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skills and techniques USAHS Midterm Exam
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what is contact precautions? - ✔✔used to prevent transmission of infectious agents that are spread by direct or indirect contact with patient or environment. when would you use contact precautions? - ✔✔excessive wound drainage, fecal incontinence, other discharges from body with increased risk of transmission what are the Contact precautions guidelines? - ✔✔wash hands before and after entering, gloves, gown (when in direct contact with patient or environment), 3ft between beds and dedicated equipment what is droplet precautions? - ✔✔used to prevent transmission of pathogens spread through mucus membranes or close respiratory contact with respiratory secretions what are the guidelines for droplet precaution? - ✔✔wash hands before and entering room, wear a mask, pt. should have a private room, and pt. should wear a surgical mask outside of room what are airborne precautions? - ✔✔used to prevent transmission of infection agents that remain infectious over long distance when suspended in air examples of airborne precautions - ✔✔chickenpox, measles, TB, SARS-CoV
what are the guidelines for airborne precautions? - ✔✔wash hands before and after entering room, wear N-95 respirator (fit test needed), discard mask after leaving room, room should be private with door remaining closed, patient should wear mask when transported Doning PPE order - ✔✔hand hygiene gown mask eye protection gloves Doffing PPE Order - ✔✔Gloves eye protection gown mask hand hygeine Which cushion is the lowest cost, and has firm support? - ✔✔standard foam Which cushion is best to use in combination with the standard foam? - ✔✔Gel or memory foam the standard foam is best for individuals with low risk of...... - ✔✔developing pressure sores which cushion is primarily used for support and positioning? - ✔✔standard foam
The wheel chair ________ sometimes require an extension to allow caregivers to maintain a more upright position when transporting - ✔✔hand grips/push handles _______ aid in safety, pressure reduction and position for a wheelchair user - ✔✔armrest pads ______help balance and contain the user in the wheelchair - ✔✔armrests when transferring a patient, a ______ is typically removed to create an unobstructed transfer plane. - ✔✔side panel the wheelchair seat width is usually the measurement of the ______ between the arm rests - ✔✔seat upholstery the ______ is sometimes outfitted with straps to help users maintain an upright position when appropriate - ✔✔wheelchair back upholstery to make transfers easier____ are usually removable and swing away - ✔✔riggings a _____ that is too high or too low can cause discomfort and can put more pressure on your joints - ✔✔footplate wheelchair caster wheels are mounted to a _____ assembly - ✔✔caster fork
the ________ swivel in all directions to improve your wheelchairs maneuverability - ✔✔front casters the ____ are two of the four points of the wheelchair that come in contact with the environment and they are the instrument through which independent manual mobility happens - ✔✔rear wheels a _____ on the rear wheels help protect the nuts and bolts of the wheel and maintain its integrity and safety - ✔✔cap hub the most common type of wheelchair______ are called the push/pull lock - ✔✔brakes what can too narrow of a wheelchair cause? - ✔✔restriction and pressure on greater trochanters what problems can occur is a wheelchair is too wide? - ✔✔hard to drive and navigate What is the ideal width of a wheel chair? - ✔✔one finger width between hip and wheelchair side what is the ideal depth/length of a wheelchair - ✔✔two finger widths from back of the knee what are some problems when the wheelchair is too deep/too long? - ✔✔creates pressure on the popliteal fold and causes pressure behind the leg and cuts off circulation causing a risk to skin integrity. Also causes the patient to slouch forward.
knees at a 90 degree angle feet firmly supported on footrests leg resting on the seat surface posture isn't always possible how long can someone sit in one position when they have no feeling in their butt and has a history of open pressure ulcers on their butt and is unable to shift their weight? - ✔✔1 hour how long can someone sit in one position if they are under 18/still growing and arms or legs become highly rigid or tense making movement stiff or slow? - ✔✔2 hours What is independent assistance? - ✔✔the patient is able to perform without any type of assistance, including verbal and manual assistance what is a modified independent assistance? - ✔✔patient may require verbal cues or assistive/adaptive equipment. (bedrails or sliding board) What is standby assistance? - ✔✔the patient requires cues, directions or instructions from another person positioned close to the patient but not touching them what is contact guarding assistance? - ✔✔the patient requires a person positioned close to and with contact on the patient what is minimal assistance? - ✔✔the patient performed more than 75% of the activity
what is moderate assistance? - ✔✔the patient performs 50-74% of activity what is maximal assistance? - ✔✔the patient performs 25-49% of activity what is dependent assistance? - ✔✔the patient requires total physical assistance from one or more persons to accomplish the activity safely; special equipment may be used what are the benefits of proper use of body mechanics and core stability? - ✔✔energy conservation reduces stress and strain on body structures reduces risk of personal injury elads to safe movements of the spine promotes and maintains proper body control and balance promotes effective and efficient respiratory and cardiopulmonary function what is object COG? - ✔✔point where the object is heaviest to move or most difficult to adjust to a new position what is a person's COG? - ✔✔2nd sacral segment in center of pelvis how do you adjust COG to reduce torque to move or carry an object? - ✔✔position the persons COG closer to the objects COG. its easier to adjust the COG of an object than a Person
