TBI

Question 1

ranchos los amigos levels 1-3

Answer 1

R = response

Question 2

ranchos los amigos level 1

Answer 2

no response - coma

Question 3

ranchos los amigos level 2

Answer 3

generalized response

non-purposeful whole body, vocal inconsistent

Question 4

ranchos los amigos level 3

Answer 4

local response

purposeful
local and specific
inconsistent

follows simple commands - closes eyes, squeezes hands

Question 5

ranchos los amigos levels 4,5,6

Answer 5

C = confused

Question 6

ranchos los amigos levels 7,8

Answer 6

A = appropriate

Question 7

how to manage levels 1,2,3

Answer 7

positioning - head neutral, prevent ulcer, sit
gentle PROM - joint integrity, skin integrity
respiratory care - postural drainage, percussion, vibration
educate family - what to expect, how to be more involved

Question 8

RLA level 4

Answer 8

confused and agitated

heightened activity, just coming out of coma
aggresssive: doesn’t cooperate, verbalization is incoherent, confabulations (making up stories)

no selective attention

no long and short term memory

Question 9

RLA level 4 - tx

Answer 9

confused: consistent, same staff, establish a routine, orient patient

memory: no carryover - chart and graph to measure progress

agitated - calm behavior. do NOT confront
environment - closed - prevent harm to others

give pt options, NO yes/no q or open ended q

Question 10

RLA level 5

Answer 10

confused inappropriate

behavior: responds consistently to SIMPLE commands
responds inconsistently to complex commands
with structure, able to socialize for short period

memory - memory is impaired inappropriate use of objects, can’t learn new task

Question 11

RLA level 6

Answer 11

confused appropriate

behavior: follows simple commands consistently
goal oriented behavior with external input

memory: carryover of previous skills present (self care)

Question 12

treatment for 5 and 6

Answer 12

follow goals from level 4

complex commands cannot be followed - allow more complex open environemnts

Question 13

RLA level 7

Answer 13

automatic appropriate

oriented in home and hospital
daily routine - automatic but robot-like
judgement impaired
able to initiate social or recreational activity with structure

Question 14

RLA level 8

Answer 14

purposeful appropriate

carryover of new skills present
impaired judgment in an emergency situation, abstract reasoning and reduced tolerance for stress

Question 15

how to manage levels 7 and 8

Answer 15

focus on re-entry to work and community

emphasize skills related to problem solving, social interaction

trial period of independent living

adaptation at work or School to return to normal life