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Putting it all together

Putting it all together. Dr. Robin McKenzie Rehabilitation Nursing Principles Fall 2009. Goals for the Didactic and Clinical Rehab Program. Safe & Effective Care Environment. Identify the roles of the interdisciplinary team Collaborate w/members of the rehab team

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Putting it all together

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  1. Putting it all together Dr. Robin McKenzie Rehabilitation Nursing Principles Fall 2009

  2. Goals for the Didactic and Clinical Rehab Program

  3. Safe & Effective Care Environment • Identify the roles of the interdisciplinary team • Collaborate w/members of the rehab team • Delegate and supervise selected nursing tasks as part of the care for the rehab patient • Coordinate recommendations for home modification w/patient, family, OT and case manager • Transfer & ambulate patient safely

  4. Health Promotion & Maintenance • Assess the patient’s ability to perform ADL • Interpret physical & psychosocial assessment findings for the patient in rehab • Develop a teaching plan for the rehab patient with impaired physical mobility • (Assess ADL, Eating, Dressing, Toileting, Bathing, Grooming, Hygiene, Oral hygiene, Mobility with walker, wheelchair or cane, Transfer, performance, Positioning self, Range of Motion, Communication, Bed mobility

  5. Physiologic Integrity • Assess the ability of patients to use assistive/adaptive devices to promote independence • Differentiate training techniques for a pt with spastic versus flaccid bowel or bladder • Evaluate patient outcomes of the interdisciplinary program • Explain the primary concerns for patients being discharged to home from rehab

  6. Spastic Bowel (defecation without warning) • Flaccid Bowel (infrequent small stools) • Spastic Bladder (incontinence with sudden, gushing voids-bladder does not empty completely) • Flaccid bladder (results in urinary retention and overflow-dribbling) • Patient outcomes: Evaluate • Coping • Stress • Sense of control • Use and availability of social support • Actively seeks information r/t treatment and illness • Modifies lifestyle • Adapts to life changes • Concerns: • Current living situation at home • Adequacy of home environment • Potential needs including assistance with ADL, nursing care, and PT or OT • Life planning for TBI pt • Healthcare/Community resources

  7. Psychosocial Integrity • Assess the patients response to chronic or disabling health problems • Assess the family’s response to the patient’s chronic or disabling health problems • Promote independence for the rehab patient and family

  8. Body image • Self esteem (promote self worth) • Use of coping and defense mechanisms • Response to loss of body part or function • Presence of stress related to physical problem • Depression • Fatigue • Feelings of powerlessness • Change in appetite • Availability of support systems • Spiritual and religious needs • Functional status • Meaningful education and training • Employment • Physical demands of the tjob • Coordinate with employer regarding work environment modifications to meet special needs

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