Seat height – horizontal (vertical) fingers between the underside of the patient’s distal thigh and the surface of the front of the seat ◦ Armrest height – sweep vertical fingers between the underside of the patient’s forearm and the top of the drive wheel ◦ Leg rest length – sweep vertical fingers between the floor and the footrest ◦ Seat back height – vertical fingers between the top of the wheelchair back and the patient’s axilla ◦ Slide fingers between positioning straps and the patient’s body

Answer 56

2” and for improved stability and prevent tipping.

Answer 57

Olecranon to seat and add 1”

Answer 58

Use 2 fingers or vertical hands between patient and wheelchair.

Answer 59

all of the above

Answer 60

Difficulty propelling the wheelchair

Answer 61

Turn castor wheels forward

Answer 62

Stance phase - the period of time when the limb under consideration is in contact with the floor Swing phase - the period of time when the limb under consideration is not in contact with the floor Double support - when both feet are in contact with the ground at the same time (occurs twice in the cycle) Single support - the period of time when only one foot is in contact with the ground

Answer 63

(stride duration)- the activity that occurs between the time the heel of one extremity touches the floor and the time the same foot touches the floor again (1 sec.)

Answer 64

Nonsupport - A period of time when neither foot is in contact with the ground Cadence - steps per minute (113 steps/min) Velocity - time taken to walk a set distance (82 m/min)– consider “speed” of gait Stride length - the distance of the gait cycle Step length - distance between heel strike of one limb and heel strike of the other limb Stride or step width - the distance between the two feet, measured from the mid-points of the heels (2-4 inches) COG – Center of gravity – point in body from which weight is equally distributed. Sacral vertebrae 2 (S2)

Answer 65

Stance phase is approximately 60% of the Gait cycle. --1. Heel Strike 2. Foot Flat 3. Mid-stance 4. Heel off 5. Toe Off Swing phase is appropriately 40% of the gait cycle. --Has 3 parts: acceleration, mid-swing, deceleration ------One “gait cycle” refers to the movement of one lower limb moving through both stance and swing phase. The limb we are talking about is called the reference limb.

Answer 66

first moment of foot-floor contact for the reference limb

Answer 67

the whole foot comes into contact with the floor --Shock absorption

Answer 68

the body is carried forward over the stance limb and the opposite is in the swing phase. The body’s COG passes from behind to in front of the stance foot and it rises to its highest point.

Answer 69

heel leaves the supporting surface this is followed by push off

Answer 70

last contact with the ground before swing phase begins

Answer 71

◦ Begins once the toe leaves the ground ◦ Continues until mid-swing or the point at which the swinging is directly under the body ◦ Movements include ◦ Active hip flexion ◦ Active knee flexion

Answer 72

◦ The reference limb passes directly beneath the body

Answer 73

Occurs after mid-swing when the tibia passes beyond the perpendicular and the knee is extending in preparation for heel strike ◦ Movements include ◦ Knee extends ◦ Ankle moves into dorsiflexion

Answer 74

Width of walking base – 2-4” Degree of toe out – 7°

Answer 75

The resulting gait is less efficient.

Answer 76

◦ FWB- full weight bearing ◦ PWB- partial weight bearing ◦ NWB- non-weight bearing ◦ WBAT- Weight bearing as tolerated

Answer 77

1. Body Weight Support (BWS) 2. Parallel bars 3. Walkers * Standard walker, Front-wheel walker (FWW), Walkane or hemicane * Rollator ◦ Modifications, such as a platform attachment 4. Axillary crutches 5. Forearm crutches 6. Canes  Large-base quad cane  Small-based quad cane  Single point cane

Answer 78

◦↓ risk of falls ◦ ↓’s demands on patient and therapist ◦ Allows easier facilitation of reciprocal movement ◦ Treadmill and over ground ◦ Can reduce arm swing ◦ Can’t determine exact amount of body weight that is supported

Answer 79

◦ Often site of initiation of gait training ◦ Maximum support and stability ◦ Severely limits mobility ◦ Bars should be adjusted to patient’s height ◦ When patient is grasping bars, angle of elbow flexion should be 20° to 30° when patient grasps bars 6 inches anterior to hips. ◦ Bars should be at level of greater trochanter or wrist crease, ulnar styloid, with arm straight along side ◦ Look at these two pictures. Are bars at correct height?

