TBI - 2b Mod-Severe TBI Flashcards
(36 cards)
what is the focus of the RLA
general pattern w focus on cog and behavior
what type of responses can be expected from RLA 1-3
no - generalize - localized
what are the 5 main intervention categories to manage RLA 1-3
sensory stim
communcation
cardiopulm
prevention of indirect impairment
family/caregiver ed
how should sensory stim be presented and what should you look for for for RLA 1-3
present in highly structured manner
monitor for:
- subtle response (HR, RR, BP)
- motor response (face, posture, head turn, vocalization)
when can communication as an intervention be introduced and how is it utilized across RLA 1-3
as begins to respond to commands via eye opening, changes in BP/HR/RR w stim
encourage vocalization/verbal
integrate movement w meaning as start to follow commands
what are appropriate cardiopulm interventions for levels 1-3
positioning
bronchopulm hygiene
early mob OOB
what are interventions to prevent indirect impairments in RLA 1-3
positioning
ROM
serial casting
- phenol, botox
what are things to educate the family/caregiver on in RLA 1-3
stages of disability
POC
ROM, positioning, communication, sensory stim
what type of response can be expected from RLA 4-5
confused agitated - confused inappropriate
what are 5 components of managing RLA 4-5
manage agitation
behavior modification technique
consequent control
antecedent control
pt/family ed
what are strategies to manage the agitated pt
MDs - optimize med status and meds
orient - non threatening and provide info to pt
safety, constant supervision
what is consequent control and how can this be utilized in RLA 4-5
consequence immediately following behavior is assumed to have some significant effect on future probability of behavior
- token economy
- positive re-inforcement
- redirection/time out
- shaping
what is antecedent control and how can this be utilized in RLA 4-5
stimulus present prior to and during behavior
- can elicit, maintain, modify behavior
can use environment as stim early in treatment (primary means of control)
- how you deliver stim is important
what are things to educate the pt/family on in RLA 4-5
focus on family
- explain part of recovery
- teach strategies - consistency, calm behavior
what type of responses can be expected from RLA 5-6
confused-inappropriate / confused-appropriate
what are strategies to utilize in managing RLA 5-6 (6)
- frequent re-orientation but try not to cue continuously
- explain what you are doing and why
- establish routine and structure -> memory charts, lists
- environment control
- appropriate amt of supervision vs restraints for safety
- avoid mental and physical fatigue (ie allow for rest breaks)
what are things to educate the family and pt on in RLA 5-6
pt may be moving but lack insight into deficits
- family teaching regarding assisting, wc use, body mechanics (unable to complete tasks (I) w/o cueing)
what are safety considerations when managing RLA 5-6
PT/OT may co-tx (rehab aide)
don’t leave unit/gym
- risk of elopement
what responses can be expected from RLA 7-8
automatic appropriate - purposeful appropriate
what is the emphasis of pt management of RLA 7-8 and what is an important thing to cut back on to encourage this
beginning community re-entry, return to work or school
wean from structure of inpatient rehab
what is the main strategy of pt management of RLA 7-8 and what are examples of this
progressive build up of cog components
- negotiate obstacles
- use environmental cues
- integrate compensatory strategies during “PT” activities
- low to high level of distraction in environment
- decision making
- problem solving
what are things to educate the patient and family on in RLA 7-8
community resources
-support groups
what type of response can be expected from RLA 8-10
purposeful - appropriate
what is an important thing to remember when managing patients RLA 8-10
pts not at baseline
