2.4: Medical Problems/Pathologies

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Page ID: 160139

staff
Quality Care Health Foundation

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Orthopedic

ORIF vs. THR Patients
ORIF ORIF = Open Reduction Internal Fixation – “pinned hip” Incisional and bone pain	THR THR = Total Hip Replacement Incisional pain only
Position will be limited by pain	Precautions on positioning: Six to eight weeks No hip flexion past 60º-90º No adduction No internal rotation
Usually TDWB to NWB six or more weeks TDWB = Touch Down Weight Bearing NWB = Non-Weight Bearing	Often PWB to WBAT PWB = Partial Weight Bearing WBAT = Weight Bearing As Tolerated
Difficulty with transfer and gait is secondary to limited weight-bearing and pain	Less pain with mobility Dislocation risk as there often is no pain

Thought

If some important activity is taken away (i.e. walking), you must replace it with another equally important activity.

Common Characteristics of CVAs

Cerebrovascular Accidents

Muscle weakness or paralysis.
Sensory impairment – loss of feeling.
Depression is common.
Emotional lability – inappropriate crying or laughing unrelated to situation.
May be disoriented.
May have problems with eye-hand coordination and balance – more severe in the right CVA, left hemiplegic.

Different Characteristics of Right and Left CVAs

Right CVA

Left hemiplegia

Left CVA

Right hemiplegia

Visual impairment/neglect of left side of self in environment and written material.
Poor safety judgment, impulsive.
Short attention span – highly distractible, may fixate on inappropriate topics.
May speak clearly but not make any sense as to content.
Limb apraxia – may misuse objects such as comb, razor, toothbrush, etc.
May use yes and no inappropriately.
Difficulty reading clocks.
May be confused about time and space, gets lost easily.
Fast learner – but quickly forgets newly learned tasks.

Visual impairment/neglect of right side of self in environment and written material.
Slow, cautious behavior.
Difficulty changing topics and tasks.
May be aphasic – complete breakdown in any or all communication, writing, speaking, listening.
May be anomic – unable to name objects even though their usage is understood.
Verbal apraxia – may mix up sounds and words.
Uses jargon, made-up words.
Slow learner – but once a task is learned, it is retained.

Chronic Neurological

Diamond diagram showing four conditions (CVA, Parkinson disease, Alzheimer disease, and senility) around the edges, with nine shared symptoms listed inside: poor judgment, increased anxiety, personality changes, forgetfulness and memory loss, confusion, loss of balance, problems swallowing, difficulty with ADLs, and wandering. — Figure \(\PageIndex{1}\): The four sides of the diamond are labeled CVA, Parkinson disease, Alzheimer disease and Senility. Inside are the symptoms these conditions have in common: poor judgment; increased anxiety; personality changes; forgetfulness and memory loss; confusion; loss of balance; problems swallowing; difficulty with ADLs; wandering.

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