Term
| When was the American Disability Act "ADA" passed? |
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Definition
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Term
| What is the goal of rehabilitation? |
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Definition
| To restore the patient's ability to function independently or at a preillness or preinjury level of functioning as quickly as possible. If this is not possible, the aims are to maximize independence and prevent secondary disability as well as to promote a quality of life accceptable to the patient. |
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Term
What are some emotional reactions exhibited by patients with disabilities?
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Definition
| Shock, anxiety, denial, depression, anger, hostility and adjustment |
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Term
| Who is a key member of the rehabilitation team? |
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Definition
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Term
| Does rehabilitation need to be a written order from a physician |
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Definition
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Term
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Definition
Activites of Daily Living:
bathing, showering, dressing, getting in or out of bed or a chair, using the toilet, eating |
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Term
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Definition
Independent Activities of Daily Living
cooking, cleaning, shopping, laundry, managing personal finances, developing social and recreational skills, handling emergencies. |
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Term
| What is an adaptive device |
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Definition
| type of assistive technology that is used to change the environment or help the person to modify the environment. ie. wheelchair ramps |
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Term
| What is an assistive device? |
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Definition
| a type of assistive technology that helps people with disabilities perform a given task. ie. cup with a handle will aid in drinking. |
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Term
| What is the most frequent method used to assess functional ability |
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Definition
FIM, functional independence measure. Consists of 18 questions. Scoring based on 7 pt scale.
*there are other methods used: PULSES profile, Barthel Index, PECS etc |
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Term
| on as When does an ADL program start? |
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Definition
| As soon as the rehabilitation process begins, because the ability to perform ADLs is frequently the key to independence, return to the home and reentry into the community. |
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Term
True or False
Patients taking an anticoagulant medicine should be encouraged to use an electric shaver. |
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Definition
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Term
| What are some interventions to prevent musculoskeletal complications |
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Definition
*Proper positioning while patients are in bed by using pillows, splints...
*frequent position changes
*use of trochanter roll or towels to prevent external rotation of the hip
*The use of hightop tennis shoes or pt sitting at 90 degree angle in wheelchair w/ feet on footrests or flat on the floor to prevent footdrop
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Term
| What are the 5 therapeutic exercises |
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Definition
Passive
Active-assistive
Active
Resistive
Isometric
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Term
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Definition
movement that flexes or bends the hand back toward the body or the foot toward the leg.
[image] |
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Term
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Definition
| movement that flexes or bends the hand in the direciton of the palm |
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Term
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Definition
| Movement that flexes or bends the foot in the direction of the sole. |
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Term
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Definition
| touching the thumb to each fingertip on the same hand |
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Term
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Definition
| movement that turns the sole of the foot inward |
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Term
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Definition
| movement that turns the sole of the foot outward. |
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Term
What is done when muscle spasms occur while performing ROM exercises?
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Definition
| Move the joint slowly to the point of resistance. Gentle, steady pressure is then aplied until the muscle relaxes and the motion is continued to the joint's final point of resistance. |
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Term
| How often should exercises be performed. |
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Definition
| Unless otherwise prescribed, each joint should be moved through its range of motion three times twice a day. |
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Term
| What is a way a pt. can maintain muscle strength while having long periods of time in a wheelchair? |
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Definition
| Perform wheelchair push-up exercises. |
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Term
| Which assistive device is best for a pt. who w/ poor balance and poor cardiovascular reserve. |
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Definition
| A pick-up walker or a roll walker for patients who can not pick up a walker while walking. |
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Term
| What crutch gait is best for a patient who has partial weight bearing on both feet, maximal support provided, and requires constant shift of weight |
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Definition
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Term
| What is the most advanced crutch gait? |
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Definition
| The swing-through. It is weight bearing. requires arm strength, coordination and balance. |
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Term
| A patient using a brace to walk is an example of an orthosis or prosthesis? |
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Definition
Orthosis:
it is an external appliance that provides support, prevents or corrects deformities and improves function. Also included are: splints, collars, corsets. They can be static (no moving) or dynamic (flexible) |
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Term
| Is an artifical knee classified as an prosthesis? |
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Definition
| Yes, a prosthesis is an artifical body part; it may be internal or external. |
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Term
| What is a pressure ulcer? |
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Definition
| Localized areas of necrotic soft tissue that occur when pressure applied to the skin over time is greater than normal capillary closure pressure, which is about 32mm Hg. |
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Term
| What is the average length of stay in a hospital related to the development of a pressure ulcer? |
