Phys Rehab 414 Test 2
Terms
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- This is the transfer of energy to a patient to produce an increase or decrease in tissue temperature
- Thermal agents
- Examples of this include Ultrasound,and phonophresis
- Deep Heating
- Examples of this include hot pack, microwave heated towels, rice, gel packs
- Superficial heating
- Examples of this include cold packs, ice massage, vapor sprays, bags of frozen peas, ice cubes
- Cooling agents
- This is the transfer of heat from one object to another - heat goes from higher temperature to lower temperature material. Ex: Hot pack, paraffin bath, cold pack.
- Conduction
- This is the transfer of heat between a surface and a moving medium or agent. Ex: Fluidotherapy, whirlpool.
- Convection
- This is the transfer of heat from one form to another (sound waves transferred to heat; vibration of molecules in tissue result in increased friction produces heat). Ex: Ultrasound
- Conversion
- This is when heat is applied to cutaneous tissue; decreases pain by closing the pain gate mediated by the spinal cord
- Superficial heat
- Name some examples of superficial heat
- Moist hot packs, paraffin, heating pads
- This type of heat is used to stretch skin, joint, & fascia. You use it when you want to increase elasticity.
- Superficial heat
- What is the depth of penetration for superficial heat?
- 1-2 centimeters
- Between moist and dry superficial heat, which one penetrates to a slightly deeper level?
- Moist
- This type of heat includes ultra sound, short wave diathermy and microwave
- Deep Heat
- This type of heat has a depth of penetration 5-8 centimeters depending on the type of deep heat used and the tissue type.
- Deep Heat
- This type of heat is used to stretch deep structures: joint capsule, contractures.
- Deep Heat
- True or False: According to Weinberger, deep heating in RA decreases intrarticular temperature and inflammation.
- False. Deep heating in RA increases intrarticular temperature and inflammation.
- According to Weinberger this kind of heating is effective in heating periarticular tendons. Increases tendon excursion = more lengthened tendons
- Superficial Heating (moist hot pack)
- According to Weinberger this type of heating may speed reduction of inflammatory process.
- Non-thermal heating (phonopheresis)
- This type of heat application can be used prior to ROM, occupational performance, PNF, MFR and NDT
- Hot packs
- This type of heat application can be used for sub-acute inflammation - osteoarthritis, sports injuries (> 2-3 days, strains and old sprains
- Hot packs
- This type of injury results from excessive physical effort
- Strain
- This type of injury is to ligament around a joint (pain, swelling, discoloration)
- Sprain
- Treatment for this injury includes support rese, alternate heat & cold after initial acute stage
- Sprain
- Tx for this injury includes RICE
- Strain
- What does RICE stand for?
- Rest, ice, compress, elevate
- This type of heat application promotes tissue healing and can be used for muscle spasm, neuralgia, decreased ROM and flexibility and joint stiffness
- Hot packs
- A hydrocollator unit is used with which heat application?
- Hot packs
- This heat application has these advantages. Easy to apply, low level skill application, covers various contours of body.
- Hot packs
-
Place these steps in treatment application of hot packs in the correct order:
Place the hot pack over the area to be treated
Check the pt 5 min after application to determine heat tolerance
Wrap Hot Moist Pack (HMP)
Set a timer to -
1)Remove the hot pack from the hydrocollator unit with tongs
2)Wrap Hot Moist Pack (HMP)
3)Place the hot pack over the area to be treated
4)Secure the HMP in place to prevent migration
5)Set a timer to desired time
6)Check the pt 5 min after application to determine heat tolerance
7)Remove HMP after 20-30 minutes of application - The disadvantages of this heat application include that it requires constant monitoring, no method of temp control, decreased tolerance to wt
- hot packs
- How many layer of towels should you use with hot packs?
- 6-8 layers
- What is paraffin combined with when heated?
- mineral oil
- The effect of this tx is therapeutic heating or warming of superficial tissue.
