Chapter 39 Rehabilitation Nursing
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Chapter 39 Rehabilitation Nursing - Marcador
Chapter 39 Rehabilitation Nursing - Detalles
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| Chronic illness | A chronic illness generally refers to a condition or state that lasts for 3 months or longer |
| Commission on Accreditation of Rehabilitation Facilities | A nonprofit, privat, international standard-setting and accreditation body whose mission is to promote and advocate the delivery of quality rehabilitation |
| Comprehensive rehabilitation plan | Plan of care within 24 hours of the patient's hospital admission and have it ready for review and revision by the rehabilitation team within 3 days of the admission |
| Disability | The loss of ability to participate in on or more major life activities as a result of mental, emotional, or physical impairments |
| Exacerbation | An increase in the seriousness of a disease or disorder; marked by greater intensity in the signs or symptoms of the patient being treated |
| Family centered care | A philosophy that recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions |
| Functional limitation | Any loss of ability to perform tasks or activities of daily living |
| Gerontological rehabilitation nursing | A specialty practice that focuses on the unique requirements of older adult rehabilitation patients |
| Impairment | Any loss or abnormality of psychological, physical, or anatomic structure or function |
| Interdisciplinary rehabilitation team | Collaborates to identify individual's goals and features a combination of expanded problem solving beyond the boundaries of the individual disciplines, together with discipline-specific work toward goal attainment |
| Multidisciplinary rehabilitation team | Characteristics of this model are discipline-specific goals, clear boundaries between disciplines, and outcomes that are the sum of each discipline's efforts |
| Pediatric rehabilitation nursing | A specialty practice area that also continues to expand within the field of rehabilitation |
| Physiatrist | Physicians specializing in physical medicine or rehab |
| Posttraumatic stress disorder (PTSD) | Defined as a mental health condition related to the experiencing of or witnessing of a traumatic event outside the normal range of human experience |
| Spinal cord injury (SCI) | Any injury in which the spinal cord undergoes compression by fracture or displacement of vertebrae, by bleeding, or edema |
| Transdisciplinary rehabilitation team | The blurring of boundaries between disciplines, as well as cross training and flexibility to minimize any duplication of effort toward individual goal attainment |
| Traumatic brain injury (TBI) | Ranging from mild concussion to the more devastating kind that renders injured people comatose for the remainder of their lives |
| Explain the goal of rehabilitation nursing | Restoring the patient to the fullest physical, mental, social, vocational, and economic capacity of which he or she is capable |
| What is the underlying philosophy of rehabilitation? | To focus on abilities rather than disabilities to continually make the most of the abilities that remain intact |
| Rehabilitation is a bridge for the patient spanning the gap between what? | Uselessness/usefulness Hopelessness/hopefulness Despair/happiness |
| What criteria is placed into all rehabilitation goals? | Maximize quality of life Address the patient's specific needs Assist the patient with adjusting to an altered lifestyle Directed toward promoting wellness and minimizing complications Assist the patient in attaining the highest degree of function and self-sufficiency possible Assist the patient with home and community reentry |
| Focus on the individual | All efforts of rehabilitation are centered on the patient's goals and objectives |
| Community reentry | Rehab is considered successful if the patient is able to reenter the community through participation in social, vocational, and recreational activities |
| Independence | Focus on promoting and maintaining the patient's physical and emotional independence |
| Functional ability | Progress in rehab is measured in terms of functional outcomes |
| Ream approach | Goals are achieved through the work of the rehab team members, including the patient and family |
| Quality of life | Goals focus on improving the quality of live rather than increasing quantity |
| Prevention and wellness | Rehab goals focus on preventing complications and maximizing function |
| Change process | Directing the change in as positive a manner as possible |
| Adaptation | Learning to adapt to the circumstances created by the limits of their abilities is a positive method of coping |
| Patient and family education | Patients have the potential to obtain a degree of independence through patient education which enables them to direct their own care |
| The goals must be what? | Measurable, described in functional or behavioral terms, and must have associated time frames for achievement, and the responsible team member or members must be listed |
| Patient's role and actions | Role-key member Actions-Participates in goal setting, takes control of own life |
| Physiatrist's role and actions | Role-Rehab physician Actions-Provides support, educates patient and family concerning rehabilitation process, promotes independence |
| Rehab LVN role and actions | Role-Care provider, patient's advocate Actions-Provides support, reinforces education to the patient and family concerning the rehabilitation process, assists in treatment plan and implementation |
| Physical therapist's role and actions | Role-Designing exercise program Actions-Assesses patient's needs, provides trainings |
| Occupational therapist's role and actions | Role-Assessing independent living needs Actions-Recommends equipment modifications, adapts equipment |
| Speech-language pathologist's role and actions | Role-Performing assessment of communication and swallowing abilities, designing rehab communication program Actions-Helps patient regain communication skills, teaches patient |
| Therapeutic recreation therapist's role and actions | Role-Recreation planner Actions-Plans leisure activities, promotes patient's interest in activities |
