Conditions and Occupational Therapy Activities/Interventions – Flashcards
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Autism
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A syndrome of extreme withdrawal and obsessive behavior that manifests in early childhood. Notable impairment in socialization, communication, activities, and other interests.There is a delay in the onset of speech Evidence suggests that the disease is hereditary or possibly linked to predisposing factors of maternal rubella, encephalitis, and phenylketonuria. Treatment includes Risperidone, behavioral therapy, antidepressants, and antiepileptics.
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What are some OT interventions for autism?
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Symbolic play therapy to improve social skills, sensory integration to reduce sensory defensiveness and overload, and increasing body awareness through the use of obstacle courses.
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Asperger's Disorder
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Symptoms are similar to autism but clients tend to have average or above average intelligence. Additionally, they tend to have a very narrow range of interests, may have difficulty concentrating, experience poor coordination, and have trouble adjusting to changes.No delay in speech
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Developmental Delay
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This condition indicates delay in one or more of the following developmental areas: cognitive, physical (including vision and hearing), communication, social or emotional, and adaptive. Can be caused by heredity, infectious disease, birth trauma, in utero growth retardation/drug use, and accidents.
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What are some OT interventions for Developmental Delay?
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Improve hand use and function by dropping objects into containers to practice grasp-release patterns, improve hand-eye coordination by using games such as ring stack/ring toss, and reduce tactile sensory defensiveness while increasing tactile exploration through the use of brushing, vibration, and touching of textured materials.
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Duchenne's Muscular Dystrophy
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Progressive degeneration and weakening of the skeletal muscles where muscle fibers are abnormally vulnerable to injury, usually diagnosed soon after birth or during early childhood. This condition is caused by a X-linked recessive genetic defect characterized by the absence of dystrophin and affects the muscles of the shoulders, hips, thighs, and calves, causing a characteristic waddling gait and toe walking. Treatment includes PT, exercise, surgery, corticosteroids, and orthoses to preserve mobility.
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What are some OT treatments for Duchenne's Muscular Dystrophy?
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Adaptive equipment to help the person perform basic ADLs, prevent contractures by providing AROM and PROM, and promote energy conservation by allowing time for rest periods.
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Down's Syndrome
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Genetic syndrome where the individual has an extra copy of the chromosome 21 resulting in mild to severe mental retardation accompanied by characteristic facial features and distinctive physical abnormalities of small head, slanted eyes, flat nasal bridge, protruding tongue, short stubby fingers, simian line, and exaggerated space between the big and little toes.
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What are some OT treatments for Down's Syndrome?
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Compensate for vestibular deficits by using balancing boards, improve visual-spatial skills by playing with nesting cups, and using a stability ball and strengthen trunk/core muscles.
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Fetal Alcohol Syndrome
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Birth deficits and other associated problems in infants born to alcoholic mothers who consume alcohol during the gestational period. Infants are short and below average in weight with characteristic facial features of small eye openings with eyes spaced widely apart and a thin upper lip. These patient may also experience CNS problems and heart defects. Treatment is supportive because neurological damage cannot be reversed.
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What are some OT treatments for Fetal Alcohol Syndrome?
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Sensory integration building blocks, Play-Doh, and a "sensory box", and group-based or play therapy to focus on improving social skills and reinforce appropriate behavior.
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Athetoid CP
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A subtype of CP characterized by involuntary writhing "wormlike" muscle movements and reduced muscle tone, and trouble with speech. Treatment includes a multidisciplinary approach which may include PT/ST/OT and special education. Orthopedic intervention with casts, braces, and traction or surgery may be required.
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What are some OT treatments for Athetoid CP?
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Adaptive equipment such as an adapted toilet seat or tub/shower chair to provide postural stability during performance of basic ADLs. Patient can also be taught to use electronic devices to aid in socialization, leisure, and communication performance areas. Also, play activities that focus the activity toward the midline are helpful in compensating for simultaneous head/trunk movements.
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Hypotonic CP
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A subtype of CP characterized by decreased muscle tone, and loose, floppy limbs. It is the CP subtype with the worst prognosis. Joint subluxation and contractures are common.
