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Neuro 2 - Exam 2 > TBI - 3 > Flashcards

TBI - 3 Flashcards

(84 cards)

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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
how long does level 4 last
2-4 weeks
26
goals of level 4
decrease agitation assist pt to control behavior keep pt safe increase attention to the environment
27
strategies for level 4
use a quiet room be consistent model calm behavior be reassuring allow freedom of movement structured setting w/ little demands medications sparingly
28
what do we provide w/ level 4
pt and family education
29
level 5
confused, inappropriate, non-agitated maximal assistance
30
how is the pt in level 5
may still become agitated in response to external stimulation &/or lack of environmental structure
31
what will the pt do at level 5
follow simple commands
32
attention span--> level 5
decreased
33
speech --> level 5
tangential use of jargon
34
memory --> level 5
severely impaired
35
level 5 pt is unable to
learn new info
36
level 5 pt has decreased
initiation of tasks
37
level 5 pt may
wander
38
objects --> level 5
misuse of objects
39
level 6
confused, appropriate moderate assistance
40
how is a level 6 pt oriented
inconsistently oriented to person, place, time still has memory deficits
41
what does a level 6 pt consistently do
follow simple commands
42
what is a level 6 pt able to do
attend to highly familiar tasks in non-distracting environment for 30 minutes w/ moderate redirection
43
decreased --> level 6
problem solving or planning has increased initiation
44
what is a level 6 pt able to use
assistive memory aide w/ max assist
45
emerging --> level 6
awareness of appropriate response to self, family and basic needs
46
goals for levels 5&6
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
level 7
automatic, appropriate min assist for daily living skills
48
how is a level 7 pt
consistently oriented to person and place w/in highly familiar environments needs moderate assistance for orientation to time
49
what is a level 7 pt able to attend to
highly familiar tasks in a non-distracting environment for at least 30 mins w/ min assist
50
new learning --> --> level 7
minimal supervision
51
awareness of problems --> level 7
increased
52
judgement --> level 7
still poor
53
driving --> level 7
no
54
in a structured environment --> level 7
pt seems goal directed and purposeful
55
level 8
purposeful, appropriate SBA
56
level 8 pt
consistently oriented to person, place, time
57
how does a level 8 pt attend to tasks
completes familiar tasks for 1 hr in distracting environments
58
new learning --> level 8
retained better
59
memory and concentration --> level 8
continues to improve
60
when may a problem emerge --> level 8
new or hard tasks
61
goals for 7&8
increased ability to respond to minimally structured environment integrated increased cognitive fxn into fxnal activity w/in the community provide pt education
62
level 9
purposeful, appropriate SBA on request
63
tasks --> level 9
independently shifts b/w tasks and completes accurately for at least 2 hours
64
assistive memory device --> level 9
uses w/ assistance when requested
65
what do level 9 pts initiate and complete
familiar tasks independently and unfamiliar tasks with assistance when requested
66
what does a level 9 pt require
SBA to adjust to task demands, acknowledging others needs and feelings
67
what is a level 9 pt able to think about
consequences of decisions/actions w/ assistance on request
68
what could continue --> level 9
depression easy irritation low frustration tolerance
69
what is a level 9 pt able to do
self monitor appropriateness of social interaction w/ SBA
70
goals for level 9
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
increase pt and family awareness --> level 9
recognition of stressors, strategies to minimize impact of stressors
72
level 10
purposeful, appropriate modified independence
73
what is a level 10 pt able to handle
multiple tasks simultaneously in all environments may require periodic breaks
74
what can a level 10 pt independently do
procure create maintain own AD
75
task completion --> level 10
independently initiates and carries out steps to complete familiar and unfamiliar tasks may require more time/compensatory strategies to complete
76
anticipates --> level 10
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
consequences --> level 10
independently think of consequences may need increased time and compensatory strategies to select appropriate decision/action
78
accurately --> level 10
estimates abilities and independently adjusts to task demands
79
recognizes --> level 10
needs and feelings of others w/ appropriate response
80
what may occur --> level 10
periodic periods of depression
81
irritability and low frustration --> level 10
tolerance when sick, fatigued &/or under emotional stress
82
social interaction --> level 10
consistently appropriate
83
where will a level 10 pt be seen
outpatient/home care
84
goals for level 10
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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