- Paraffin
- The indications for this heat application include arthritis, joint stiffness, contracture, ligament tightness, scar tissue, sudek's atrophy/RSD, tenosynovitis
- Paraffin
- Contraindications for this heat application include open wounds, dermatological disorders,(psoritic arthritis), PVD with compromised circulation, acute sprains, Raynauds and tumors
- Paraffin
- Advantages of this heat application include: Inexpensive, easy to apply, achieve good contact with contoured areas, body part can be elevated, oil lubricates and softens skin, low specific heat allows higher tx temp, low thermal conductivity allows tissu
- Paraffin
- True or false: Hardened paraffin should not be used as an exercise tool
- False, hardened paraffin can be used as an exercise tool
- Some disadvantages of this modality include, messy & time consuming, can't use over open sound, contamination with reuse, dependent position, effective only on distal extremities, no method of temp control and heating only lasts 20 min.
- Paraffin
- What should therapist do before a paraffin bath?
- Remove jewelry from patient and wash area to be treated
- How should therapist instruct pt to dip hand in paraffin bath?
- with fingers spread apart and wrist into the paraffin bath
- How long should you wait before dipping pts hand again in paraffin bath?
- When paraffin has solidified & opaque
- How many times and for how much time should pts hand be dipped into paraffin?
- 8-10 times for 3-5 seconds
- After pts hand is covered in paraffin, what is the next step for dip and wrap?
- Wrap pts hand in plastic bag, then towel for 20-30 minutes to maintain heat
- For the Dip and Immersion technique of paraffin bath, what is the benefit?
- Provides vigorous heating
- In the dip and immersion technique of paraffin bath, how long should pt reimmerse in the tank?
- 20-30 minutes
- What is the purpose of dip and wrap method of paraffin bath?
- provides mild heating
- Name two precautions for paraffin
- Check thermostat, keep CO2 fire extinguisher handy
- This PAM can be used for adhesions, pain relief, arthritis, open wounds, tenosynovitis, sprains, edema control and joint stiffness
- Whirlpool
- Contraindications for this PAM include edema, skin rash, infection in part immersed, bleeding, recent skin grafts
- Whirlpool
- If whirlpool is used with a bleeding pt, what can happen?
- increase bleeding via venous circulation & vasodilation
- If you use whirlpool with a pt with PVD, what temp water should you use?
- Lukewarm
- This PAM's therapeutic effects include, aids in debridement, stimulation and formation of granulation, raise oxygen level, antibodies, and leukocytes, removes metabolites, can help decrease pain and relaxation
- Whirlpool
- What are three advantages of whirlpool?
- Complete contact with client's skin, Allows m/m during application, Water heats, cools and controls pain
- What are three disadvantages of whirlpool?
- Distal extremity in dependent position, costly to maintain, must keep this clean to avoid spread of infection
- What is the most common water temp in whirlpools for mild heating?
- 96-98 degrees
- Name three additives for whirlpools
-
povidone iodine
chlorine bleach
chloramine T -
Match the following to one of three additive to whirlpools
* Povidone Iodine * Chlorine Bleach * Chloramine T
Aids in control of infection but corrodes stainless
antimicrobial, does not corrode
not effective in -
* Chlorine Bleach - Aids in control of infection but corrodes stainless
* Chloramine T - antimicrobial, does not corrode
* Povidone Iodine - not effective in the presence of blood & tissue - How long is typical treatment in whirlpool?
- 20-30 min
- Name three precautions for whirlpools?
- Edema, pressure on axilla, electrical safety
- What temp in whirlpool is used for acute inflammation?
- Cold - 32-79 degrees
- What temp in whirlpool is used for exercise and acute inflammation if colder is not tolerated?
- Tepid - 79-92 degrees
- What temp in whirlpool is used for Open wounds, medically compromised pt with circulatory, sensory or cardiac disorders and decrease tone?
- Neutral warmth - 92 - 96 degrees
- What temp in whirlpool is used for Increase mobility in burn pt?
- Mild warmth - 96-98 degrees
- What temp in whirlpool is used for controlling pain?
- Hot - 99-104 degrees
- What temp in whirlpool is used for Increse soft tissue extesibility, chronic conditions (limited body area only)?
