TBI

Question 1

Describe 4 clinical signs of a TBI

Answer 1

period of loss/decreased consciousness
loss of memory
neuro deficits
slowed thinking, confusion

Question 2

what is ranchos los amigos scale used for?

Answer 2

measure awareness, cog, behavior

Question 3

What is normal ICP?

Answer 3

17-15mm of mercury

Question 4

Descrie EVD

Answer 4

done bedside, catheter placed in ventricles to drain CSF, Must ask nurse to clamp before working

Question 5

Craniotomy vs craniectomy

Answer 5

iotomy: put skull back in immediately
iectomy: remove skull/blood place in stomach for healing

Question 6

when working with patients level 7-10 what are some cognitive intervention?

Answer 6

problem solving training, verbal self instruction,

Question 7

when should you use metacognitive training approache?

Answer 7

when patients have emergent awareness anticipatory awareness (usually level 8)

Question 8

what type of approach would you use with level 7-10pts

Answer 8

multicontextual approach: checklist, audio reminder, mental rehearsal
CO-OP

Question 9

when using metacognitive training what type of awareness does one might need?

Answer 9

emergent or higher- know they have a problem while its happening

Question 10

What type of awareness does one must have to use CO-OP?

Answer 10

emergent and anticipatory

Question 11

What are the key features of CO-OP?

Answer 11

client centered, dynamic performance analysis, cog strategy, guided discovery, enable principles

Question 12

Describe a rancho 4

Answer 12

alert with heightened activity
purposeful attempt to remove tubes
short attention span
no new learning

Question 13

What can OT do for a patient level 4 rancho?

Answer 13

help them feel comfortable in their enviornment, keep enviornment quiet, structure tasks, incorporate frequent breaks, familiar objects

Question 14

Describe a patient level 5 rancho

Answer 14

very distractible
no new learning
oriented to self
no problem solving
may be agitated with overstimulation

Question 15

OT considerations during treatment with level 5

Answer 15

repeat things, questions should be simple, routine/automatic overlearned activities, simple commands

Question 16

Describe rancho level 6

Answer 16

inconsistent orientation, poor awareness, attent to familiar tasks for 30min
emerging awareness
demonstrate carry over

Question 17

OT intervention considerations for level 6 rancho

Answer 17

encourage note taking, new learning, orientation questions, ADLs, task modifications

Question 18

What does GCS look at?

Answer 18

eye opening, motor responses, verbal responses

Question 19

What is a high score for GCS and what does that mean?

Answer 19

15- oriented x3, follows commands, opens eyes

Question 20

What is a low GCS score and what does that mean?

Answer 20

3
no response, no response to stimuli, does not open eyes

Question 21

What does someone typically look like at rancho level 1

Answer 21

no eye opening, no movement, no response to commands/tactile/auditory

Question 22

Describe RLA 2

Answer 22

total assist,

Question 23

describe RLA 3

Answer 23

follows commands, gestural or verbal yes/no, purposeful movements, turns away/toward stimuli

Question 24

describe OT role in RLA 3

Answer 24

wheel chair position, manage dysphagia, emotional/behavioral, family/caregiver edu

Question 25

What types of splints may we use with patients in RLA 1-3

Answer 25

resing hand splint- cone splint, pillow splint