Patient Functional Assessment Overview

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Questions and Answers

What is the primary focus of the functional mobility training prescribed for the patient?

  • To enhance speech clarity
  • To promote independence in mobility tasks (correct)
  • To improve vision
  • To increase muscle strength

The patient is currently in an intensive rehabilitation facility.

True (A)

What does 's/p' stand for in the context of the patient’s condition?

status post

The patient experiences __________ hemiparesis after a right CVA.

<p>left</p> Signup and view all the answers

Match the following aspects of the patient's treatment with their corresponding goals:

<p>Bed Mobility = Independent with all aspects Transfers = To all surfaces with contact guard Ambulation = Ambulate &gt; 75 feet with supervision Stairs = Negotiate 4 steps with assistive device</p> Signup and view all the answers

What type of assistive device does the patient use when ambulating?

<p>LBQC (Left Base Quad Cane) (B)</p> Signup and view all the answers

The patient has no issues with static and dynamic standing balance.

<p>False (B)</p> Signup and view all the answers

What is the ultimate long-term goal (LTG) for the patient regarding stairs?

<p>Negotiate 4 steps with a right rail with contact guard to allow safe entry into home.</p> Signup and view all the answers

The patient is experiencing shortness of breath and _____________ to ambulate longer distances.

<p>lack of endurance</p> Signup and view all the answers

What concern does the patient's wife express during therapy sessions?

<p>Concerns about the stairs (C)</p> Signup and view all the answers

What type of assistance is the patient receiving during bed mobility?

<p>Minimal assistance to manage upper body (A)</p> Signup and view all the answers

The patient is able to transfer to all surfaces independently.

<p>False (B)</p> Signup and view all the answers

How many feet can the patient ambulate on a level tiled surface with the use of a small base quadruped cane?

<p>100 feet</p> Signup and view all the answers

The patient negotiates four steps using a step to step pattern with a _____ for stability while ascending and a _____ for descending.

<p>right rail; right small base quadruped cane</p> Signup and view all the answers

Match each functional mobility task with the level of assistance required:

<p>Bed mobility = Independent with some assistance for upper body Transfers = Contact guard for occasional loss of balance Ambulation = Contact guard due to episodes of loss of balance Stair negotiation = Minimal assistance and verbal cues</p> Signup and view all the answers

What is the patient's respiratory rate after ambulation?

<p>22 breaths/min (C)</p> Signup and view all the answers

The patient exhibits no issues with static and dynamic sitting balance.

<p>True (A)</p> Signup and view all the answers

What should be added to the patient's program to enhance balance?

<p>Single leg stance (SLS) balance activities</p> Signup and view all the answers

The patient is expected to achieve _____ in transfers and ambulation during the final week of rehab.

<p>independence</p> Signup and view all the answers

What type of education was provided to the patient's wife?

<p>Proper guarding on stairs (B)</p> Signup and view all the answers

Flashcards

Functional Assessment

An evaluation of a patient's abilities to perform daily activities.

Bed Mobility

Ability to move in bed, including rolling, sitting, and lying.

Transfers

Ability to move from one surface to another, like from bed to chair.

Ambulation

Ability to walk.

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Balance

Ability to maintain equilibrium while stationary or moving.

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Short-term Goals (STGs)

Specific, measurable, achievable, relevant, and time-bound goals for the next two weeks.

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Long-term Goals (LTGs)

Goals for the next 3 weeks.

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Hemiparesis

Weakness or paralysis on one side of the body.

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CVA

Cerebrovascular accident (stroke).

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Patient Education

Instructing the patient on their condition, treatment, and self-management.

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Bed Mobility (Cephalo-Caudal)

Patient's ability to move their body up and down in bed (head to feet and vice versa).

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Bed Mobility (Rolling)

Patient's ability to move from side to side in bed.

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Ambulation (Level Surface)

Patient's ability to walk on a flat surface.

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Stair Negotiation

Patient's ability to climb and descend stairs.

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Static Sitting Balance

Maintaining balance while sitting without movement.

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Static Standing Balance

Maintaining balance while standing still.

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Dynamic Standing Balance

Maintaining balance while standing and moving.

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Loss of Balance Episodes

Number of times the patient lost their balance during ambulation.

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Patient Education (Stairs)

Instructing the patient's wife on assisting safely with stair use.

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Study Notes

Patient Functional Assessment

  • Patient demographics: 56-year-old male, post-CVA (right cerebrovascular accident) with left hemiparesis.
  • Rehabilitation setting: Maryview ARU (acute rehabilitation unit) for 3 weeks of functional mobility training.
  • Goal: Return home with wife.
  • Bed Mobility: Patient demonstrates moderate (mod) to minimal (min) ability in various positions such as cephalad/caudad, rolling (left/right), and supine to sit.
  • Transfers: Patient can transfer from supine to standing (stand-step to wheelchair), and wheelchair to bed using assistive devices.
  • Ambulation: Patient ambulates 20 feet on a tiled surface with assistance (gait belt, LBQC (left beam-walking cane) required), but endurance is limited, and long distances lead to shortness of breath.
  • Stairs: Not assessed yet.
  • Balance: Static and dynamic sitting balance is normal. Static standing balance demonstrates some challenges (3+ / 5 rating). Dynamic standing shows inability to move outside the base of support (BOS) without falling.

Short-Term Goals (STGs)

  • Week 1: Patient will demonstrate (independent) bed mobility, transfer to all surfaces, and ambulate greater than 75 feet with assistance.
  • Week 2/3: Additional mobility (ambulatory) targets:
    • Transfer: Patient will transfer to all surfaces, including cars.
    • Ambulation: Patient will ambulate farther (more than 100 feet), with minimal assistance.
    • Home Return: Patient will be able to safely navigate home and step up/down stairs

Long-Term Goals (LTGs)

  • Week 3: Patient will transfer to all surfaces (including cars), ambulate greater than 100 feet (independent), and negotiate stairs independently.

Functional Mobility Assessment (Follow-up)

  • Bed mobility: (Independent)
  • Transfers: (Independent)
  • Ambulation: (Moderate support required)
  • Balance: Static and dynamic sitting balance is sufficient. Static standing balance is moderate challenge. Dynamic standing needs more practice.

Patient Concerns and Education

  • Patient's wife expresses concern about stairs.
  • Patient education provided on stair safety, including proper guarding techniques by the wife.
  • Referral made for contractor to install stair rails.

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