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What are some OT treatments for Hypotonic CP?
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Hippotherapy can be used to address posture, gross motor function, and coordination. Also, adaptive equipment can be used such as customized dining chairs with head support to aid in the ADL of eating.
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Ataxic CP
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A subtype of CP characterized by lack of control over voluntary movements, poor balance, and wide gait.
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What are some OT treatments for Ataxic CP?
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Prevent contractures with AROM/PROM (especially in the lower extremities), compensate for delayed speech and language development by providing alternative methods to communicate with, and suggest clothing adaptations to facilitate self-dressing.
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Spastic CP
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A subtype of CP characterized by hyperactive reflexes or rapid muscle contractions and scissor gait. Can affect one or more extremities simultaneously, usually with hypertonicity in one extremity and hypotonicity in the opposing muscle group and tone levels may fluctuate.
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What are some OT treatments for Spastic CP?
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Brushing to reduce tactile defensiveness, AROM/PROM to prevent contractures, and adaptive seating to promote appropriate postural support and stability.
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CVA (Cerebrovascular Accident)
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A neurologic emergency that occurs when the brain is damaged by a sudden disruption in the flow of blood to a part of the brain, or by bleeding inside the brain. Symptoms include sudden severe headache, sudden aphasia, sudden dysphagia, sudden weakness/numbness/paralysis of the face, confusion, visual changes, and loss of balance and coordination. Treatments include anticoagulants, thrombolytic agents, antiplatelet medication, and surgical repair.
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What are some OT Treatments for CVA?
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Environmental modification to promote spatial awareness to orient the person toward neglected side, i.e. placing alarm clock on the nightstand of the affected side. Hand-over-hand guiding as well as verbal cues can be used to guide the client toward the unattended side. "Clock method" of food plating and thickening agents can aid with self-feeding. Proper positioning in bed can aid in preventing shoulder subluxation in the case of a hemiplegic shoulder.
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TBI (Traumatic Brain Injury)
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This occurs when an external force injures the brain. Symptoms can be mild (concussion) to severe (depressed skull fractures). Treatments include bed rest, craniotomy, and monitoring of vital signs and behavior.
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What are some OT treatments for TBI?
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Promote the completion of self-care ADLs by having the client set up items in plain view and in the appropriate order of completion. Visual cues (labeling items) can help orient the client. Sensory integration techniques can also help the client improve sensory processing (sensory box).
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Multiple Sclerosis
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Inflammatory disease of the CNS affecting the myelin sheath and causes scarring of the nerve fibers. It it thought to be autoimmune. Treatment includes interferon, corticosteroids, immunosuppressive therapy, muscle relaxants, and vitamins.
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What are some OT treatments for MS?
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Adaptive equipment to perform self-care ADLs can be used to conserve energy. Progressive resistance exercises to improve upper extremity strength within the person's limits of fatigue.
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Parkinson's Disease
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A slowly progressive neurologic disorder characterized by the onset of recognizable disturbances: "pill-rolling" tremor, muscular rigidity, slowness of movement, postural instability, and shuffling gait.Upper motor neurons. Treatment includes antidepressants, anticholinergics, dopamine-based drugs, and deep brain stimulation.
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What are some OT treatments for Parkinson's?
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Compensate for tremors by using both hands simultaneously or use one hand/extremity to stabilize the other in order to perform ADL of eating/drinking. Prevent contractures by stretching tight muscles and performing AROM/PROM. Can also use a metronome to provide a rhythm for practicing posture and balance activities.
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Myasthenia Gravis
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Chronic, progressive neuromuscular disease that is thought to stem from the presence of autoantibodies to the acetylcholine receptor. Symptoms include extreme muscle weakness without atrophy, drooping eyelids, diplopia, and difficulty with talking, chewing, and swallowing. Treatment includes plasmapheresis, thymectomy, anticholinesterase drugs, corticosteroids, restricted activity, Mestinon, and immunosuppression.
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What are some OT treatments for Myasthenia Gravis?