- Very hot - 104-110 degrees
- What temp should you not go above in whirlpool?
- 110 degrees
- What is the temp range and how long should fluidotherapy be used?
- 100-118 degrees, 20 - 30 minutes
- How is heat transferred in fluidotherapy?
- convection
- The indications for this PAM include flexion tendon repairs, extensor tendon repairs, contractures, joint stiffness, acute soft tissue injury, adhesions, and desensitization.
- Fluidotherapy
- Containdications for this PAM include decreased sensation, decreased circulation, respiratory problems, edema, open wounds and infections.
- Fluidotherapy
- If using fluidotherapy with a pt with open wounds, what should be done first?
- Cover wound with plastic bag to prevent contact with particles
- Name three advantages of fluidotherapy
- pt may exercise during heating, portholes allow OT to manipulate body part during heating, easy to administer
- Name a major disadvantage of fluidotherapy
- expensive
- What is another name for cold therapy?
- Cryotherapy
- This PAM is used to minimize the initial reaction of tissues to local trauma. The application can cause vasoconstriction, decreased blood flow, decreased local metabolic activity, decreased local temp and decreased pain. It can also be used to break up m
- Cold (Cryotherapy)
- Using therapeutic techniques of stretch in cold therapy minimizes what?
- Edema
- Contraindications for this PAM include Raynaud's phenomenon, regenerating peripheral nerve, peripheral vascular disease (PVD), superfical main branch of nerve, directly over open wound
- Cold therapy
- Name three advantage of cold therapy
- Easy to use, Cost varies, ROM during application
- Name two disadvantage of cold therapy
- Uncomfortable, Supervision to ensure timely transition from on temp to another
- What should you ask Dr before using ice packs?
- If they want skin contact if not indicated on order
- What is the tx time for cold packs?
- 10-15 min
- What temp are cold packs stored at?
- -5 degrees C
- How often should you use cold packs to control pain and inflammation?
- every 1-2 hours
- What are four sensations that may come from cold packs?
- cold, burning, aching, numbness (CBAN)
- What are three alternatives to cold packs?
- ice towels, cold bath (64 degrees), 1/2 water & 1/2 alcohol placed in a ziplock bag (conforms)
- What are the two indications for ice massage?
- stretching exercises, before friction massage
- Name four contraindications for ice massage
- cold sensitivity, raynauds disease, regenerating peripheral nerves, compromised vascular tissue/disease
- Name three advantages of ice massage
- target specific tx area, used for acute injuries, cools intramuscular temp more rapidly than ice pack
- How should ice be applied in ice massage?
- water is frozen in paper cup or on a popsicle stick and applied directly to the skin in a circular or longitudinal motion of the targeted area
- Name two disadvantages of ice massage
- Direct ice on skin may increase pat discomfort, plan for melting ice - cover pt to avoid moisture
- How long should you continue ice massage?
- 10-15 min or until pt experiences (CBAN)
- This PAM in indicated for arthritis of peripheral joints, joint sprains, deQuervains, toughen amputee stumps, edema management, decrease pain, increase circulation
- Contrast Baths
- The contraindications of this PAM include diabetes, raynauds, replants (crush injuries), wound healing, buergers disease inflamed/thrombotic arteries in leg or foot
- Contrast Baths
- What should the water temps be for contrast baths?
-
Cold - 55-65
Warm - 100-111 - How long should you immerse pts hand in warm and cold water for contrast bath?
- Immerse pt in warm water for 10 minutes. Immerse in cold water 1 minute. return to warm water for 4 minutes then cold for 1 min. complete 4:1 cycle two more times. repeat for 30 minutes. End with warm water.
- The indications for this PAM include myofascial trigger points, muscle spasms, decreased ROM, Acute stiff neck (torticollis), acute bursitis of shoulder, ankle sprain, headaches, referred pain from trigger points.
- Vapocoolant Sprays
- What are the two main ingredients in Vapocoolant Sprays?