lift objects as if removing a golf ball from the cup what is the proper position of the half kneel lift? - ✔✔kneel on one knee positioning behind and on one side of the object position the other leg with foot flat and hip and knee flexed to 90 degrees grasp and lift object with arms then place object on thigh of the flexed leg move the object close to the body rise to a standing position maintaining normal lordosis of the lumbar spine throughout the lift what is the proper body position of the traditional lift? - ✔✔face the object with feet in an AP position on each side of the object and legs in a deep squat grasp object underneath with arms parallel or AP to one another contract flexors of the elbow and shoulder contract extensors of legs to further raise the object hold object close to the body maintain normal lordosis of the lumbar spine throughout the lift what is the proper body position of the stoop lift? - ✔✔partially flex hips and knees maintain normal lordosis of the lumbar spine grasp objects with hands use legs to raise body and object, keeping object close to the body what wheelchair is designed for smooth surfaces and not for vigorous functional activities? - ✔✔standard
what wheel chair has a low profile, fixed frame and is lightweight? - ✔✔sports what is unique in the design of the sports wheelchair? - ✔✔low back with canted rear wheels fixed or adjustable axels fixed or adjustable seat and backrest what are some conditions that need a semi- or fully-reclining wheelchair? - ✔✔severe arthritis respiratory difficulties poor trunk stability quadriplegia head injuries post radical laminectomy severe MS muscular dystrophy severe decubitus ulcers on butt Balanced posture - ✔✔neutral pelvic tilt neutral angle of hips and knees body position for carrying - ✔✔keep COG close to object, shortening lever arms best to carry near waist, mid chest
deep-cycle battery system; joystick, chin piece, mouth piece - ✔✔Externally Powered Designed for people weighing > 200lb, allows for vigorous functional activities - ✔✔heavy duty flat back - ✔✔posterior pelvic tilt slight hyperextension of hips and knees "lack of shock absorption in this posture what does flat back look like - ✔✔legs are parallel, back is flat, parallel to the floor with torso hinged at hips when moving a patient from supine to prone, if they do not have full shoulder motion where do you put their arm? - ✔✔tuck it in what lift requires a half squat? - ✔✔power lift what lift requires full hip and knee extension? - ✔✔deep squat lift head hip ratio for lateral swing transfer - ✔✔head goes away from where they are going, point toes away from where they are moving hemiplegia positioning - ✔✔scapula should stay protracted
What lift requires hips and knees to be partially flexed for objects below waist - ✔✔stoop lift how do pathogens leave the host - ✔✔portal of exit if a patient has less that 3/5 strength in their legs and less than 3/5 strength in arms which transfer do you perform - ✔✔one person dependent lift transfer or 2 person dependent lift transfer if a patient has less than 3/5 strength in legs and more than or equal to 3/5 strength in arms then what type of transfer should you do - ✔✔start with sliding board the progress to lateral swing if a patient has less than 3/5 strength in their legs what type of transfer should you do? - ✔✔sliding if a patient has more than or equal to 3/5 strength in both affected legs what type of transfer should you do? - ✔✔standing dependent pivot transfer if a patient has more than or equal to 3/5 strength in legs and only ONE leg is affected, what type of transfer should you do? - ✔✔standing assisted pivot transfer if a patient had more than or equal to 3/5 strength in legs, what type of transfer should you do? - ✔✔standing transfer immobility side effects on urinary system - ✔✔reduced kidney function incontinence UTI
immobility side effects on cardiovascular system - ✔✔blood clots reduced blood flow immobility side effects on respiratory system - ✔✔pneumonia decreased respiratory effort decreased oxygenation of blood how do you properly push or pull and object? - ✔✔keeping COG close to object bend hips and knees keep elbows slightly bent apply force to move object parallel how do you properly perform a half-kneeling lift? - ✔✔kneel on one leg with the other leg flexed at 90 degrees at the knee and hip causes of kypholordotic posture - ✔✔habit, pregnancy, obesity, weak abdominals What is kypholordotic posture? - ✔✔increased lumbar lordosis and increased thoracic kyphosis what is shortened during a kypholordotic posture - ✔✔hip flexors lumbar extensors pecs and lats upper traps and levator
scalenes SCM suboccipitals what is lengthened during a kypholordotic posture - ✔✔abdominals thoracic erector spinae low and middle traps hamstrings what type of wheelchair has large drive wheels in the front and small caster wheels in the back? - ✔✔indoor what is the posture of a lordotic back? - ✔✔anterior pelvic tilt and slight hyperextension of the knees what is the normal kyphosis area of the spine - ✔✔thoracic region where are the normal lordosis regions of the spine? - ✔✔cervical and lumbar spine where is the approximate location of a person's COG when standing - ✔✔second sacral segment in the center of the pelvis pillow placement when patient is prone - ✔✔under shins and stomach
protect bony prominences perform careful and gentle exercises several times a day
