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Neuro 2 - Exam 2 > TBI - 3 > Flashcards

TBI - 3 Flashcards

1
Q

ranchos los amigos cognitive scale revised

A

examines changes in behavior after brain injury

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2
Q

ranchos los amigos has

A

10 stages (3 of which are related to coma)

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3
Q

ranchos los amigos –> stages

A

usually pts follow these stages

2 or more stages may be seen at one time

length of each stage varies

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4
Q

level 1

A

no response

total assistance

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5
Q

level 1 is

A

complete absence of observable change in behavior

when presented w/ visual, auditory, tactile, proprioceptive, vestibular or painful stimuli

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6
Q

what does level 1 need

A

regular stimulation

do not shout at pt

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7
Q

level 2

A

generalized response

total assistance

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8
Q

what does level 2 demonstrate

A

generalized reflex response to painful stimuli

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9
Q

what does a level 2 respond to

A

external stimuli w/ physiological changes

generalized gross body movement

not purposeful vocalization

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10
Q

what may a level 2 do

A

be awake for brief periods

need to stimulate the pt

allow plenty of time for rxn

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11
Q

level 3

A

localized response

total assistance

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12
Q

what does a level 3 do

A

reacts more but not all the time

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13
Q

what does a level 3 demonstrate

A

w/drawal or vocalization to painful stimuli

pt is more aware of their body

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14
Q

what does level 3 respond to

A

discomfort

inconsistently follows 1 step commands

may respond to some people but not others

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15
Q

goals of level 3

A

increase attention to task

follow commands

use objects in a simple way

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16
Q

problem of levels 1-3

A

decreased response to the environment

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17
Q

goals of levels 1-3

A

prevent sensory deprivation

prevent contractures, decubiti, DVTs and pneumonia

elicit responses to sensory stimuli

increase frequency, rate, duration, quality of responses

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18
Q

what do we provide w/ levels 1-3

A

family education

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19
Q

level 4

A

confused/agitated

maximal assistance

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20
Q

what is level 4

A

severe internal confusion and inability to filter out external stimuli

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21
Q

what does level 4 result in

A

pt’s disruptive exaggerated behavior

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22
Q

how is the pt at level 4

A

alert

becomes more active (heightened state)

safety is a concern

restless

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23
Q

what may we perform with a level 4

A

motor activities w/o apparent purpose

sitting, reaching, walking

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24
Q

the pt is unable to –> level 4

A

focus

process

interpret

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25
Q

how long does level 4 last

A

2-4 weeks

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26
Q

goals of level 4

A

decrease agitation

assist pt to control behavior

keep pt safe

increase attention to the environment

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27
Q

strategies for level 4

A

use a quiet room

be consistent

model calm behavior

be reassuring

allow freedom of movement

structured setting w/ little demands

medications sparingly

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28
Q

what do we provide w/ level 4

A

pt and family education

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29
Q

level 5

A

confused, inappropriate, non-agitated

maximal assistance

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30
Q

how is the pt in level 5

A

may still become agitated in response to external stimulation &/or lack of environmental structure

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31
Q

what will the pt do at level 5

A

follow simple commands

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32
Q

attention span–> level 5

A

decreased

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33
Q

speech –> level 5

A

tangential

use of jargon

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34
Q

memory –> level 5

A

severely impaired

35
Q

level 5 pt is unable to

A

learn new info

36
Q

level 5 pt has decreased

A

initiation of tasks

37
Q

level 5 pt may

A

wander

38
Q

objects –> level 5

A

misuse of objects

39
Q

level 6

A

confused, appropriate

moderate assistance

40
Q

how is a level 6 pt oriented

A

inconsistently oriented to person, place, time

still has memory deficits

41
Q

what does a level 6 pt consistently do

A

follow simple commands

42
Q

what is a level 6 pt able to do

A

attend to highly familiar tasks in non-distracting environment for 30 minutes w/ moderate redirection

