2Goals for Rehabilitation Patient’s physical, emotional, and social functions will be restored and maintained.
3Specialized Rehabilitation Centers There are specialized rehabilitation centers for:Brain and spinal cord injuriesStroke rehabilitationBurn injuriesAcute mental illnessDrug or alcohol addiction
4Members of the Rehabilitation Team Rehabilitation physician (physiatrist)Rehabilitation nurseOccupational therapistPhysical therapistSpeech therapistRehabilitation aideOrthotistProsthetistNeuropsychologist
5FACTORS AFFECTING REHAB EFFORT ATTITUDE AND COPING SKILLSREQUIRES EFFORTIS OFTEN PAINFULSUCCESS DEPENDENT OF COPING SKILLSRESPONSE OF FAMILY AND CAREGIVER TO DISABILITYALLOWING THE PERSON TO DO THEIR OWN CARE
6FACTORS AFFECTING REHAB EFFORT OVERALL HEALTH STATUSMAY BE CHRONIC HEALTH PROBLEMS PRESENTEX. DIABETES, OSTEOPOROSIS, ARTHRITISDELAY THE REHAB EFFORT AND MAKE COMPLETE RESTORATION IMPOSSIBLEAGEAGE RELATED CHANGES MAKE IT MORE DIFFICULT FOR THE ELDERLY
8SPINAL CORD INJURIES DISABLITY DEPENDS ON THE SEVERITY OF INJURY LOCATION OF THE INJURYCERVICAL (C5, C6, C7)= QUADRIPLEGIATHORACIC (T12, L1)=PARAPLEGIALUMBAR =PARAPLEGIASACRALRARELY RESULTS IN PARALYSIS
9Traumatic Brain Injury A concussion is a temporary change in mental status caused by head trauma.A skull fracture occurs when the bones of the skull break.A cerebral contusion is a bruise on the brain that occurs when the brain tissue hits the skull.A hematoma is a pool of blood.An epidural hematoma occurs when blood collects between the skull and the dura mater.
11QuestionBleeding and swelling of the brain tissue after trauma results in an increase in which of the following?TBIIntracranial pressureConcussionOsteoporosis
12Answer B. Intracranial pressure The ICP is the pressure in the space between the skull and the brain. (Intra means “within” and cranial means “the skull.”) An increase in the ICP can crush the brain tissue, reduce blood flow to the brain tissue, or cause structures in the brain to shift position. If the ICP remains too high for too long, severe disability or death can result.
13Observations to Report to the Nurse Immediately The person complains of headache or increased head painThe person complains of dizzinessThe person is restless or agitatedThere are changes in the person’s respirationsThe person’s pupils are unequal in sizeThe person complains of sudden weakness or loss of feeling in any body partThe person’s speech is slurredThere is drainage from the person’s ears or nose
14STROKE (CVA) TWO TYPES ISCHEMIC BLOCKAGE OF AN ARTERY PREVENTING BLOOD FLOW TO THE BRAINLACK OF OXYGEN CAUSES TISSUE TO DIEHEMORRHAGICARTERY IN THE BRAIN BURSTSBLEEDING INTO SURROUNDING TISSUE CAUSING DAMAGE
15ACUTE AND SUBACUTE PHASES MONITOR LOCRESPIRATORY SUPPORTMONITOR VITALSOBSERVATION FOR INTERNAL BLEEDINGAIRWAY SUCTIONING
16CHRONIC PHASE OF REHAB SELF CARE SKILLS COGNITIVE SKILLS SPEECH SKILLS SWALLOWING
17Observations to Report to the Nurse Immediately (cont) There is a change in the person’s LOCThere is a change in the person’s vital signs, especially the blood pressure or pulseThe person shows signs or symptoms of a stroke that were not present before (for example, drooling; drooping of the eyelid; slurred speech; paralysis, tingling, or numbness of an arm, leg, or one side of the face)The person complains of the sudden onset of a severe headache
18CARDIOVASCULAR DISORDERS MOST COMMONCORONARY ARTERY DISEASENARROWING OF CORONARY ARTERIES DECREASING BLOOD FLOW TO THE HEARTMYOCARDIAL INFARCTIONONE OR MORE OF THE CORONARY ARTERIES BECOME BLOCKEDPART OF THE HEART DIE FROM LACK OF OXYGEN
19ACUTE AND SUBACUTE PHASES MEDICATIONS TO STOP OR CONTROL CARDIAC SYMPTOMSMONITOR OXYGEN LEVELSBED RESTCONTINUOUS ECG
20CHRONIC PHASE REGAIN STRENGTH ADOPT HABITS TO HELP CARDIO SYSTEM BECOME HEALTHIEREXERCISEPROPER DIETSMOKING CESSATIONMEDICATIONS
21Observations to Report to the Nurse Immediately (cont) complains of chest pain, “crushing,” or “squeezing”pain that travels down either arm or up the neck into the jawsweaty, skin is cool and clammy, or face appears pale or graydifficulty breathingnausea, vomiting, or hiccupsfaints or complains of feeling very weak or tireddisorientated, confused, or restlesschanges to vital signs (either an increase or a decrease)changes in the appearance of the ECG on the monitor
22MUSCULOSKELETAL DISORDERS HIP FRACTURESOME RESULT IN DEATH IN ELDERLYCAN CAUSE IMMOBLITYCOMPLICATIONS OF IMMOBILITYPNEUMONIABLOOD CLOTS
23MUSCULOSKELETAL DISORDERS ACUTE AND SUB-ACUTE PHASESSTABILIZE THE PATIENTPAIN MANAGEMENTPREVENT MOVEMENT THAT CAUSES MORE DAMAGE TO HIPPREPARE FOR SURGERY
33ACUTE AND SUBACUTE PHASE INTUBATION AND VENTILATOR MAY BE NECESSARY IF THE LUNGS INHALED HOT AIRUNRINARY CATHETER CAREINFECTION PREVENTIONROM TO PREVENT CONTRACTURESPAIN MANAGEMENTFLUID BALANCEMONITOR I AND O
34CHRONIC PHASE MAY BE OVER THE COURSE OF MANY YEARS SPLINTS AND OTHER SUPPORTIVE DEVICES MAY BE USEDSURGICAL PROCEDURESSKIN GRAFTSDEBRIDEMENTPSYCHOLOGICAL CARE
35Question Tell whether the following statement is true or false. Geriatric patients receive no benefit from rehabilitation.TrueFalse
36AnswerB. FalseLike all rehabilitation programs, geriatric rehabilitation programs focus on helping the person regain or maintain function and independence. Many elderly people entering rehabilitation programs were independent before rehabilitation and will return to being independent after rehabilitation. Others are entering rehabilitation with a certain degree of disability that is not expected to be resolved by rehabilitation. When this is the case, the rehabilitation effort focuses on helping the person to regain strength and prevent the loss of additional function.