- Fluoromethane and liquid ethyl chloride
- Name four contraindications for Vapocoolant Sprays
- Allergy to Fluoromethane or ethyl chloride sprays, open wounds, adverse reactions to cold, use around eyes
- Name three advantages of Napocoolant sprays
- easy to use, cost effective, able to target specific area
- Name three disadvantages of Vapocoolant sprays
- Requires prescription to use as. May cause frostbite if not used competently. Ethyl chloride is flammable & becomes general anesthetic if inhaled.
- Give three examples of superficial heat
- moist hot packs, paraffin baths, heating pads
- Name six kinds of burns
- Thermal, electrical, chemical, radiation, smoke inhalation and friction
- Name five causes of thermal burns
- steam, not liquids, not metals, extreme cold
- What are 80% of burns caused by?
- scalds/flame
- What are two causes of electrical burns?
- electric current, lightning
- What happens to 5% of people who suffer from electrical burns?
- cardiac, respiratory arrest
- What do the severity of chemical burns depend on?
- duration/contact with skin, whether there is involvement with lungs
- Name two types of radiation burns.
- laser, sunburn
- Name the three categories of burns
- 1st, 2nd and 3rd
- This category of burn is superficial and only the epidermis is affected.
- 1st degree
- This category of burn is painful, dry and without blisters. Regeneration occurs rapidly (4-7 days)
- 1st degree
- An example of this category of burn is sunburns.
- 1st degree
- This category of burn destroys entire epidermis & dermis down to subcutaneous tissue and may destroy muscle & tendon
- 3rd degree
- This category of burn is not painful because nerves are damaged
- 3rd degree
- In this category of burn, regeneration of epidermis occurs at wound margins only. Spontaneous healing is not possible.
- 3rd degree
- In this category of burn, skin grafting is required to promote wound healing, minimize scarring, and contractures
- 3rd degree
- In this category of burn, peripheral vascular system is compromised (increased edema) and pt may require eschartotomey or fasciotomy.
- 3rd degree
- This category of burn is superficial
- 1st degree
- This category of burn is Partial Thickness and Superficial
- 2nd degree
- This category of burn is Partial Thickness and Deep
- 2nd degree
- This category of burn is Full Thickness
- 3rd degree
- In this category of burn, the epidermis and some portion of the dermis is injured
- 2nd degree
- This category of burn is painful, red, exudative, subcutaneous edema and sensation is intact
- 2nd degree
- In this category of burn regeneration of the epidermis occurs by epithelization and may be very painful
- 2nd degree
- In this category of superficial burn epithelization occurs in 10-14 days without scarring. Will have fluid filled blisters
- 2nd degree
- In this category of deep burn, 3-4 weeks for epithelization may require grafting scarring occurs. Pressure sensation is intact, decreased light touch, there is modled yellow yuckiness and it can convert to full thickness if infected
- 2nd degree
- This type of wound involves the epidermal layer and superficial dermis and is AKA partial thickness wound.
- Epidermal Wound
- This type of wound heals by regeneration, without scar formation, & healing time is short
- partial thickness or epidermal wound
- This type of wound involves the complete epidermis, dermis and subcutaneous tissue, these wounds involve tissue, muscle & bone.
- Full thickness or dermal wound
- These type of wounds heal with scar formation and healing is complex and slow
- dermal or full-thickness wounds
- This skin graft is pts own skin, skin harvested from an unburned area (donor site) such as thigh, low back or outer arm. It is painful, red and scarring is possible
- Autograft
- This type of graft the dermatome set to remove a predetermined thickness of skin and contains epidermis and superficial dermis
- Split thickness graft (STSG)
- This type of graft is done under anesthesia and covers a large area
- Mesh graft
- This type of graft used a strip of unaltered skin to be used on face, hads, nect
- Sheet graft
- This type of graft consist of full dermal thickness (both dermis and epidermis
- Full thickness graft (FTG)
- This type of graft uses skin from another species. It is a temporary graft that allows donor sites to heal.
- Xenograft or heterograft
- This type of graft is from same species. Cadaver skin is frozen and kept in skin banks. It is temporary and lasts 2-3 weeks and must be on immunosuppressants.
- Homograft or allograft
- This is a layer of skin or other tissue and is sx separated and attached.