43
Q

decreased –> level 6

A

problem solving or planning

has increased initiation

44
Q

what is a level 6 pt able to use

A

assistive memory aide w/ max assist

45
Q

emerging –> level 6

A

awareness of appropriate response to self, family and basic needs

46
Q

goals for levels 5&6

A

decrease confusion

increase frequency, rate, duration, quality of appropriate interactions w/ environment

incorporate increased cognitive fxn into fxnal activities

provide pt and family education

47
Q

level 7

A

automatic, appropriate

min assist for daily living skills

48
Q

how is a level 7 pt

A

consistently oriented to person and place

w/in highly familiar environments

needs moderate assistance for orientation to time

49
Q

what is a level 7 pt able to attend to

A

highly familiar tasks in a non-distracting environment for at least 30 mins w/ min assist

50
Q

new learning –> –> level 7

A

minimal supervision

51
Q

awareness of problems –> level 7

A

increased

52
Q

judgement –> level 7

A

still poor

53
Q

driving –> level 7

A

no

54
Q

in a structured environment –> level 7

A

pt seems goal directed and purposeful

55
Q

level 8

A

purposeful, appropriate

SBA

56
Q

level 8 pt

A

consistently oriented to person, place, time

57
Q

how does a level 8 pt attend to tasks

A

completes familiar tasks for 1 hr in distracting environments

58
Q

new learning –> level 8

A

retained better

59
Q

memory and concentration –> level 8

A

continues to improve

60
Q

when may a problem emerge –> level 8

A

new or hard tasks

61
Q

goals for 7&8

A

increased ability to respond to minimally structured environment

integrated increased cognitive fxn into fxnal activity w/in the community

provide pt education

62
Q

level 9

A

purposeful, appropriate

SBA on request

63
Q

tasks –> level 9

A

independently shifts b/w tasks and completes accurately for at least 2 hours

64
Q

assistive memory device –> level 9

A

uses w/ assistance when requested

65
Q

what do level 9 pts initiate and complete

A

familiar tasks independently and unfamiliar tasks with assistance when requested

66
Q

what does a level 9 pt require

A

SBA to adjust to task demands, acknowledging others needs and feelings

67
Q

what is a level 9 pt able to think about

A

consequences of decisions/actions w/ assistance on request

68
Q

what could continue –> level 9

A

depression

easy irritation

low frustration tolerance

69
Q

what is a level 9 pt able to do

A

self monitor appropriateness of social interaction w/ SBA

70
Q

goals for level 9

A

pts typically seen in outpatient PT/home care

increase pt problem solving skills

increase pt higher level of cognitive fxning

increase pt and family awareness

71
Q

increase pt and family awareness –> level 9

A

recognition of stressors, strategies to minimize impact of stressors

72
Q

level 10

A

purposeful, appropriate

modified independence

73
Q

what is a level 10 pt able to handle

A

multiple tasks simultaneously in all environments

may require periodic breaks

74
Q

what can a level 10 pt independently do

A

procure

create

maintain own AD

75
Q

task completion –> level 10

A

independently initiates and carries out steps to complete familiar and unfamiliar tasks

may require more time/compensatory strategies to complete

76
Q

anticipates –> level 10

A

impact of impairments/disabilities on ability of ADLs/tasks

takes action to avoid problems before they occur but may need increased time/compensatory strategies

77
Q

consequences –> level 10

A

independently think of consequences

may need increased time and compensatory strategies to select appropriate decision/action

78
Q

accurately –> level 10

A

estimates abilities and independently adjusts to task demands

79
Q

recognizes –> level 10

A

needs and feelings of others w/ appropriate response

80
Q

what may occur –> level 10

A

periodic periods of depression

81
Q

irritability and low frustration –> level 10

A

tolerance when sick, fatigued &/or under emotional stress

82
Q

social interaction –> level 10

A

consistently appropriate

83
Q

where will a level 10 pt be seen

A

outpatient/home care

84
Q

goals for level 10

A

minimize pt breakdown when stressors occur

increase pt/family awareness for recognition of stressors/strategies to minimize impact of those stressors

pt to independently recognize difficulty

decrease time/compensation for pt to initiate/carry out familiar and unfamiliar tasks

Neuro 2 - Exam 2 (16 decks)

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