Transcript Slide 1

ORDERED TO:
 REDUCE PHYSICAL ACTIVITY
 REDUCE PAIN
 ENCOURAGE REST
 REGAIN STRENGTH
 PROMOTE HEALING
MAY BE ON:
COMPLETE (STRICT) BED REST
BEDREST WITH BATHROOM PRIVILEDGES (BRP)
CONTRACTURES
CAUSED BY ABNORMAL
SHORTENING OF A MUSCLE
MUSCLE IS FIXED IN POSITION, IS
DEFORMED, AND CAN NOT BE
MOVED
THE PERSON IS PERMANENTLY
DEFORMED
ATROPHY
DECREASE IN THE SIZE OR
THE WASTING AWAY OF
MUSCLE TISSUE
ORTHOSTATIC HYPOTENSION
ABNORMALLY LOW BLOOD PRESSURE WHEN THE PERSON
STANDS UP TO SUDDENLY
WHEN YOU STAND TOO QUICKLY, THE BLOOD PRESSURE
DROPS.
THE PERSON MAY FEEL DIZZY, WEAK, HAVE SPOTS BEFORE THE
EYES
HAND ROLLS PREVENT CONTRACTURES OF THE FINGERS
AND WRIST
WHAT CAN YOU USE IF YOU DO NOT HAVE A HAND ROLL?
FOOTBOARD
BED CRADLE
PLACED SO THE SOLES OF THE
FEET ARE FLAT AGAINST IT
KEEPS THE WEIGHT OF THE TOP
LINEN OFF THE FEET AND TOES
THE FOOT IS BENT DOWN
PLANTAR FLEXION
TROCHANTER ROLL
HIP ABDUCTION WEDGE
PREVENTS THE HIP AND LEG
FROM ROTATING OUTWARD
KEEPS THE PERSON’S LEGS ABDUCTED
SPLINT
KEEPS THE
ELBOWS,WRISTS,THUMBS,
FINGERS, ANKLES, OR
KNEES IN NORMAL
POSITION
THE MOVEMENT OF A JOINT TO THE EXTENT POSSIBLE WITHOUT
CAUSING PAIN
 MOVE THE JOINT THROUGH THEIR COMPLETE RANGE OF MOTION
 DONE AT LEAST TWICE A DAY
 WILL BE ORDERED BY DOCTOR OR NURSE
ACTIVE RANGE-OF-MOTION EXERCISES - DONE BY THE PERSON
PASSIVE RANGE-OF-MOTION EXERCISES - ANOTHER PERSON
MOVES THE JOINT
ACTIVE-ASSISTIVE RANGE OF MOTION EXERCISES - THE PERSON
DOES SOME OF THE MOVEMENT WITH HELP FROM ANOTHER
PERSON
ABDUCTION - MOVING A BODY PART AWAY FROM THE MIDLINE OF THE
BODY
ADDUCTION - MOVING A BODY PART TOWARD THE MIDLINE OF THE
BODY
EXTENSION - STRAIGHTENING A BODY PART
FLEXION - BENDING A BODY PART
ROTATION - TURNING THE JOINT
INTERNAL ROTATION - TURNING THE JOINT INWARD
EXTERNAL ROTATION - TURNING THE JOINT OUTWARD
PLANTAR FLEXION - BENDING THE FOOT DOWN AT THE ANKLE
PRONATION - TURNING THE JOINT DOWNWARD
SUPINATION - TURNING THE JOINT UPWARD
WHEN DELEGATED RANGE-OF-MOTION EXERCISES YOU WILL NEED THIS
INFORMATION TO SAFELY COMPLETE THE TASK
 WILL YOU PERFORM ACTIVE, PASSIVE, OR ACTIVE ASSIST RANGE-OFMOTION
 WHICH JOINT WILL YOU BE EXERCISING
 HOW OFTEN WILL YOU BE DOING THE EXERCISE
 HOW MANY TIMES WILL YOU REPEAT EACH EXERCISE