- Flaps/Plasty
- This is bio-brain synthetic skin, nylon mesh, collagen, silicone
- Biological
- Name the three stage of maturation of scars
- Immature (0-4 mo), Semi-mature (0-8 mo), Mature (8-12 mo)
- In this stage of scar maturation the scar is red, warm, raised and rigid. It is active and will respond to compression.
- Immature
- In this stage of scar maturation the scar tissue is becoming pinker, less rigid, and not as warm. Compression initiated now may still be effective. Scar will conform to pressure and remain flat on the surface.
- Semi-mature
- In this stage of scar maturation the scar is paler, flatter, and softer. Scar will not respond to tx. Requires surgical intervention.
- Mature
- True or False. Pressure should be applied to a scar ASAP
- True, the sooner the better
- How might pressure impact hypertophic scarring? Name 6 effects of pressure.
-
* Hastens the scar maturation.
* Thins the dermis.
* Alters the biomechanical structure of the scar.
* Decreases blood flow to the area.
* Reorganized collagen bundles.
* Decreases tissue water content. - This is a thick, raised, firm irregular margined scar. It primarily occurs in people of color and grows away from the surface
- Keloid
- What is the anti-deformity position for the neck?
- neutral/slight extension
- What is the anti-deformity position for the chest/abdomen
- trunk extension, shoulder retraction
- What is the anti-deformity position for the Axilla
- shoulder abduction 90 - 100 degrees
- What is the anti-deformity position for the elbow/forearm
- elbow extension, forearm neutral
- What is the anti-deformity position for the wrist/hand
- wrist extension 30 degrees, thumb abducted and extended, MCP flexion 50 - 70 degrees, IP extension
- What is the anti-deformity position for the hip/thigh
- neutral extension, hips 10 - 15 degrees abduction
- What is the anti-deformity position for the knee/lower leg
- knee extension; anterior burn; slight flexion
- What is the anti-deformity position for the ankle/foot
- neutral to 1 - 5 degrees dorsal flexion
- What is the anti-deformity position for the ears/face
- prevent pressure
- This is a disease in which the beta cell of the islets of Langerhans in the pancreas do not produce enough insulin, or in which the body is resistant to the insulin which is produced
- Diabetes
- The symptoms of this include rapid onset, generalized weakness, rapid weight loss (eating lots though) and water loss due to increased metabolism
- Type I diabetes
- The symptoms of this include itching, chronic overeating desensitizes insulin receptors and can reverse process (eat right and exercise)
- Type II diabetes
- The symptoms of this include extreme thirst, heartburn/nausea,. fast deep respirations, excessive urination with ketones in the urine, headache, blurred vision, constipation and coma if not treated.
- Ketoacidosis
- This complication of diabetes is when changes occur in the body's small and large blood vessels because the body is not able to process fat efficiently. Fatty substances build up on the walls of the arteries narrowing passage. Can cause: Hypertension, he
- Artherosclerosis
- This complication of diabetes is damage to the small blood vessels on the eye that causes vessels to bulge and lead fluids into the retina causing blurred vision. The assoc. bleeding, scaring, and retinal detachment may lead to blindness. Halos, floaters
- Diabetic Retinopathy
-
This complication of diabetes is Decreased sensation affect nerves responsible for controlling sensation in the feet, hands, and joints.
* Distal to proximal
* LE to UE
* More sugar destroys myelin sheath = reduced conduction and damage - Peripheral neuropathy
- This complication of diabetes is assoc. with arthrosclerosis and impairs kidney's ability to filter waste products.
- Chronic renal failure
- Name four complications of diabetes.
- Artherosclerosis, diabetic retinopathy, peripheral neuropathy, and chronic renal failure
- This occurs when Blood glucose levels are too high above 140-180 mg/dl and too little insulin in the blood; blood sugar level is too high.
- Hyperglycemia
- Symptoms of this condition include extreme thirst, excessive urination, constipation, heartburn/nausea, headache, fast deep respirations, blurred vision, coma if not treated
- Hyperglycemia
- What should you do for hyperglycemia?