| Clinical psychologist's role and actions | Role-Emotional evaluator Actions-Assesses patient's position on the mental health continuum, promotes patient's independence by maximizing active participation, assists patient in developing realistic positive attitudes |
| Chaplain's role and actions | Role-Spiritual consultant Actions-Provides spiritual support and guidance |
| Vocational rehabilitation counselor's role and actions | Role-Vocational planner Actions-Helps patient obtain training for new or current employment |
| Pathophysiology | The disordered physiological processes associated with disease or injury |
| Roles of the Rehab Nurse | Educator Provider of care Collaborator Patient advocate |
| 5 step approach to guide nursing interventions | 1. Assess patient's and family's needs, abilities, and concerns 2. Plan interventions based of needs, abilities, and concerns 3. Implement educational plan 4. Document the educational process 5. Evaluate and revise |
| Key elements of family-centered care | Incorporating Facilitating family-professional collaboration Exchanging complete and unbiased info Encouraging and facilitating family-to-family support Appreciating unique characteristics of families and children |
| Cultural competence | Requires the acknowledgment and awareness of one's own cultural norms Involves the awareness and acceptance of those cultural values and behaviors of another |
| What describes a culturally competent practitioner | Has the capacity for cultural self-assessment Provides health care that is sensitive to the culture and values of the patient and is linguistically appropriate Conscious of the dynamics of difference Disseminates cultural knowledge Adapts to diversity |
| Cultural proficiency | Hold culture in high regard |
| Issues in rehabilitation | Quality vs. quantity Care vs. cure High cost of interdisciplinary care vs. long-term care |
| PT/BRI | Polytrauma-blast related injury as result of explosions |
| Primary blast related injuries | Air filled cavities in the body (ears, lungs, and gastrointestinal tract) and organs enveloped by fluid (brain and spinal cord) are most susceptible to compression damage from high explosive blasts |
| PTSD was also known as what? | Shell shock War neurosis |
| When is the diagnosis of PTSD considered? | If the symptoms do not improve or even worsen after at least 1 month and are dependent on the identification of a traumatic event or re-living traumatic events through dreams or reoccurring vivid memories or flashbacks interfering with normal life functions |
| What is the Americans with Disabilities Act and when did it become law? | 1990 Provides protection against discrimination for people with disabilities |
| Injury to the spinal cord is______ | Irreversible in that the cord is unable to repair itself |
| Complete injury | No motor or sensory function below the level of injury |
| Incomplete injury | Some or all motor or sensory function below the level of injury |
| Quadriplegia | Damage to the cervical spine or the neck that involves weakness or paralysis in all four extremities |
| Paraplegia | Damage below the cervical area that involves weakness or paralysis in the trunk and lower extremities |
| Paresis | Slight paralysis, incomplete loss of muscular power, or weakness of a limb |
| Cervical cord injury | Level of injury is at the cervical spine (C2-C7) Paralysis of all extremities and trunk |
| Thoracic cord injury | Level of injury is at the thoracic spine (T1-T12) involves paralysis of lower extremities After injury, muscles are flaccid and later become spastic |
| Lumbar cord injury | Injury of the lumbar spine (L1-L2) Paralysis of lower extremities, bladder, rectum, loss of sexual function |
| Postural hypotension | Common for many quadriplegic patients to have a bp of 90/60 or lower when sitting as a result of the pooling of the blood in the lower extremities and in the abdominal area |
| Autonomic dysreflexia | Patients with spinal cord lesions above T5 sometimes experience sudden and extreme elevations in blood pressure cause by a reflex action of the autonomic nervous system Is the result of some stimulation of the body below the level of injury |
| Heterotopic ossification | The abnormal formation of bone cells in joints |
| Deep vein thrombosis | Clotting of blood within vessels of the legs cause by slowing of the circulation or an alteration in the blood vessel walls |
| Shearing | When the brain mass is rotated in the cranial vault |
| Classifications of brain injuries | Mild Moderate Severe Catastrophic |
| Mild brain injury | Brief or no loss of consciousness |
| Moderate brain injury | Period of unconsciousness ranging from 1-24 hours Cognitive skills including planning, sequencing, judgment, reasoning, and computation skills are usually impaired |
| Severe brain injury | Experience unconsciousness or post-trauma amnesia for longer than 8 days Cognitive, psychosocial, and behavioral disabilities result |
| Catastrophic brain injury | Coma lasting several months or longer Affected individuals sometimes appear to be awake They generally never regain significant, meaningful communication with their environment |
| Explain post-concussive syndrome and how long it can last | Can persist for months, years, or indefinitely Signs/symptoms: fatigue, headache, vertigo, lethargy, irritability, personality changes, cognitive deficits, decreased information processing speed, and difficulties with memory, understanding, learning, and perception |
| With moderate brain injury what type of psychosocial problems can occur? | Self-centeredness, denial, mood swings, agitation, depression, lethargy, sexual dysfunction, emotional lability, low tolerance for frustration , poor judgment, and behavioral outbursts |
| Explain what pediatric rehab nurses do | Collab with the interdisciplinary team, provide a continuum of care so that affected children can become contributing members of society and function at their maximal potential |
| Rehabilitation vs. habilitation | Rehab: refers to the relearning of skills or behaviors lost as a result of disease or injury Habilitation: refers to the process of acquiring skills and behaviors by an individual whose development has been affected by disease or other disabling conditions since birth or early childhood |
| Comprehensive rehabilitation plan | A multifaceted and properly involves a functional assessment, an evaluation conference and a family conference |