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Definition
| 13 days @ a cost of $37,800/affected patient. |
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Term
| What are some risk factors for pressure ulcers? |
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Definition
| immobility, prolonged pressure on tissue, sensory deficit/loss, poor skin perfusion, malnutrition, friction, shearing, trauma, incontinence, excessively dry or moist skin, advanced age, debilitation, & equipment (casts, restraints) |
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Term
| What are some some areas of the body more susceptible to pressure ulcers. |
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Definition
| Bony prominence areas: occiput, ear, scapula, elbow, sacrum, greater trochanter, ischial tuberosities, medial condyle of tibia, fibular head, medial malleolus, lateral malleolus, heel |
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Term
| Is a patient at risk for friction or shear when they are dragged across a bed? |
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Definition
friction:
is the resistance to movement that occurs when two surfaces are moved across each other. |
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Term
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Definition
| It is created by the interplay of gravitational forces and friction. ie. sliding down in bed when in semi fowlers. When shear occurs, tissue layers slide over one another. |
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Term
| What is used to assess a pressure ulcer |
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Definition
| Scales such as Braden scale or Norton scale |
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Term
| What stage is a pressure ulcer that presents with area of erythema that does not blanch with pressure, elevated skin temp, swollen tissue, no skin breaks |
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Definition
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Term
| Stage II pressure ulcer presents with skin breaks, blisters, shallow craters, discharge, edema and a partial-thickness wound. True or False |
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Definition
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Term
| Stage______pressure ulcer presents with an ulcer extending into subcutaneous tissue, necrosis, infection, drainage, full-thickness wound. |
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Definition
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Term
| What stage is a pressure ulcer with eschar? |
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Definition
| You can not classify a pressure ulcer with eschar because it covers the ulcer. Debridement must be performed first. |
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Term
| Stage IV pressure ulcers extend to muscle and bone. True or False |
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Definition
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Term
| Why is the recumbent position preferred to the semi-Fowlers oisutuib when positioning a patient at risk for pressure ulcers? |
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Definition
| Because of increased supporting body surface area in the recumbent position |
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Term
| What is the bridging technique? |
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Definition
| A position technique to relieve pressure over bony prominences through correct placement of pillows. |
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Term
| What are the two most susceptible areas for pressure ulcers? |
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Definition
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Term
| What is the number one lab value to check for decreased nutritional status that can be a risk factor for pressure ulcers? |
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Definition
Albumin:
< 3g = low nutrition. |
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Term
| Where is the best area to check skin turgor for patients over 60 years old? |
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Definition
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Term
| What are some pressure-relieving devices? |
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Definition
| rotation beds, air mattress, waffle mattress, bed cradle, waffle boots |
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Term
| What are the nutritional requirements to promote pressure ulcer healing? |
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Definition
Protein for tissue repair
calories for spare protein & maintain body weight
Water for homeostasis
Multivitamin promote collagen formation
Vit. C promote collagen synthesis & strong capillary wall
zinc sulfate cofactor for collagen form. & protein synthesis
Vit A stimulate epith. cells & immune response
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Term
| What wound dressings can be used for Stage I and II pressure ulcers? |
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Definition
Transparent films (Tegraderm): ie. skin tear
Hydrogens: deep wounds, +/- infection, some exudate
Hydrocolloids (Duoderm): Stay on 1 wk/ swells as absorbs
Guaze: wet to dry, change q. 12-24 hrs
Nonadhearing: skin grafts, staples |
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Term
| When and what is a foam wound dressing used? |
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Definition
Stage III and IV
excessive exudate, easily stretched for over bony prominences, inexpensive |
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Term
| What is an alginate wound dressing made of? |
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Definition
algae/sea weed:
Used for Stage III and IV ulcers with heavy drainage. |
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Term
| Collagen wound dressings promote______and ________. |
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Definition
collagenation
granulation
Can pack in tunnel wound |
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Term
| Which nutrient is responsible for collagen synthesis? |
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Definition
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Term
| What is a main factor in urinary incontinence? |
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Definition
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Term
| How many liters of water should a patient consume to promote urinary continence? |
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Definition
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Term
| What is biofeedback in bladder training? |
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Definition
| The conscience decision to do something. ie. Kegel exercises. |
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Term
| People with more acidic or alkaline bladders contract UTIs more frequently due to the environment promoting bacteria growth |
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Definition
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Term
| What are the cells of the epidermis that transmit stimuli to the axon through a chemical synapse? |
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Definition
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Term
| When promoting wound healing what is needed to spare the protein and to provide an energy sourch? |
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Definition
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Term
| What may be used to promote noninfected ulcers healing by secondary intention? |
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Definition
VAC: vacuum-assisted closure (involves the use of neg-pressure sponge dresing in the wound to increase blood flow.
