Rehabilitation Programs for Brain and Spinal Cord Injuries

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Questions and Answers

What is a primary goal of stroke recovery programs?

Pain management

Alternative pain treatment modalities

Cognitive remediation and teaching self-care skills (correct)

Vocational assessment and reentry into employment

What is a key component of spinal cord injury rehabilitation programs?

Neurogenic bowel and bladder management (correct)

Monitored exercise and nutritional counseling

Joint protection and energy conservation

Comprehensive pain management

What is a primary focus of orthopedic rehabilitation programs?

Comprehensive pain management

Vocational assessment and reentry into employment

Pain management and joint protection (correct)

Cognitive remediation and teaching self-care skills

What is emphasized in cardiac rehabilitation programs?

Monitored, progressive exercise and nutritional counseling Signup and view all the answers

What do pulmonary rehabilitation programs help patients achieve?

More effective breathing patterns and energy conservation Signup and view all the answers

What is the focus of comprehensive pain management programs?

Pain management and alternative pain treatment modalities Signup and view all the answers

What is a goal of spinal cord injury rehabilitation programs?

Vocational assessment and reentry into employment Signup and view all the answers

What do orthopedic rehabilitation programs help patients learn?

How to be independent with a prosthesis or new joint Signup and view all the answers

What is the main goal of surgical procedures for hiatal hernia?

To prevent the herniated portion of the stomach from moving upward through the hiatus Signup and view all the answers

What is the term for an abnormal protrusion of an organ or structure through the wall of the cavity normally containing it?

Hernia Signup and view all the answers

What is the main cause of indirect hernias?

A defect of structural closure Signup and view all the answers

What is a risk factor for abdominal hernias?

Obesity Signup and view all the answers

What type of hernia is commonly seen in males?

Inguinal hernia Signup and view all the answers

What is a characteristic of umbilical hernias?

Seen most often in obese women and in children Signup and view all the answers

What is a common symptom of abdominal hernias?

An abnormal bulging in the affected area of the abdomen Signup and view all the answers

What can increase the risk of ventral hernias?

Obesity and poor wound healing Signup and view all the answers

What percentage of gastric ulcers is caused by a certain bacterium?

80% Signup and view all the answers

What can contaminated water do?

Play a role in developing peptic ulcers Signup and view all the answers

What effect does smoking have on peptic ulcers?

It increases the harmful effects of H. pylori Signup and view all the answers

What can relieve pain caused by peptic ulcers?

Eating Signup and view all the answers

Where is the pain usually located in gastric ulcers?

Mid epigastrium Signup and view all the answers

What is a symptom of bleeding due to peptic ulcers?

Low hematocrit and hemoglobin levels Signup and view all the answers

How is H. pylori diagnosed?

With a urea breath test Signup and view all the answers

What is a complication of peptic ulcers?

Hemorrhage Signup and view all the answers

What is a common preoperative nursing diagnosis for a patient with breast cancer?

Deficient knowledge about the planned surgical treatments Signup and view all the answers

A patient with breast cancer is experiencing anxiety related to their diagnosis. What is the primary goal of nursing care?

Reducing preoperative and postoperative fear and anxiety Signup and view all the answers

A patient has undergone an Axillary Lymph Node Dissection (ALND). What is a critical aspect of their postoperative care?

Hand and arm care after ALND Signup and view all the answers

What is a potential complication of breast surgery?

Infection Signup and view all the answers

A patient with breast cancer is experiencing disturbed body image. What is the primary goal of nursing care?

Improving self-esteem and body image Signup and view all the answers

What is a critical aspect of postoperative care for a patient with breast cancer?

Arm exercises to regain mobility of affected extremity Signup and view all the answers

What is a major goal of nursing care for a patient with breast cancer?

Increased knowledge about the disease and its treatment Signup and view all the answers

A patient with breast cancer is experiencing deficient knowledge about their treatment options. What is the primary goal of nursing care?

Increasing knowledge about treatment options Signup and view all the answers

What should the patient be taught to recognize after hernia surgery?

Signs of incarceration or strangulation Signup and view all the answers

What is the purpose of holding the abdomen with a splint during coughing and moving?

To support the weakened abdominal muscles Signup and view all the answers

What may be ordered to reduce swelling of the scrotum after hernia surgery?

Icepacks and elevation of the scrotum Signup and view all the answers

Why is it important to monitor bowel sounds after hernia surgery?

To detect temporary stoppage of peristalsis Signup and view all the answers

What should the patient be instructed to report after hernia surgery?

Discomfort or distention and signs of infection Signup and view all the answers

What is the usual duration of activity limitation after hernia surgery?

2 to 6 weeks Signup and view all the answers

What is the usual time frame for patients to return to work after hernia surgery?

2 weeks Signup and view all the answers

Where does ulcerative colitis typically occur?