-
-Check blood glucose level
-Check urine for ketones
-Drink water
-Call physician if blood glucose remains 180 mg/dl for 2 days -
In this condition Blood sugar levels may drop below 50 mg/dl for men when accompanied by symptoms and 40 mg/dl for women when accompanied by symptoms.
Too much insulin in the blood; blood glucose level is too low.
-Missing or delaying meals
- Hypoglycemia
- The symptoms of this conditions include Extreme hunger, Sweating, Dizziness, Cold and clammy, Tremors, Palpitations, Weakness, Slurred speech, Nervousness, Incoordination, Confusion
- Hyppoglycemia
- This allows glucose from the blood to enter muscles and cells.
- Insulin
- This allows the body to metabolize sugar for energy.
- Insulin
- This, combined with meal planning and exercise deeps blood sugar in target zone.
- Insulin
- This keeps the body from sending extra sugar into the blood when there is more stress.
- Insulin
- What is the A1C test?
- Memory glucose test over 2-3 months (+ ketones)
- What is the fastest site for insulin injection?
- Abdomen
- Where is insulin injection slowest?
- Buttocks
- Name some things that should be included in an OT evaluation of diabetes.
- ADL's, Sensory testing, vocational history, psychosocial adjustment, visual perception, UE ROM, strength, coordination, sensation, leisure interests & skills, physical conditioning, need for ancillary services, clinical observation of skin, home safety, pt's ability to inspect skin, community mobility, presence of edema, safety awareness
- What things can an OT do in tx of the diabetic pt?
- Splinting (wrist cock-up splint), adaptive equipment and compensatory techniques, work simplification and energy conservation, avoid risk of injury to the lower extremities, teach safety precautions and compensation for visual and sensory loss (syringe magnifier, large screen computers), have sugar available in tx setting (hard candy, oj), work on meal preparation that fits into dietary restrictions, exercise (regular schedule, decreases blood sugar)
- List 4 functions of the kidneys
-
* Filter waste products from the blood
* Absorb water and nutrients
* Regulate the concentration of salt and potassium
* Maintain normal acid base - What is the normal ph of the blood?
- 7.45
- What happens if the ph level is < 7.45?
- blood too acidic = Acidosis & results in diabetes
- What happens if the ph level is > 7.45?
- blood too alkaline = Alkolosis & results in nausea, vomiting (too much CO2 – hyperventilate)
- What is the functional unit of the kidney
- Nephron
- Name three parts of the nephron
- Bowmans capsule, Glomerulus, tubules
- This part of the nephron collects filtered urine
- Bowmans capsule
- This part of the nephron filters blood & fluid across capillaries
- Glomerulus
- This part of the nephron transit of urine from renal pelvis to ureter
- Tubules
- This type of renal failure develops suddenly, can be tx successfully and is reversible
- Acute
- This type of renal failure is caused by decreased blood flow to the kidneys, trauma, burns, placenta previa, surgical shock, transfusion and alcoholism
- Acute
- What are some symptoms of acute renal failure?
-
* Gastrointestinal distress
* Breath odor of ammonia due to the accumulation of nitrogen in the blood
* Increased potassium buildup (hyperkalemia) may cause muscle weakness an slow the heart to the point of cardiac arrest - Name three types of renal failure.
- Acute, Chronic, End Stage
- The causes of this type of real failure include hypertension, glomerulonephritis, pyelonephritis, polycystic kidney disease, analgesics, pyuris and diabetic nephopothy
- Chronic Renal Failure
- What are some symptoms of Chronic Renal Failure?
-
* Pulmonary edema
* Painful itching
* Altered nervous system function
* Reduced mental ability
* Reduced bone density – can’t absorb calcium
* Change in skin color – ashen, pale, gray, no color - This is when kidney function has deteriorated < 20 – 25%, the kidneys are not capable of sustaining life. Damage is irreversible.
- End stage renal disease
- What are some residual complications of end stage renal disease?