Answer 80

◦ Maximal support and stability with mobility ◦ Most have 4 legs ◦ Some have wheels ◦ Disadvantages: ◦ Difficult to store and transport ◦ Difficult to use on stairs ◦ Reduces speed of ambulation ◦ Difficult to perform normal gait pattern ◦ Difficult to use in crowded or narrow area

Answer 81

◦ Allow greater selection of gait patterns, amb. speed and good stability ◦ Disadvantages ◦ Less stable ◦ can cause injury to vessels under arm ◦ require good standing balance ◦ functional muscle strength of UE and trunk muscles is required ◦ elderly may feel insecure

Answer 82

◦ Use height markings on crutch 77% of patient’s height ◦ Subtract 16 in. from pt’s height ◦ Measure from floor of axilla to 6-8” lateral from heel ◦ In standing: ◦ Position tips of crutches 2 inches out and at least 4-6 inches forward from toes. ◦ Adjust the length of the crutch so that you can get two finger widths between the axilla and the top of the crutch * Adjust hand grip after height using same technique as walker * To check fit: * With crutch positioned ready to walk, there should be 20° to 30° and you should be able to get 2-3 fingers between floor of axilla and top of crutch.

Answer 83

◦ Easy to store ◦ Stays on forearm when arm is moved ◦ Disadvantages: ◦ Provide less stability ◦ Require good standing balance and good upper body and UE strength ◦ Cuff makes it difficult to remove crutch ◦ Elderly may feel insecure ◦ Fitting ◦ Height of hand piece is measured using same method as for the walker ◦ Forearm cuff should be located 1 to 1½ inches distal to olecranon process when patient grasps hand piece with the cuff on and wrist in in neutral

Answer 84

◦ More functional on stairs, in narrow areas ◦ Can be stored and transported easily ◦ Disadvantages ◦ Provides limited stability ◦ Fitting ◦ Place cane parallel to femur and tibia with tip resting on floor ◦ Patient’s wrist, greater trochanter, ulnar styloid should be even with hand grip ◦ Wrist should be in neutral position ◦ How much elbow flexion should there be with cane in position to walk?

Answer 85

◦ requires bilateral ambulation devices ◦ slow, but safe pattern ◦ hand, opposite foot, other hand, other foot ◦ R cane, L foot, L cane, R foot

Answer 86

◦ Use one or two ambulation devices ◦ Simultaneous and reciprocal forward placement of device and patient’s opposite LE ◦ Requires coordination ◦ Faster than 4 point, not as stable ◦ R crutch and L foot, L crutch and R foot ◦ R crutch and L foot, L arm and R foot

Answer 87

◦ Not “task force” language, but used in other textbooks ◦ Use one ambulation device ◦ Aid is held in the hand opposite to LE requiring assistance ◦ Same sequence as 2 or 4 point

Answer 88

◦ bilateral aids (not canes) or walker ◦ used when patient is PWB or NWB on one extremity ◦ less stable, but very fast ◦ energy expenditure is high ◦ patient needs good UE and trunk strength ◦ Device and involved extremity are advanced at same time then uninvolved extremity

Answer 89

Step-to – LE advanced only as far as the assistive device Step-through – LE is advanced beyond assistive device Swing-to – Crutches are advanced simultaneously, then legs are simultaneously advance to device Swing-through – Same as above, but feet are advanced beyond device

Answer 90

Educate patient about ◦ Remove small rugs or mats that might slide ◦ Avoid waxing floors or use a “nonskid” wax ◦ Immediately wipe fluids from floors ◦ Check ambulation aids weekly for loose nuts, cracks, worn tips, and clean tips ◦ Remove clutter ◦ Keep devices clean with damp cloth ◦ Teach safety specific to device ◦ Wearing house slippers, socks with non-skid soles, or shoes

Answer 91

1. (least stable) Single Point Cane 2. Bilateral Crutches 3. Walker 4. (most stable) Parallel Bars

Answer 92

Loss of stability

Answer 93

Assistive devices must always be fit while the patient is supine.

Answer 94

Standing behind and slightly to the right of the patient

Answer 95

subjective objective assessment plan

Answer 96

◦ Includes relevant information reported by the patient ◦ Can be left blank ◦ Information from caregivers/family members goes here. ◦ Ask questions to get more information, ie when did it start, rate it, why? ◦ If pain changes during treatment, can be put in “O” ◦ Provide location and scale ------5/10 in the right hip ◦ Tips for Documenting: ◦ Don’t repeat “patient” after first used in section. ◦ Use quotes if the patient’s actual words make the relevance clearer. ◦ Common verbs used to document information: states, reports, complains of, expresses, describes, denies. ◦ Record relevant information provided by someone else

Answer 97

◦ Results of measurements and tests ◦ Description of function ◦ Description of interventions ◦ PTA’s objective observations of patient ◦ Patient education done that day ◦ Should reflect data collected by PT. Can provide comparison to initial evaluation if appropriate. ◦ Tips for Documenting ◦ Documentation should be consistent with initial evaluation in procedure, technique, and how recorded (eg. cm vs inches) ◦ Should paint a picture of the treatment session, so someone else can duplicate the session ◦ Group like information together – intervention descriptions, results of tests and measurements, descriptions of patient functioning ◦ Can use charts or graphs to give a quick picture.

Answer 98

draw a single line through the error, write the correction and initial and date the correction. ◦ Don’t erase, white or black out the error.

