Chapter: 22 physical Agents

What are three reasons for applying a cast?

1. A fracture2. Weak or dislocated joints3. To promote healing after a surgical correction, such as knee surgery

List two reasons for prescribing a walker.

1. Healing process of knee/hip replacement surgery2. Weakness or balance problems

List two examples of conditions for which a splint may be applied.

1. Protects areas that are sprained or strained2. Immobilize a displaced or fractured part of the body

List two reasons for prescribing a cane.

1. Weakness on one side2. Slight assistance with walking

List eight guidelines that must be followed during crutch use to ensure safety.

1. Wear well-fitting flat shoes2. Use correct posture to prevent strain3. Support weight with hands on the handgrips4. Look ahead when walking, not down5. Be aware of the surface you're walking on6. Keep crutches 4 to 6 inches out from the sides of your feet7. Report tingling or numbness in upper body8. Keep crutch tops dry to maintain surface tension

Short leg cast

A cast that begins just below the knee and extends to the toes

Long arm cast

A cast that extends from the axilla to the fingers, usually with a bend in the elbow

List three that must take into consideration when applying heat or cold

Age, Location of Application, Impaired circulation, Impaired sensation, Individual (tolerance to change in temp)

List two reasons for applying cold locally.

Applying cold locally helps with swelling and bruising.

Marlyne fitted Katie's crutches correctly. When Katie gets home, she adjusts the crutches to a longer length. Katie is putting herself at risk for

Crutch palsy

How is a cast removed?

Cut the cast into two halves with a cast cutter, pry apart with a cast spreader, cut with bandage scissors through the cast padding and stockinette

Why should the following precautions be taken when applying a synthetic cast?- Removing synthetic casting particles using an alcohol swab.

If they're not removed they may work their way under the cast causing irritation and infection

What symptoms may indicate that a cast is too tight and an infection is developing?

Increased pain and swelling that doesn't go away

Describe one advantage of the forearm crutch.

Individual can release the handgrip, enabling use of the hand

Why is it important to dry a synthetic cast as soon as possible after it gets wet?

It can bear weight approximately 30 minutes to 1 hour after application

What may occur if axillary crutches are not fitted properly?

It increases the patients ability of developing back pain, nerve damage, and injuries to the axillae and palms of the hand

Why should the following precautions be taken when applying a synthetic cast?- Checking the circulation, sensation, and movement of the extremity.

Make sure the cast is not too tight

What are the symptoms of a pressure area?

Painful rubbing, burning or stinging sensation

What is the purpose of applying cast padding during cast application?

Prevents pressure areas and shields the patient's skin when the cast is removed

What is the purpose of covering the body part with a stockinette before applying a cast?

Provides the patient comfort and to cover the rough edges at the ends of the cast

List one example of a condition for which a brace may be applied.

Short leg walker which is used to heal a stable fracture of the lower leg

What will the affected extremity look like after a cast has been removed?

Skin looks yellow and scaly, extremity appears thinner and muscles are flabby

List the three types of canes.

Standard, Tripod, Quad canes

Dr. Walker told Katie not to put weight on her left foot for the next 5 days. What is the most appropriate crutch gait for Katie?

Three-point gait

What are the complications of a pressure ulcer?

Turns into erosion into the subcutaneous tissue and eventually erosion into the muscle and bone

What factors does the physician take into consideration when prescribing an ambulatory assistive device?

Type and severity of the disability, amount of support required, patients age and degree of muscular coordination

What causes a pressure area?

When the cast presses or rubs against the patient's skin and prevents adequate circulation to the area.

Swing-to gait

both crutches are advanced together and then both legs are lifted and placed down again on a spot behind the crutches. * the feet and crutches form a tripod*

How does the local application of cold for a short time to an affected the area influence the diameter of the blood vessels in the affect area?

constriction or decreases in diameter

How does the local application of cold for a short time to an affected the area influence the tissue in the affected area?

decrease

How does the local application of cold for a short time to an affected the area influence the blood supply to the affected area?

decreased blood supply

How does the local application of heat to an affected are for short period of time influence the tissue metabolism in the affected area?

increases

How does the local application of heat to an affected are for short period of time influence the blood supply to the affected area?

increases the blood supply to the area

three reasons for applying heat locally.

low back pains, arthritis, menstrual cramping and localized abscesses

How does the local application of heat to an affected are for short period of time influence the blood vessels in the affected area?

produces dilation, organ increase in diameter of the blood vessels in the affected area.

What happened to the diameter of the blood vessels if heat is applied for a prolonged time (more than 1 hour)?

produces secondary affect, blood vessel constrict, and blood supply to the area decreases.

Four-point gait:

used when both legs can bear some weight; right foot, left crutch, left crutch, right foot

Three-point gait:

used when only one leg can bear weight