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Adaptive equipment to conserve energy while performing basic ADLs, ptosis crutches to remediate visual problems caused by eyelid drooping, and non-resistive exercises to increase strength and endurance.
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Guillain Barre Syndrome
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An acute, rapidly progressive disease of the spinal nerves characterized by ascending paralysis and demyelination of the nerves. It is thought to be autoimmune in nature and treatment includes plasmapharesis and IVIG.
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What are some OT treatments for Guillain Barre Syndrome?
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Gentle, nonresistive activities and games can help improve muscle strength and prevent contractures and muscle atrophy. Task simplification methods can be used to conserve energy while completing work/home tasks.
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(ALS) Amyotrophic Lateral Sclerosis
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Progressive, destructive motor neuron disease that results in muscular atrophy and is characterized by fasciculations and weakness/atrophy in the forearms and hands. Upper and lower motor neurons involved. Symptoms progress to include difficulties with speech, chewing, swallowing, and breathing. The disease is thought to be autosomal in nature and treatment includes drug therapy, muscle relaxants, and other supportive measures.
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What are some OT interventions for ALS?
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Hand splints, neck supports, overhead slings, or mobile arm supports can help compensate for muscle weakness and provide stabilization. Passive stretching and range of motion can be used to prevent contractures. Changing the consistencies of foods can help facilitate swallowing.
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COPD (Chronic Obstructive Pulmonary Disease)
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A condition of slow and irreversible progressive airway obstruction that encompasses several different diseases of the lungs including chronic bronchitis, bronchiectasis, asthma, emphysema, cystic fibrosis, and pneumoconiosis. Etiology may be viral, allergic, or related to foreign bodies (dust/chemicals). Treatments include oxygen therapy, corticosteroids, antibiotics, bronchodilators, and nebulizer treatments.
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What are some OT treatments for COPD?
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Provide adaptive equipment to assist the person in performance of ADLs while conserving energy (reachers, shoe horns, etc.). Modifications can also be made to provide easier access to patient's daily medications such as nebulizers and inhalers. Also, gravity-resistive exercises can be used to increase muscle strength and endurance.
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Ischemic Heart Disease
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This disease occurs when blood flow and oxygen flow are decreased in the heart muscle. This condition may lead to MI. Treatments include changes in diet and lifestyle, anti-platelet agents, lipid-lowering medications, beta blockers, ACE inhibitors, and treatment/control of associated disorders such as diabetes mellitus.
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What are some OT treatments for Ischemic Heart Disease?
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Patient can be instructed in work simplification, pacing, and energy conservation. Also, patient can modify existing leisure activities to fit within permitted energy expenditure levels. Exercises to prevent muscle loss can be graded so that client can complete them within their limits. They can be taught to monitor their heart rate and bp.
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Congestive Heart Failure
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Acute or chronic inability of the heart to pump enough blood throughout the body to meet the demands of homeostasis. This usually leads to distended neck veins, edema, liver and spleen enlargement, and respiratory difficulties. This disease is usually the result of MI, chronic hypertension, coronary artery disease, COPD, cardiac valve damage, arrhythmias, and cardiomyopathy. Treatment includes digitalis preparations, ACE inhibitors, ARBs, diuretics, vasodilators, aldosterone antagonists, reduced fluid and sodium intake.
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What are some OT treatments for CHF?
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Patient can be instructed to modify activities to conserve energy. Modifications can be made to help person adhere to medication routines (medication alarms or journals). Suggestions for possible modifications of the home/work environment based on ergonomics can be suggested to reduce cardiac stress.
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What are some OT treatments for total hip replacement?
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Adaptive equipment can be used to help independently perform self-care ADLs (reachers, raised toilet seats, bath chairs, etc.). Walkers will help promote mobility as soon as tolerated/recommended by doctor. Good circulation can be promoted through the use of compression stockings. Modifications to clothing/shoes should be recommended to help client dress themselves easily while maintaining precautions.
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What are some OT treatments for total knee replacement?