 RECORD THE FOLLOWING:
* THE TIME YOU PERFORMED THE EXERCISES
* THE JOINTS THAT WERE EXERCISED
* THE NUMBER OF TIMES THE EXERCISES WERE PERFORMED ON
EACH JOINT
* ANY COMPLAINTS OF PAIN OR STIFFNESS
* TO WHAT DEGREE DID THE PATIENT ASSIST
 EXERCISE ONLY THE JOINTS THE NURSE TELLS YOU TO EXERCISE
 EXPOSE ONLY THE BODY PART BEING EXERCISED
 USE GOOD BODY MECHANICS
 SUPPORT THE PART BEING EXERCISED
 MOVE THE JOINT SLOWLY, SMOOTHLY, AND GENTLY
 DO NOT FORCE A JOINT BEYOND ITS PRESENT RANGE OR MOTION OR
TO THE POINT OF PAIN
 REPEAT EACH EXERCISE 5 TIMES PER JOINT
 KNOW THE FACILITY POLICY IN REGARDS TO RANGE OF MOTION
EXERCISES FOR THE NECK
AMBULATION IS THE ACT OF WALKING
 SOME PEOPLE ARE WEAK AND UNSTEADY
 CHECK THE CARE PLAN TO SEE WHAT ASSISTANCE IS NEEDED
 ALWAYS USE A GAIT BELT
 KNOW THE PERSON’S LIMITATIONS
* HOW FAR CAN THEY WALK
* ANY PARALYSIS OR WEAKNESS IN LEGS
* ANY ASSISTIVE DEVICE (CANE, WALKER, CRUTCHES)
 THE PERSON MUST WEAR NON-SKID SHOES
 DANGLE THE PERSON FOR A FEW MINUTES BEFORE STANDING
THEM UP
 WALK TO THE SIDE AND SLIGHTLY BEHIND THE PERSON
 STAND ON THE PERSON’S WEAK SIDE
 THE PERSON SHOULD LOOK FORWARD, NOT AT THE FLOOR
 ENCOURAGE THEM TO WALK NORMALLY
DO NOT TRY TO PREVENT THE FALL
YOU COULD HURT YOURSELF OR THE PATIENT BY DOING SO
IF A PERSON BEINGS TO FALL, STEP BACK AND EASE HIM TO THE FLOOR
THIS ALLOWS YOU TO CONTROL THE FALL
DO NOT ALLOW THE PERSON TO GET UP UNTIL CHECKED BY THE NURSE
CRUTCHES ARE USED WHEN THE PERSON CANNOT
USE ONE LEG OR WHEN ONE LEG IS WEAK
 MUST HAVE RUBBER TIPS ON THE BOTTOM
 CHECK ALL BOLTS FOR TIGHTNESS
 WEAR NON-SKID SHOES
 MUST BE ADJUSTED CORRECTLY FOR PERSON’S
HEIGHT
CANES ARE USED FOR WEAKNESS ON ONE SIDE OF THE BODY. THEY
HELP PROVIDE BALANCE AND SUPPORT
 CANES ARE HELD ON THE STRONG
SIDE OF THE BODY
 DIFFERENT CANES MEET DIFFERENT
NEEDS OF THE PERSON
WALKING CANE
TRIPOD
QUAD
 SUPPORT WEIGHT ON STRONG LEG AND MOVE CANE FORWARD
ABOUT 6 - 10 INCHES
 THE WEAK LEG IS ROUGHT FORWARD EVEN WITH THE CANE
 SHIFT WEIGHT TO THE WEAK LEG AND THE CANE, MOVING THE
STRONG LEG FORWARD AHEAD OF THE CANE
 REPEAT MOTIONS TO MOVE AHEAD
A WALKER GIVES MORE SUPPORT THAN A CANE
 THE WALKER IS PICKED UP AND MOVED ABOUT 6 TO 8 INCHES IN FRONT
OF THE PERSON
 THE PERSON MOVES THE WEAK LEG FORWARD