and/or
hyperbaric O2 treatment. |
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Term
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Definition
| involuntary elimination of urine associated w/ a strong perceived need to void. |
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Term
| Reflex (neurogenic) incontinence |
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Definition
| associated with a spinal cord lesion that interrupts cerebral control, resulting in no sensory awareness of the need to void. |
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Term
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Definition
| associated w/ weakened perineal muscles that permit leakage of urine when intra-abdominal pressure is increased (ie. coughing/sneezing) |
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Term
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Definition
| incontinence in patients w/ intact urinary physiology who experience mobility impairment, environmental barriers, or cognitive problems and cannot reach and use the toilet before soiling themselves. |
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Term
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Definition
| occurs in patients who cannot control excreta because of physiologic or physhological impairment; management of the excreta is an essential focus of nursing care. |
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Term
| When is intermittent self-catherization appropriate? |
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Definition
| When managing reflex incontinence, urinary retention, and overflow incontinence due to an overdistended bladder. |
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Term
| What classification is a condom catheter? |
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Definition
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Term
| The external layer of the epidermis is replaced every |
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Definition
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Term
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Definition
| An insoluable, fibrous protein that forms the outer layer of the skin. Barrier |
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Term
| What controls the production of melanin? |
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Definition
| Melanocyte-stimulating hormone released from the hypothalamus. |
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Term
| What cells of the epidermis play a role in the cutaneous immune system reactions? |
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Definition
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Term
| How are fingerprints formed? |
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Definition
| By the rete ridges which are a junction between the epidermis and dermis. This area consists of many undulations and furrows. |
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Term
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Definition
| In the hair follicle found in the dermal layer of the skin. It is present all over the body except the soles of the feet and palms of the hand. The hair on the beard area for men grow the fastest. |
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Term
| What cells if damaged are responsible for hair loss? |
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Definition
| The stem cells housed on the side of the hair follicle |
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Term
| What male hormone controls hair growth in certain locations of the body? |
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Definition
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Term
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Definition
| Hair loss in women. Cushings is a main cause of this. |
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Term
| What is the growth cycle of hair follicles? |
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Definition
| The anagen phase lasting up to 6 years. |
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Term
| What is the resting phase of hair growth? |
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Definition
| The telogen phase lasting around 4 months. |
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Term
| Do fingernails or toenails grow faster? |
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Definition
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Term
| What do spoon shape nails indicate? |
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Definition
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Term
| What do clubbing nails indicate? |
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Definition
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Term
| What do pitted nails indicate? |
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Definition
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Term
| What do Beau's lines on the nail indicate? |
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Definition
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Term
| What does paronychia of the nails indicate? |
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Definition
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Term
| What is the function of the sebaceous gland and where is it found? |
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Definition
| Found in the dermis associated with hair follicles. The glands empty sebum onto the space between the hair follicle and the hair shaft providing lubrication for the hair. |
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Term
| What are the 2 kinds of sweat glands? |
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Definition
Eccrine: found in all areas of the skin producting sweat in response to elevated ambient and body temps.