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CROM to improve circulation and prevent development of a thrombus is recommended soon after surgery. Adaptive equipment (walker, cane) to promote mobility should be introduced soon after surgery. Home evaluation/modification can be performed to assess for any risk factors that may cause re-injury to the knee (throw rugs, uneven stairs, etc.).
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What are some OT treatments for Colles' Fracture?
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Splinting can be done if surgery is not required. This will immobilize the arm and promote stability of the arm/joints and healing. After the fracture has healed, OT can practice ROM and grip-strengthening exercises to help client regain function and strength lost during the healing phase.
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Congenital Hip Dysplasia
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Abnormal development of the hip joint that ranges from an unstable joint to dislocation of the femoral head from the acetabulum that occurs shortly before, during, or shortly after birth. Treatment is aimed at using various devices - such as harnesses, splints, or casts - to reduce the hip dislocation.
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What are some OT treatments for Congenital Hip Dysplasia?
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Prevent dislocation of the hip joint by educating parents on proper swaddling techniques. Adaptive equipment (walkers) can be introduced when the patient is ready to start being mobile. Also, upper extremities can be used to compensate for lower extremity weakness.
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(AMC) Arthrogryposis Multiplex Congenita
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Nonprogressive condition that involves multiple congenital contractures and may affect other body systems. The disease may involve the extremities only, the extremities and other body systems, and extremities along with the CNS. It is thought to be caused by decreased movement of the fetus in the uterus.
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What are some OT treatments for AMC?
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Maintain joint mobility and prevent additional contractures with ROM exercises. Use of adaptive equipment can be used to help complete ADLs (adapted dining chair, strollers, etc.). Promote achievement of gross and fine motor skills through the use of graded grasping activities.
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Osteoarthritis
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Type of arthritis that results from the breakdown and eventual loss of cartilage in one or more joints. It is the most common type of arthritis and most people 75+ have some sort of manifestation. Heberden's and Bouchard's nodes are classic manifestations of the disease. Treatment includes physical and drug therapy aimed at reducing inflammation and pain, and maintaining joint function.
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What are some OT treatments for Osteoarthritis?
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Aquatic therapy is very beneficial because it increases strength and endurance with minimal stress to the joints. Maintain mobility by encouraging the patient to take daily walks or by using a treadmill during OT intervention. Compensate for pain flare ups by suggesting patient wear loose-fitting clothing with front openings to make dressing easier.
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Carpal Tunnel Syndrome
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Compression of the median nerve of the wrist, resulting in numbness, tingling, and/or pain in the thumb, index, middle, and radial half of the ring finger. This is caused by repetitive overuse. Treatment includes PT, identification/cessation of the repetitive motion, antiinflammatory drugs, ice packs, splints, oral corticosteroids, local injection into the affected area, and surgical intervention if necessary.
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What are some OT interventions for Carpal Tunnel?
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Splinting to compensate for pain and to prevent repetitive flexion while performing occupation. Ergonomic modifications can be made in the work environment. Maintain joint mobility through activities such as crafts, games, cooking, etc.
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Rheumatoid Arthritis
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Chronic, inflammatory, systemic disease that affects the joints and commonly causes deformity and disability. "Swan Neck" deformity in the fingers is a classic sign of the disease. It is thought to be autoimmune and heredity may predispose some persons. Treatment is aimed at reducing inflammation and pain, preserving joint function, and preventing joint deformity. This may include medication, rest, special exercises, joint protection, antiinflammatory meds, NSAIDs, corticosteroids, and antirheumatic drugs.
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What are some OT treatments for Rheumatoid Arthritis?
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Maintain muscle strength and joint mobility through aerobic exercises during periods of remission. Compensate for exacerbation periods by employing energy conservation methods and allowing for periods of rest. Splinting, and using the opposite hand for twisting motions - such as opening a jar - can also be used to prevent ulnar deviation deformity.
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Describe the treatment of renal calculi.
