The short-term goal for the patient is to be minimally assisted in bed mobility. What are two bed mobility activities to teach this patient to achieve this goal.
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A 60-year old male patient, right-handed, single, tricycle driver is diagnosed with R CVD infarct, at day 5 post-ictus. On personal social history, the patient is living in a bungalo house with his 70-year old sister and her 20-year old son. Upon evaluation, the patient is awake, dysarthric, but manages to follow commands. The following are the pertinent physical examination findings:
Shallow R nasolabial fold, fair gutturals, lingual, (+) gag reflex
Tone and reflex: hypotonic, hyporeflexive left upper and lower extremities
Motor: MMT 0/5 left upper and lower extremities, 5/5 on right upper and lower extremities
Sensory: 50% deficit on left upper and lower extremities
Other systemic physical examination findings were unremarkable
Functional assessment: moderately assisted in all ADLs
The short-term goal for the patient is to be minimally assisted in bed mobility. What are two bed mobility activities to teach this patient to achieve this goal.
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- A 60-year old male patient, right-handed, single, tricycle driver is diagnosed with R CVD infarct, at day 5 post-ictus. On personal social history, the patient is living in a bungalo house with his 70-year old sister and her 20-year old son. Upon evaluation, the patient is awake, dysarthric, but manages to follow commands. The following are the pertinent physical examination findings: Shallow R nasolabial fold, fair gutturals, lingual, (+) gag reflexTone and reflex: hypotonic, hyporeflexive left upper and lower extremitiesMotor: MMT 0/5 left upper and lower extremities, 5/5 on right upper and lower extremitiesSensory: 50% deficit on left upper and lower extremitiesOther systemic physical examination findings were unremarkableFunctional assessment: moderately assisted in all ADLs The patient will be progressed from bed mobility skills to transitions to sitting. How will this be instructed?18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…
- 18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…
- 18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…
- 18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs. Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions. On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries. Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%. Patient reports pain to be 5/10 at occipital region, no analgesia taken prior to presentation. Patient states is usually fit and well. Past medical history Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies. Intervention: The decision is made to keep Zac in hospital overnight, for observation. Paracetamol is charted for pain. No other medications are…The patient is a 9-year old male, grade 2 student, managed as a case of Paraplegia sec to Spinal Cord Injury ASIA A (anatomic level: T10, sensory level: T10, motor level: T10, neurologic level: T10). Pertinent PE findings: Tightness B heelcordsHyporeflexive both LE, Hypotonic both LEsWeakness on B LEMyotomes- bilateral C5-T1 level MMT: 5/5, bilateral L2-S1 level MMT: 0/5Sensory deficit on B LEDermatomes- bilateral C2-T10 level 2/2, bilateral T11-S3 level 0/2Lax sphincter tone, (-) bladder filling sensationLimited Activity: moderate assist in bed mobility, transitions, transfers, moderate assist in ADLs What are two recommendations for this patient in order to minimize potential pressure sores from prolonged sitting?The patient is a 9-year old male, grade 2 student, managed as a case of Paraplegia sec to Spinal Cord Injury ASIA A (anatomic level: T10, sensory level: T10, motor level: T10, neurologic level: T10). Pertinent PE findings: Tightness B heelcordsHyporeflexive both LE, Hypotonic both LEsWeakness on B LEMyotomes- bilateral C5-T1 level MMT: 5/5, bilateral L2-S1 level MMT: 0/5Sensory deficit on B LEDermatomes- bilateral C2-T10 level 2/2, bilateral T11-S3 level 0/2Lax sphincter tone, (-) bladder filling sensationLimited Activity: moderate assist in bed mobility, transitions, transfers, moderate assist in ADLs What are two things that you will consider when handling and transitioning a paraplegic patient?