Apocrine: larger than eccrine located in the axillae, anal region, scrotum and labia majora. Their ducts open onto the hair follicles and become active at puberty. They produce a milky sweat. |
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Term
| Which aprocrine gland produces ear wax (cerumen)? |
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Definition
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Term
| What is the only means of temperature regulation that is effective with high ambient temperatures? |
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Definition
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Term
| What does the skin produce with the exposure to UV light? |
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Definition
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Term
| What does the lack of Vitamin D cause? |
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Definition
|
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Term
| What are some color variations (dyschromias) common in elderly skin? |
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Definition
solar lentigo (liver spots)
melasma (dark discoloration of the skin)
lentigines (freckles) |
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Term
| What is seborrheic keratoses? |
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Definition
| crusty brown stuck on patches found commonly on elderly skin |
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Term
| Is telangiectasias a normal condition of elderly skin? |
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Definition
Yes:
red marks on skin caused by stretching of the superficial blood vessels |
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Term
| Along with wrinkles, xerosis is common on elderly skin. What is this? |
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Definition
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Term
| What are the yellowish waxy deposits found on elderly uppper and lower eyelids called? |
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Definition
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Term
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Definition
| Primary lesion, flat, nonpalpable, skin color change <1cm. ie. freckle |
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Term
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Definition
Primary: A macule > 1cm
ie. flat mole, vitiligo |
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Term
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Definition
| Primary: elevated, palpable, solid mass w/ circumscribed border, <0.5cm ie. elevated nevi, wart |
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Term
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Definition
| Primary: papule > 0.5 cm, ie. psoriasis |
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Term
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Definition
| Primary: Elevated, palpable, solid mass extending deeper into dermis that a papule, 05.-2 cm, circumscribed, ie. lipoma, squamous cell carcinoma |
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Term
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Definition
| Primary: Nodule greater than 1-2 cm and borders so not always have sharp borders, ie. larger lipoma, carcinoma |
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Term
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Definition
| Primary: Circumscribed, elevated, palpable mass, contains serous fluid, < 0.5cm, ie. chickenpox |
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Term
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Definition
| Primary: vesicle larger than 0.5 cm, ie. burn blister, contact dermatitis |
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Term
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Definition
| Primary: elevated mass with transient borders, often irregular, size & color varies. Caused by serous fluid moving into dermis, no cavity. ie. hives, insect bites |
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Term
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Definition
| Primary: pus-filled vesicle or bulla, ie. acne |
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Term
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Definition
| Primary, encapsulated fluid-filled or semisolid mass in the subq. tissure or dermis, ie. sebaceous cyst |
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Term
| What is erosion of the skin? |
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Definition
| secondary lesion: loss of superficial epidermis not extending to the dermis, depressed, moist area, ie. ruptured vesicles, scratch marks |
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Term
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Definition
| Secondary lesion, skin loss from past the epidermis to bone/muscle, ie. pressure ulcer |
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Term
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Definition
| Secondary lesion, linear crack in the skin may extend to the dermis, ie. chapped hands |
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Term
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Definition
| Secondary lesion, flakes secondary to desquamated, dead epithelium that may adhere to skin surface, ie. dandruff |
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Term
|
Definition
| secondary lesion, dreied residue of serum, blood or pus on skin surface, ie. scab |
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Term
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Definition
| secondary lesion, thickening and roughening of skin due to repeat rubbing, irritation, scratching, ie. contact dermatitis. |
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Term
| What are the ABCDE of lesions? |
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Definition
| Asymmetry, border, color, diameter, elevation |
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Term
| A circular or arcing skin lesion configeration: |
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Definition
|
|
Term
| skin lesion configeration that is linear and along a nerve route? |
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Definition
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|
Term
| Clusterd skin lesion configeration |
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Definition
|
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Term
| Merged skin lesion configuration |
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Definition
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Term
| Seperate and distinct skin lesion |
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Definition
|
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Term
| What is the most common cause of hair loss? |
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Definition
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Term
| What are some skin disorders associated w/ Diabetes Mellitus: |
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Definition
Diabetic dermopathy: shin spots, bilateral and linear clusters
Stasis Dermatitis: b/c blood vessel damage from diabetes, skin thick, leathery, yellowish waxy hue
Bacterial/Fungal Skin infections
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Term
| What can be one of the first signs of HIV infection? |
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Definition
| cutaneous signs: Kaposi sarcoma, oral hairy leukoplakia, oral candidiasis, facial molluscum contagiosum. |
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Term
| Food allery testing uses this method? |
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Definition
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Term
| Skin scrapings are used to test for: |
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Definition
|
|
Term
| Tzanck smear test is used for? |
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Definition
| testing of cells from blistering skin conditions. ie. herpes zoster |
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Term
| What is another name used for a bruise? |
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Definition
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Term
| Does telangiectasia blanch ? |
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Definition
| No. It is a vascular skin lesion found on legs & thighs in association with venus statis. See leg cramps and RLS as symptoms. |
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