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Treatment of kidney stones includes analgesic therapy and hydration in an attempt to get the calculi to pass naturally. If this is unsuccessful, surgical procedures such as lithotripsy or electrohydraulic lithotripsy where shock waves or lasers are utilized to break up the calculi into smaller pieces that can be passed naturally. If this is unsuccessful, more invasive methods such as cystoscopy and percutaneous nephrolithotomy are performed where a small incision is made directly into the kidney and the stone(s) are shattered by ultrasound or EHL.
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Explain the signs/symptoms and treatment of diabetic nephropathy.
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This condition refers to changes in the kidneys associated with diabetes mellitus. These symptoms include urinary retention, hypertension, nausea, and protein in the urine. UTI and pyelonephritis commonly occur with diabetic neuropathy. Treatment includes control of the diabetes mellitus and blood pressure, drug intervention, balanced fluid intake, low-protein low-fat diet, and prompt treatment of any infections that may occur. If ESRD is a factor, patient may be a candidate for dialysis or kidney transplantation.
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Stress Incontinence
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Involuntary loss of small amounts of urine with increased intra-abdominal pressure. Leakage of urine include exercise, laughing, sneezing, coughing, and lifting.
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Describe treatment of neurogenic bladder? What is the difference between reflex neurogenic bladder and autonomous neurogenic bladder?
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Neurogenic bladder is a dysfunction of the urinary bladder that consists of difficulty in emptying the bladder or incontinence in some patients. Patients with reflex neurogenic bladder experience a loss of sensation, uncontrolled bladder contractions, and spontaneous voiding of urine. Patients with autonomous neurogenic bladder experiences a loss of all sensations and has absent contractile functions, which results in the inability to void without manual pressure to the suprapubic area. Treatment involves preventing UTIs and restoring function to as normal as possible. Patients are provided with devices to store urine and empty the bladder. Catheterization and surgery are possible interventions. Drug therapy can also be indicated in certain cases.
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Describe hemodialysis and peritoneal dialysis.
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Hemodialysis involves removing impurities or wastes from the patient's blood by using an artificial kidney (hemodialyzer machine) that passes the blood through a semipermeable membrane and returns the cleansed blood back into the patient via an internal fistula. This process takes 3 to 4 hours and can take place in the home or hospital 2 or 3 times per week. Peritoneal dialysis involves using the patient's peritoneal membrane as the means of filtering out harmful toxins and excessive fluids. Clean dialyzing fluid passes through the peritoneal cavity via a permanent indwelling peritoneal catheter and wastes are diffused across the peritoneal membrane. The contaminated fluid is drained and subsequently replaced with fresh fluid. This process can be continuous ambulatory where the dialysis fluid drains into a bag worn around the patient's waist and done 3 or 4 times a day in 15-minute intervals and once a night. Continuous cycling involves using a cycling machine and is performed nightly while the patient sleeps. Intermittent peritoneal dialysis is done 3 to 5 times a week, takes several hours, and usually takes place in a clinic environment.
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Acute Glomerulonephritis
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Inflammation and swelling of the glomeruli of the kidney Can be primary disease of the kidney Can develop secondarily to a systemic disease Usually follows a streptococcal bacterial infection or the throat or skin
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Symptoms of Acute Glomerulonephritis
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Protein in urine edema decreased urine volume blood in urine Sometimes hypertension
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Treatment for AG
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Antibiotic if infection present rest diuretics restrict sodium steroids if immune reaction suspected
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Chronic Glomerulonephritis
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slowly progressing NON infectious disease that can result in irreversible renal damage and renal failure seen in advance stage kidney disorders reduces glomerular filtration
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Symptoms of CG
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Initially no symptoms mid stage- hypertension,hematuria,proteinuria,edema,slight or infrequent urination(oliguria) late stage- severe hypertension excessive wastes in blood (azotemia)
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Nephrotic Syndrome
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Caused bu excessive loss of protein in the urine resulting in: depressed plasma protein levels increased water and sodium retention increased susceptibility to infection
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Symptoms of Nephrotic Syndrome
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Bloody urine loss of appetite pale skin puffiness around eyes swollen ankles weight gain
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Treatment of Nephrotic syndrome
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Reduced protein intake lower sodium intake use diuretics to control edema monitor urine output Corticosteroids may help some control proteinuia
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Acute Renal Failure
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ARF is characterized by a sudden reduction in renal function Clinical emergency due to nitrogenous waste products accumulating in blood
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Symptoms of ARF
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Slight or infrequent urination (oliguria) gastrointestinal disturbances headache drowsiness
