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Promote communication redirection attracting pt

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Promote communicationRedirection, attracting pt attention to promote communicationAsk simple, direct yes/no questionsProvide instruction with pictures
Use gesturesLimit choicesNever assume pt is totally confusedoPreventing wandering:Identify risks through familySupervision, frequent checksKeep away from stairs, elevatorsDo not changes roomsProvide frequent toiletingFrequent walks- treat restlessnessRe-orientation/ validation therapyoFamily teaching/ care at homeReduce caregiver stress: promote self-care and time away from patient forcaregiversSafe return programSafe environment: minimize clutter, alarm system/ safety locksAssist patient to remain orientated (large clocks, single-date calendars)Communicate- explain activity, use simple languageEncourage patient to be as independent as possible in ADLsMinimize excessive stimulationCommunity resources: Alzheimer’s AssociationSpinal Cord InjuryInterventions (2)oEnsure patent airwayoMaintenance of cardiovascular functionoMove client by log-rollingoGood skin careoEmotional supportoEnsure adequate nutritionoBladder and bowel trainingoLevel of injury:C3 and above: ventilator supportC4: no upper extremity muscle function, may self-feed with powereddevicesC5: neck movement possible, can drive electric wheelchairC6: partial strength in pectoralis minor, may self-drive a lightweightwheelchair, can write and care for self, can transfer from bed to chairC7: no finger muscle power, can dress lower extremities with minimalassistanceT1-T8: good upper muscle strength, some independence from wheelchair,long-leg braces for standing exercisesT5-L2: balance difficulties, still requires wheelchair, limited ambulationwith long- leg braces and crutchesL3-L5: trunk-pelvis muscle function impact, may use crutches or canesL5-S3: waddling gait, ambulation
oAutonomic dysreflexia: neurologic emergency in patients with SCI T6 and aboveSudden significant rise in sBP and dBP accompanied by bradycardiaInterventions: SIT PATIENT UP, notify HCP, assess and treat cause, checkfor urinary retention/ catheter blockage, check bladder for distention andcatheterize immediately if indicated, exam skin, nifedipine or nitrate,alpha blocker prophylacticallyoPrevent partial damage from becoming permanent damageoEmergency management is critical because improper movement can cause furtherdamage and loss of neurological functionoAssess respiratory pattern and maintain patent airwayoPrevent head flexion, rotation or extensionoMaintain traction and alignment on the head by placing both hands by the earsoHALO fixation:Realign the vertebraFacilitate bone healingSafety! Never use the halo device to move/ turn a patient, do not adjust thescrews, check with one finger between the jacket and patient for pressure,keep wrench taped to vest for emergencies, do not use sharp objects torelieve itching under the vestSafety (1)o

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Term
Winter
Professor
Wagner
Tags
morphine

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