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Nsg 552 Exam 2 Study Guide With 100% Complete Solution
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Nsg 552 Exam 2 Study Guide With 100% Complete Solution*Orthotics* - Correct Answer-- Know the general categories to describe orthotics and the purpose of each type
- Recommend orthotics for painful joints, tissue protection and immobilize for healing
- Understand principle of splinting fewest joints possible
- Describe appropriate angle of pull (90 degree) and rationale
- Understand principles related to materials, fit, and safety
What is the purpose for splinting? - Correct Answer-1. Support a painful joint
2. Immobilize
3. Protect healing or damaged tissue
4. Provide stability
5. Restrict unwanted motion
6. Substitute for weak/absent muscles
7. Prevent contractures
8. Correct contractures
9. Increase passive motion 10. Modify tone
Primary Purpose: Immobilization (static) orthosis - Correct Answer-Primary Purpose: provide support, stabilization, protection or immobilization -Communicate purpose to patient -can be for fractures
-serial static orthosis/casting Ex: hand based thumb spica, short opponents, short thumb (HFO)
Primary Purpose: Serial static orthosis/casting - Correct Answer-"Low load", prolonged duration stretch, remolding or refabricaiton of orthosis/cast as ROM increases
-communicate purpose to patient 10 to 15 minutes four times a day 10 to 15 degree at a
time
-If wear longer than 10 to 15 it can become more painful
Primary Purpose: Mobilization static orthosis - Correct Answer-*-Anything used to stretch/facilitate motion
-Purpose is to promote ROM using screws, velcro, hinges*
-includes nonelastic components such as screws, Velcro, turnbuckles, or hinges used to
promote ROM
-adjustments can be made easy by the user typically
Primary Purpose: Mobilization elastic orthosis - Correct Answer-*-Use moving parts to permit, control, or restore movement with components such as rubber bands, elastic or springs * Ex: dynamic dorsal block, Kleinert (WHFO)
-Radial nerve palsy orthotics (WHFO)
Primary Purpose: Peripheral nerve injuries orthotics - Correct Answer-1. Keep denervated muscles from remaining in an overstretched position Ex: prevent wrist drop
2. Prevent joint contractures (Nerve damage, so muscles cant fire like they are supposed to)
3. Prevent development of substitution patterns 4. Maximize function
Primary Purpose: Status post burn orthotic fabrication - Correct Answer--based on direction and line of pull of scar
-where is the scar?
-dorsal hand burns have specific protocols due to close proximity to extensor tendons -can use scar inserts to elongate tissue
-may begin using 5 days (7-10 is recommended) post grafting
Recommend orthotics for painful joints, tissue protection and immobilize for healing - Correct Answer-- Immobilizer orthotic is best for pain especially CMC thumb arthritis (thumb spica)
- Resting hand orthotic: burns for skin protection and maintenance and pain
- See notes for list of orthotics and specific associated conditions
Understand principle of splinting fewest joints possible - Correct Answer-- You do not want to immobilize joints unless absolutely necessary. It can cause more harm that good in terms of decreasing joint mobility, increasing stiffness and potential contractures
Persevering: muscle strength
muscle integrity
bone intensity
Describe appropriate angle of pull (90 degree) and rationale - Correct Answer-- The direction and magnitude of the forces applied to a joint or finger are important when applying force to increase passive ROM. The direction of pull must be at a 90-degree angle to the axis of the joint and perpendicular to the axis of rotation. -As ROM increases adjustments can be made to the outrigger to maintain the 90-
degree angle. You don't want the line of pull to be in a medial or lateral direction and disturb the mobilization of the joint
Understand principles related to materials, fit, and safety: *Materials* - Correct Answer-
1. low temperature thermoplastic -width preference -perforated vs non perforated
-highly elastic vs stiff
2. Hybrids (orficast) 3. Plaster of Paris
4. Taping: kinesiotape
5. Neoprene
Understand principles related to materials, fit, and safety: *Fit* - Correct Answer--
molding contours: use of skin creases as guidelines for boundaries -ID bony prominence and take care to dome out or avoid these areas
-reduce pressure to skin through long lever (long splint)
-support arches both longitudinal and transverse with proper alignment
-if using forces, ensure bone being mobilized is perpendicular to the outrigger -should rise 2/3 up limb supported
Understand principles related to materials, fit, and safety: *Safety* - Correct Answer--
check for latex free materials -skin precautions -pressure precautions -nerve irritation -blood vessel irritation -perfusion: capillary refill
-cognitive status influence compliance -sensory status
-ability to don/doff
*Neurodegenerative Conditions: GB, MS, ALS, PD* - Correct Answer-- Describe priorities and role of OT
- Apply precautions for treatment based on disease condition
- Apply specific strategies to enhance performance
- Know guidelines for exercise and strengthening
- Understand patient education needs
Guillian Barre Syndrome: What is it? - Correct Answer--Everyone has weakness
-It's attack on the bodies nerves
-Quadraplegia (LE & UE weakness) -Areflexia
-Parasthasia
-Sensory loss
-Sphincter involvement -Oropharyngeal weakness
-Pain (neurogenic & neuropathic)
-Respiratory failure -Oculomotor weakness
-Ataxia -speech & swallowing
-Usually are continent in bowel and bladder
-weakness proximal more than distal -quadraparesis
-respiratory failure -sensory loss
Guillian Barre Syndrome: Role of OT (Overall/Acute Care) - Correct Answer--Identified roles of OT treatment: ADL, IADL, Driving, Return to work
◼ Evidence for OT specific interventions are lacking
Acute Care:
-maintaining ROM
-positioning/splinting -PROM/AROM
-Electronic aides of daily living -communication strategies (led by SLP)
-Positioning that they don't get over stretched in that time
-can utilize the iPhone
Guillian Barre Syndrome: Precautions - Correct Answer-None Given
Guillian Barre Syndrome: Specific Strategies to Enhance Performance - Correct Answer-Proximal Weakness and Distal Mobility
Guillian Barre Syndrome: Guidelines for Exercise and Strengthening - Correct Answer--
Strengthening: allows client to learn to use muscles
-Repair from nerve comes from body
-therapeutic strengthening does not facilitate nerve repair -allows client to learn optimal use/control of muscles while nerves are repairing
-AROM: initially low weight with low repetitions -progress in repetitions before increasing weights
-protect the joints/muscles that are weak and hyporeflexive *-exercise to exhaustion will delay recovery*
-progress to task specific training (function) as soon as able
Guillian Barre Syndrome: Patient Education Needs - Correct Answer-Should leave with very little residual effects
Amyotrophic Lateral Sclerosis (ALS): What is it? - Correct Answer--ALS is a progressive
neuro degenerative disease and it is fatal
-Diagnosis to death is about 2 years
Amyotrophic Lateral Sclerosis (ALS): Role of OT - Correct Answer-*OT is usually on a consultation basis*
-maximize function and comfort -activity adaptation -equipment recommendations
-complex wheelchairs
-low tech adaptive equipment
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