Large intestine and rectum Signup and view all the answers

Study Notes

Stroke Recovery Programs and Traumatic Brain Injury Rehabilitation

Emphasize cognitive remediation to help patients compensate for memory, perceptual, judgment, and safety deficits.
Teach self-care and mobility skills to patients.
Goals include helping patients swallow food safely and communicate effectively.

Spinal Cord Injury Rehabilitation Programs

Understand the effects and complications of spinal cord injury.
Manage neurogenic bowel and bladder issues.
Focus on sexuality and fertility enhancement, self-care, and prevention of skin breakdown.
Include bed mobility and transfers, as well as driving with adaptive equipment.
Emphasize vocational assessment, training, and reentry into employment and the community.

Orthopedic Rehabilitation Programs

Manage pain and conserve energy.
Protect joints and promote independence with prostheses or new joints.
Focus on patients undergoing joint replacements and those with arthritis.

Cardiac Rehabilitation

Emphasize monitored, progressive exercise and nutritional counseling.
Manage stress and promote risk reduction.
Focus on patients who have had myocardial infarction.

Pulmonary Rehabilitation Programs

Help patients achieve more effective breathing patterns.
Teach energy conservation techniques, self-medication, and home ventilatory management.
Focus on respiratory therapists and patients with respiratory issues.

Comprehensive Pain Management Programs

Focus on alternative pain treatment modalities, exercise, and supportive counseling.
Emphasize vocational evaluation and management of chronic pain, especially low back pain.

Diagnosis and Preoperative Nursing Diagnoses

Deficient knowledge about planned surgical treatments.
Anxiety related to cancer diagnosis and treatment options.
Fear related to specific treatments and body image changes.
Risk for ineffective coping and decisional conflict related to diagnosis and treatment options.

Postoperative Nursing Diagnoses

Pain and discomfort related to surgical procedure.
Disturbed sensory perception related to nerve irritation.
Disturbed body image related to loss or alteration of the breast.
Risk for impaired adjustment and sexual dysfunction.
Self-care deficit related to partial immobility of upper extremity.
Deficient knowledge regarding drain management, arm exercises, and hand and arm care.

Collaborative Problems/Potential Complications

Lymphedema, hematoma/seroma formation, and infection.

Planning and Goals

Increase knowledge about the disease and its treatment.
Reduce preoperative and postoperative fear, anxiety, and emotional stress.
Improve decision-making ability and coping abilities.
Manage pain and improve sexual function.
Avoid complications.

Surgical Management

Perform surgical procedures to prevent the herniated portion of the stomach from moving upward through the hiatus.
Fundoplication is the most common surgical procedure.

Abdominal Hernia

A hernia is an abnormal protrusion of an organ or structure through the wall of the cavity normally containing it.
The hernia sac is formed by the peritoneum protruding through the weakened muscle wall.
Causes of abdominal hernias include:
- Weakness in the abdominal wall along with increased intra-abdominal pressure.
- Obesity.
- Pregnancy.
- Poor wound healing.
Types of abdominal hernias:
- Inguinal hernias (located in the groin).
- Umbilical hernias (seen in obese women and children).
- Ventral (incisional) hernias (result from weakness in the abdominal wall following abdominal surgery).

Signs and Symptoms

Abnormal bulging in the affected area of the abdomen.
Patient may experience discomfort or pain.
Patient may experience incarceration or strangulation.

Preoperative Care

Instruct patient in routine preoperative deep breathing and coughing techniques.
Hold abdomen with a splint to support weakened abdominal muscles during coughing and moving.

Postoperative Care

Monitor for difficulty with voiding.
Monitor bowel sounds and report discomfort or distension.
Teach patient to change dressing and report signs and symptoms of infection.
Instruct patient to avoid lifting for 2 to 6 weeks.

Ulcerative Colitis

Multiple ulcerations and diffuse inflammation occur in the superficial mucosa and submucosa of the colon.
Lesions spread throughout the large intestine and usually involve the rectum.
Causes of peptic ulcers include:
- Helicobacter pylori (responsible for 80% of gastric ulcers and more than 90% of duodenal ulcers).
- Contaminated water.
- Smoking (increases harmful effects of H. pylori, alters protective mechanisms, and decreases gastric blood flow).
Signs and symptoms:
- Dull, gnawing pain or burning sensation in the mid-epigastrium or back.
- Anorexia and nausea and vomiting.
- Bleeding may occur with massive hemorrhaging or slow oozing.
- Patients may have low hematocrit and hemoglobin levels, and gastric or fecal occult blood may be found.
Diagnosis:
- Physical examination may reveal pain, epigastric tenderness, or abdominal distension.
- H. pylori can be diagnosed with several tests, including the urea breath test.

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Description

This quiz covers rehabilitation programs for stroke and traumatic brain injury, as well as spinal cord injury. It focuses on cognitive remediation, compensation techniques, and regaining daily living skills.