-
* Uremia – Toxic condition associated with urea buildup
* Hypertension
* CHF – fluid overload, left ventricle involved 1st, the right then shuts down
* Anemia
* Gastrointestinal problems – buildup of ammonia
* Urinary infections
* Dementia type symptoms
* Psychosocial – depression – medication may be excreted through kidneys (not absorbed) - What are some ways that real function is diagnosed? (seven)
-
X-ray,
Intravenous Pyelogram,
Lab Studies
Urinalysis, BUN Blood Urea Nitrogen, Glomerular filtration rate, doppler studies, computerized tomography) - In this diagnoses for renal function, it determines the size of the kidneys, they will not give pt a contrast dye
- X-ray
- In this diagnoses for renal function, it gives a picture of kidney but not function - iodine compound
- IVP - Intravenous Pyelogram
- In this diagnoses for renal function, it is the first test performed for dx of renal disfunction
- Urinalysis
- When a urinalysis is performed for renal function, what does it mean if the dipstick test is positive and is within the 3-4+ range?
- Protein in urine
- In this diagnoses for renal function, it is also known as Azotemia and Uremia
- BUN - Blood Urea Nitrogen
- In this diagnoses for renal function, it measures rise in creatine level
- GFR - glomerular filtration rate
- In this diagnoses for renal function, US measure the flow of blood through fistula
- Doppler studies
- In this diagnoses for renal function, the shape of the kidney is looked at.
- Computerized Tomography
- This is a toxic condition associated with urea buildup
- Uremia
- This is created by anastomosis; the surgical joining of an artery and vain.
- A/V Fistula
- This is a process that removes urea, poisons, uric acid, helps bring creatine to normal. The artificial cleansing of blood.
- Dialysis
- Name 4 types of dialysis
- Hemodialysis, Peritoneal, Continuous Ambulatory Peritoneal Dialysis, and Continuous Cyclic Peritoneal Dialysis
- What are the three stage of peritoneal dialysis?
-
THREE STAGES
1. Dialysate flows into peritoneal cavity
2. Dialysate stays in cavity. Electrolytes are exchanged, pass thorough blood by osmosis (lesser ï‚® higher concentration)
3. Drain dialysate out of cavity - In this type of dialysis, pt's blood is shunted from the body through an artificial dialyzer for diffusion and ultra filtration, then returned to the pt's circulation. It is the most common (87%)
- Hemodialysis
- In this type of dialysis, The site is the upper arm, forearm (proximal or distal), wrist (radial artery and cephalic vein or ulnar artery & basilic vein), leg/thigh (posterior tibial artery & saphenous vein)
- Hemodialysis
- What is the duration of tx for hemodialysis?
-
 Requires 3-8 hours daily for acute renal failure
* 2-3 times a week for chronic renal failure
* Physician prescribes type and duration of dialysis
* Peritoneal Dialysis uses the peritonial cavity in the abdomen - This type of dialysis uses the peritonial cavity in the abdomen to filter the blood via a vast network of capillaries
- Peritoneal dialysis
- In this type of dialysis, osmosis, diffusion, & infiltration allow the electrolytes to pass to the blood stream via the vascular peritoneum to the blood vessels of the abdominal cavity
- Peritoneal dialysis
- This type of dialysis is peritoneal dialysis in which the dialysis solution is exchanged 4 times per day, 7 days a week
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- In this type of dialysis, the exchanges are spaced throughout the day (AM, noon, late afternoon, and before bedtime)
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- An advantage to this type of dialysis is that the patient can be ambulatory.
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- In this type of dialysis, the procedure is similar to the peritoneal dialysis except the abdominal cavity is infused only 4 or 5 times per day
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- In this type of dialysis, it is peritoneal dialysis in which a cycler machine does the exchange every night for 10-12 hours
- Continuous Cyclic Peritoneal Dialysis (CCPD)
- A disadvantage of this type of dialysis is that the pt cannot be mobile
- Continuous Cyclic Pertioneal Dialysis (CCPD)
- This is caused by distal hypotension (decreased circulation). Pt has cold, painful fingers.
- Radial Steal Syndrome
- Cyanotic thumb with eczematous skin changes, oozing fluid around nail bed.
- Sore Thumb Syndrome