 THEN MOVES THE STRONG LEG FORWARD
DO NOT LET THE PERSON DRAG THE
WALKER ON THE FLOOR - IT MUST BE
PICKED UP
MAY HAVE WHEELS ON THE WALKER TO
ASSIST WITH MOVEMENT
MAY HAVE BASKETS OR TRAYS ATTACHED
TO THE FRONT SO THEY MAY CARRY ITEMS
WITH THEM
BRACES SUPPORT WEAK BODY PARTS
THEY PREVENT OR CORRECT DEFORMITIES OR
PREVENT JOINT MOVEMENT
 SKIN AND BONY PROMINENCES UNDER THE
BRACE ARE KEPT CLEAN AND PROTECTED
 REPORT ANY COMPLAINTS OF PAIN OR
DISCOMFORT
 THE NURSE OR CARE PLAN WILL TELL YOU
WHEN TO APPLY THE BRACE
THE PROCESS OF RESTORING THE PERSON TO HIS OR HER HIGHEST
POSSIBLE LEVEL OF FUNCTIONING
 MUST LOOK AT THE “WHOLE” PERSON - PHYSICAL, PSYCOLOGICAL,
SOCIAL, AND ECONOMIC
 GOALS ARE DIFFERENT FOR EACH INDIVIDUAL
 STRIVE TO MAKE PERSON AS INDEPENDENT AS POSSIBLE
REHABILITATION BEGINS WHEN PERSON IS FIRST ADMITTED TO
HEALTH CARE FACILITY
NURSING CARE IS GIVEN TO PREVENT COMPLICATIONS THAT WILL
IMPACT REHABILITATION EFFORTS
SELF-CARE IS A MAJOR GOAL
PERSON WILL PERFORM ACTIVITIES OF DAILY LIVING AS
INDEPENDENTLY AS POSSIBLE
MAY NEED ASSISTIVE DEVICES
AN ARTIFICIAL REPLACEMENT FOR A MISSING
BODY PART
THE PERSON IS MEASURED AND FITTED FOR THE
PROSTHESIS
THE PERSON LEARNS HOW TO USE THE
PROSTHESIS
SELF-ESTEEM MAY BE AFFECTED BY LOSS OF FUNCTION OR
APPEARANCE
THE PERSON MAY FEEL WORTHLESS OR UNATTRACTIVE
THE PERSON MAY DENY THE DISABILITY
THEY MAY BE DEPRESSED, ANGRY, AND HOSTILE
THE PERSON MUST BE MOTIVATED TO IMPROVE OR REHABILITATION
WILL NOT BE SUCCESSFUL
THE PERSON MUST ACCEPT HIS OR HER LIMITATIONS
THE FOCUS IS ON WHAT THE PERSON CAN DO - NOT ON WHAT THEY
CANNOT DO
PROGRESS MAY BE SLOW SO SHOW POSITIVE ENCOURAGEMENT
FOR ANY SMALL SUCCESS OR PROGRESS THE PATIENT SHOWS
 MAINTAIN THE PERSON’S DAILY ROUTINE
 GIVE GOOD NURSING CARE TO PREVENT COMPLICATIONS
 REPORT ANY SIGNS OF COMPLICATIONS
 APPLY ASSISTIVE DEVICES AS NEEDED
 DO NOT GIVE SYMPATHY OR PITY THE PERSON
 ENCOURAGE THE PERSON TO BE INDEPENDENT WHEN PERFORMING
ADL’S
 DO NOT HURRY THE PERSON. GIVE THEM TIME TO COMPLETE THE
TASK
 GIVE PRAISE FOR EVERY PROGRESS MADE, EVEN IF THE PROGRESS
WAS SMALL
 PROVIDE EMOTIONAL SUPPORT
 BE UNDERSTANDING
 BE FAMILIAR WITH EQUIPMENT AND ASSITIVE DEVICES
 FOCUS ON WHAT THE PERSON CAN DO
 ALLOW THE PERSON CHOICES WHEN APPROPRIATE