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Rancho Levels & Tx (OT 530 Exam 2)

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I
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Ranchos Los Amigos scale -no response
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II
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Ranchos Los Amigos scale -generalized response
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III
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Ranchos Los Amigos scale -localized response
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IV
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Ranchos Los Amigos scale -confused-agitated
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V
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Ranchos Los Amigos scale -confused-inappropriate
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VI
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Ranchos Los Amigos scale -confused-appropriate
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VII
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Ranchos Los Amigos scale -automatic-appropriate
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VIII
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Ranchos Los Amigos scale -purposeful and appropriate w/ SBA
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IX
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Ranchos Los Amigos scale -purposeful appropriate w/ SBA on request
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X
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Ranchos Los Amigos scale -purposeful and appropriate at Mod I
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Coma/Near Coma Tx (Tx)
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-Auditory response: bell ringing; Visual: flashlight, fixation, tracking blinks; Olfactory: ammonia capsule; Tactile: shoulder taps, nasal swipe; Pain: firm pinch, pressure, ear pinch/pull; Vocalization: spontaneous, moans/groans/none; Family training
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Ranchos level I and II (Tx)
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levels? -sensory stimulation; environmental management; prevention of complications(het. ossification, skin breakdown); elicit responses/reliable communication; frequent, shorter, organized, meaningful; multisensory: auditory, tactile, olfactory, visual, kinesthetic, proprioceptive, vestibular, oral document responses; bed and w/c positioning; PROM/stretching/joint mobilization; evaluate for splints/casts; tone management; and orient to surroundings.
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Rancho level III (Tx)
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level? -sensory stimulation; increase speed and consistency of responses; develop pre-functional skills (sitting EOB); PROM/stretching/joint mobilization; reevaluate/modify splints/casts; reevaluate/modify bed and w/c positioning; tone management; mat activities; following commands; ADL training light hygiene/grooming; prefeeding training; family training; and evaluate cognitive function.
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Rancho level IV (Tx)
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level? -structure environment; PROM/SROM/mobilization; splinting/casting; mobility; tone management/facilitate normal posture/control/movements; reality orientation/validation; evaluate/address cognitive issues; ADL training; evaluate/address perceptual issues; work without restraints if possible; simple gross motor; simple automatic ADLs; and family training.
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Rancho level V (Tx)
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level? -structure and repetition; assistance with ADLs; increase length of time in therapy; possible small groups; feeding; and meaningful activities, games, tasks.
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Rancho level VI (Tx)
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level? -ROM/joint mobilization; splinting/self image; mobility; tone management; facilitate normal movement; address cognition; address perception; real ADL training: shopping, money management/banking, meal preparation, homemaking, use of media, child care, and community outings.
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Rancho level VII (Tx)
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level? -ADL training focus on problem or advanced areas; address executive function; focus on independent living; increase patient participation in planning, making choices; community reintegration; outdoor home tasks; fine motor coordination; speed of motor and thinking responses; reintegration to educational system; week end or over night passes; driving evaluation; and job coaching.
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Rancho level VIII (Tx)
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level? -increase speed and intensity of demands; engage in/shuffle multiple tasks; continuous activity for longer durations; independent execise programs; organization of daily schedule and tasks; budgeting, computerized banking; use of public transportation; vocational reintegration; job site analysis; and referrals to voc rehab.
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Rancho level IX (Tx)
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level? -needs cues to anticipate problems and adjust performance; low frustration tolerance still possible.
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Rancho level X (Tx)
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level? -may need periodic breaks, but is able to adjust tasks and performance as needed.