Answer 99

◦ Reports on progress toward goals ◦ “What does it mean?” ◦ Significance of data (interpretation) ◦ Recommended changes to POC or discharge ◦ Often the primary section read by physician or third party payer Provides: ◦ Area to note that goals may need to be modified and why ◦ Note response to treatment ◦ Connect changes in pt. functional level to goals ◦ Discrepancies between subjective and objective or other inconsistencies (refer to your data)

Answer 100

◦ What will be done in next session ◦ When next session is going to be ◦ If PT consult is needed or anyone else ◦ Info or equipment that is needed ◦ Progress toward discharge ◦ # of visits left ◦ It goals met, or changes needed, etc. ◦ Things patient is to do before next visit ◦ Verbs are in the future tense! ◦ Serves as a reminder to the therapist

Answer 101

◦ Patient is no longer making progress ◦ Not skilled service ◦ Did not used to be reimbursable as physical therapy ◦ Medicare does cover services to maintain or manage a beneficiary's current condition when no functional improvement is possible if the services are medically necessary and meet the skilled care requirements.

Answer 102

Notify the PT

Answer 103

Provides standard language world wide Describes what the individual CAN do in relation to function and positive aspects of health Describes what the individual CANNOT do in relation to disability and negative aspects of health Provides standardized coding for disease

Answer 104

◦ Pathology ◦ Impairment ◦ Functional Limitation ◦ Disability

Answer 105

◦ Body structures and function ◦ Activities ◦ Participation ◦ Environmental ◦ Personal

Answer 106

◦ Document patient’s progress (or lack thereof) and report to the PT ◦ Report if patient needs a change in the POC based on how well they are achieving the goals set by the PT ◦ Assist with the evaluation by gathering subjective data and taking measurements, performing tests and recording measurements. ◦ The interpretation of the data collected is done by the PT. ◦ Use Initial Evaluation as a guideline for documenting changes in patient status in progress notes

Answer 107

◦ History, observations, risk factor identification ◦ Subjective data ◦ Information about: Strength, ROM, Functional abilities, Pain, Muscle tone, Communication status, adaptive equipment needs, automatic reactions, abnormal reflexes, level of independence in daily care, alignment, quality of movement, cognitive function ◦ Results of tests and measures ◦ Interpretation of results ◦ PT Diagnosis ◦ PT Goals ◦ Treatment plan (POC) ◦ Name and title of PT

Answer 108

◦ Completed by PT ◦ What services have been provided ◦ Patient status ◦ Results of re-examination

Answer 109

The purpose is to either hydrate the person, administer IV antibiotics, or provide electrolytes for the patient. If the pump is not flowing then the nurse should be called. Be aware of the IV line when getting the pt. up to the chair or when taking them down to PT. If the tubing is not long enough let the nurse know for an extension.

Answer 110

◦ Inserted into an artery. Used to draw arterial blood, measure arterial blood pressure, deliver medication

Answer 111

◦ Pulmonary artery catheterization. Inserted into a large vein (subclavian v., femoral v., internal jugular v.) and moved into the pulmonary artery. Use to monitor cardiac output. ◦ Precautions Do not get anyone up with femoral line. 70 degree limit in flexion for femoral, Life threatening if pulled out, apply pressure and call for help!. Limit shoulder flexion to under 90 degrees for subcl. Limit cervical motion with jug placement.

Answer 112

◦ Implanted into a vein for long-term placement. Used to administer meds (chemotherapy), blood collection, dialysis ◦ Precautions – limit ipsilateral shoulder movements, BP measurements, no aquatic therapy until healed.

Answer 113

Non- Invasive catheter that draws urine away from body Male external catheter Female external catheter

Answer 114

Contact the patient's nurse and ask them to help reposition the IV

Answer 115

Arterial Line

Answer 116

Sequential Compression Device

Answer 117

◦ PROM - passive - the therapist or another external force moves the body part through the ROM ◦ AAROM - active assisted - the therapist assists the movement ◦ AROM - active - the patient moves the body part without assistance ◦ RROM - resisted - the movement is resisted

Answer 118

◦ Pain occurs with active contraction ◦ Paralysis or marked weakness ◦ Active contraction is prohibited ◦ Assess joint movement ◦ Counteract negative effects of immobilization ◦ Provide sensory stimulation and awareness ◦ Reduce stress on cardiopulmonary system ◦ To teach movement

Answer 119

◦ If it temporarily increases pain ◦ In patients taking medication for pain or muscle relaxants, because the patient may not be able to respond appropriately and movement may be performed too vigorously ◦ In the region of marked osteoporosis or in conditions where bone fragility is a factor. ◦ When it elicits undesired muscle tone

Answer 120

◦ Hard – OA ◦ Soft – synovitis, edema ◦ Firm – capsule, muscle, or ligament shortening/tightness ◦ Empty - patient requests movement be stopped, usually secondary to pain, so there is no end feel; bursitis, inflammation

Skills 110 Finals Written Exam Flashcards

(159 cards)