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Etiology of ARF
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Diminished blood flow to kidney intrarenal damage to the kidney mechanical obstruction of urine flow Can lead to death
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Treatment for ARF
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Reverse decreased renal function balance intake and output control sodium and potassium high carb low protein diet Drug therapy: diuretics anti infective agents anti hypertensives Prompt treatment can reverse renal failure and lead to full recovery
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Chronic Renal Failure
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Results from the gradual and progressive loss of nephrons irreversible loss of renal function gradual build up of waste in blood (uremia) hypertension arrhythmias Muscle weakness Fatigue
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Treatment of CRF
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Goal -to prolong and improve quality of life Dialysis, of transplant diuretics BP meds
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Pyelonephritis
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Inflammation of the renal pelvis and connective tissues of one or both kidneys. Most common type of renal disease
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Symptoms of Pyelonephritis
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Rapid onset of: fever chills nausea and vomiting lumbar pain usually preceded by a UTI
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Diagnosis of Pyelonephritis
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Assessment of clinical findings: blood culture radiographic white and red blood cells in urine bacteria, pus and protein in urine
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Treatment of Pyelonephritis
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oral antibiotics increase fluid to dilute urine bed rest early detection and treatment usually leads to full recovery
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Cystitis and Urethritis
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Cystitis: inflammation of the urinary bladder Urethritis: inflammation of the urethra
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Symptoms of Cystitis & Urethritis
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Frequent urination, burning sensation and discoloration pain in pelvic region and low back spasm of the bladder fever chills
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Etiology of Cystitis & Urethritis
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Bacteria E. Coli ( most common) STD's viruses parasites inflammation from chemo or radiation
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Explain the treatment and patient teaching for infectious urethritis.
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Urethritis is a common form of UTI caused by inflammation of the urethra due to the accumulation of bacteria in the urinary tract. Treatment involves antibiotic therapy that is organism-specific. Pyridium is sometimes prescribed to decrease painful urination. Patients are advised to increase fluid intake, especially water as soon as symptoms are experienced. Female patients should be instructed on proper wiping procedures after toileting (front to back) to prevent fecal matter from being brought toward the urinary meatus causing an infection. Females should also be advised to empty their bladder after sexual activity.
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Cleft Palate
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A congenital malformation that occurs in utero during the first trimester of pregnancy, and involves a fissure in the hard, soft, or both palates
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Treatment of Cleft Palate
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Surgery to close cleft
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OT intervention
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Positioning for feeding adaptive feeding equipment Will require further surgeries and the involvement of speech therapy as well as OT
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Huntington's Chorea
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Huntington's disease is a genetic degenerative neurological condition with three major characteristics. One is changes in voluntary muscle control, sometimes becoming worm or wave-like movements known as chorea. Another is changes in behavior, which can include violent outbursts. A third characteristic is changes in cognition which eventually leads to dementia . Slow onset the first 10 years
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Treatment for Huntington's Chorea
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tetrabenazidine, approved in 2008 to help treat chorea, the first drug specifically for Huntington's. Haloperidol and clonazepam can help control delusions, violent outbursts, and alleviate choreic movements. Anti-depressants and anti-anxiety drugs may be used as well; depending on the patient's specific symptoms.
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Why OT can help Huntington's Chorea
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Chorea and bradykinesia, a slowness of purposeful movement, can lead to difficulty walking and changes in gait pattern, an increased risk for falls and injuries, and eventual problems with daily self-care tasks. The loss of coordination will eventually lead to the patient being wheel chair bound. Some patients have difficulty speaking and swallowing in the later stages of the disease and are at risk for choking Cognitive and emotional changes will also greatly impact the patient and their family. As the disease progresses, the patient's ability to judge what is and is not safe diminishes. Emotional outbursts, anxiety, and depression are characteristics of the disease and can be very trying for the patent and their family members Because this disease affects a patient physically, with the diminishing of coordinated movements, all motor skills are negatively impacted and the patient will find it increasing difficult to meet daily needs, or even maintain proper positioning. Cognitive affects are across the board as well, with major impacts on sequencing, timing and judgment especially, but all process skills are affected. Emotional changes and outbursts have a negative impact on social interactions ...
