Podcast
Questions and Answers
What is the primary focus of the functional mobility training prescribed for the patient?
What is the primary focus of the functional mobility training prescribed for the patient?
The patient is currently in an intensive rehabilitation facility.
The patient is currently in an intensive rehabilitation facility.
True
What does 's/p' stand for in the context of the patient’s condition?
What does 's/p' stand for in the context of the patient’s condition?
status post
The patient experiences __________ hemiparesis after a right CVA.
The patient experiences __________ hemiparesis after a right CVA.
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Match the following aspects of the patient's treatment with their corresponding goals:
Match the following aspects of the patient's treatment with their corresponding goals:
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What type of assistive device does the patient use when ambulating?
What type of assistive device does the patient use when ambulating?
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The patient has no issues with static and dynamic standing balance.
The patient has no issues with static and dynamic standing balance.
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What is the ultimate long-term goal (LTG) for the patient regarding stairs?
What is the ultimate long-term goal (LTG) for the patient regarding stairs?
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The patient is experiencing shortness of breath and _____________ to ambulate longer distances.
The patient is experiencing shortness of breath and _____________ to ambulate longer distances.
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What concern does the patient's wife express during therapy sessions?
What concern does the patient's wife express during therapy sessions?
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What type of assistance is the patient receiving during bed mobility?
What type of assistance is the patient receiving during bed mobility?
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The patient is able to transfer to all surfaces independently.
The patient is able to transfer to all surfaces independently.
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How many feet can the patient ambulate on a level tiled surface with the use of a small base quadruped cane?
How many feet can the patient ambulate on a level tiled surface with the use of a small base quadruped cane?
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The patient negotiates four steps using a step to step pattern with a _____ for stability while ascending and a _____ for descending.
The patient negotiates four steps using a step to step pattern with a _____ for stability while ascending and a _____ for descending.
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Match each functional mobility task with the level of assistance required:
Match each functional mobility task with the level of assistance required:
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What is the patient's respiratory rate after ambulation?
What is the patient's respiratory rate after ambulation?
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The patient exhibits no issues with static and dynamic sitting balance.
The patient exhibits no issues with static and dynamic sitting balance.
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What should be added to the patient's program to enhance balance?
What should be added to the patient's program to enhance balance?
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The patient is expected to achieve _____ in transfers and ambulation during the final week of rehab.
The patient is expected to achieve _____ in transfers and ambulation during the final week of rehab.
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What type of education was provided to the patient's wife?
What type of education was provided to the patient's wife?
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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.
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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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Description
This quiz focuses on the functional assessment of a 56-year-old male patient who has experienced a cerebrovascular accident (CVA). It covers various aspects including bed mobility, transfers, ambulation, and balance. Assess your knowledge of rehabilitation techniques and patient care in acute settings.