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CABG
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CABG is a surgical procedure in which a blood vessels from another part of the body is grafted to the occluded coronary artery so blood can flow beyond the occlusion. Graft allows blood to bypass the obstructed portion of the coronary artery thus providing increase blood flow and oxygen to cardiac tissue. Can be one or multiple vessels grafted. To have CABG coronary arteries must have at least 70% occlusion. Signs may include chest pain, shortness of breath, and arrhythmia. Tests such as an EKG (Electrocardiogram), an Echocardiogram, or a Stress Test, which can include many other scans that are performed under physical stress
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Medical Management of CABG
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Once the CABG is performed the underlying condition is not instantly resolved. It is still advised to quit smoking, begin antiplatelet therapy, and take a cholesterol-lowering medications, depending of the client's medical history.
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OT for CABG
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It is common for the patient to feel depression and anxiety after a cardiac procedure. This may cause interruption in maintaining their regular activities of daily living, and even more severe a neglect of the doctors' orders given post-op. outlook. It is important as OT's as well as practitioners to recognize the signs and symptoms of depression, and anxiety.
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Medications for CABG
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B blocker
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Burns
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Burns are defined as damage to the skin or other tissues caused by heat, electricity, chemicals, radiation, and varying degrees of skin loss, pain, blisters, and swelling
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Degrees of Burns
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First - epidermis (superficial thickness) Second- epidermis and part of dermis (partial thickness) Third- epidermis, dermis and subcutaneous (full thickness) Fourth- beyond into the muscle and bone (deep full thickness)
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Medical Treatment of burns
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Stop the burning. Assess: Airway, Breathing and Ventilation, Circulation (replace fluids), Disability(neurological status), Exposure (percentage of area burned). Rules of 9's. Fluid replacement.
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Spinal Cord Injury
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Determined by the level of the vertebra closest to the injury. Bruising or severing of the spinal cord from a blow to the vertebral column resulting in muscle paralysis and sensory impairment below the injury level. Biggest group is young single males (16-30), alcohol and substance abuse, older adults are at risk due to degeneration of vertebrae, MVC (motor vehicle crashes)
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S/S of Spinal Cord Injury
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Loss of movement, sensation, bowel and/or bladder control, pain or stinging, difficulty breathing, coughing or clearing the lungs. Some people may have spasms from the wrong message being sent to the muscle.
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Different types of SCI
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Tetraplegia - which was formerly referred to as quadriplegia, is when damage occurs at the C1 to T1 level and affects the trunk, arms, hands, legs and pelvic organs.Motor and sensory neurons in both upper and lower extremities. Paraplegia- is when the damage may affect part or all of the trunk (stomach, chest, and hips), legs and pelvic organs. Motor and sensory in lower extremities and trunk.
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OT intervention for SCI
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A major issue with SCI is the loss of independence and a reduction in social skills due to activity limitations and restrictions of daily life. Depression will often interfere with progress as the patient often becomes discouraged and they will lose interest in improving. This is one reason why an OT is important in highlighting functional skills and encouraging physical, emotional, sensory and cognitive skills. An OT is needed in early treatment with an individualized therapy plan to help with the coping skills so that the person can overcome the effects of the SCI. Depending on the type of SCI, paraplegic or tetraplegia will determine the type of interventions the OT would use. In order to solve a patients access problems with ADL's many modifications need to be made such as the height of countertops, shelving and making equipment accessible. The OT will include tasks for mobility, eating, grooming and dressing and social skills, and include specific training on transfers from bed to wheelchair, wheelchair to vehicles, etc. Many of the patients with SCI who receive OT become more independent.
