logging in or signing up Special Patients aSGuest1013 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 160 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: October 15, 2008 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: drnitinchaudhari (30 month(s) ago) hey really nice video but i am not able to download this video so please do some faver and make it downloadable . thanks Saving..... Post Reply Close Saving..... Edit Comment Close By: drnitinchaudhari (30 month(s) ago) o k Saving..... Post Reply Close Saving..... 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Edit Comment Close Premium member Presentation Transcript Special Patients : Special Patients Hearing impairments : Hearing impairments Hearing impairments : Hearing impairments Types Conductive deafness Sensorineural deafness Etiologies : Etiologies Conductive deafness (curable) Infection Injury Earwax Etiologies : Etiologies Sensorineural deafness (many incurable) Congenital Birth injury Medication-induced Viral infection Tumors Prolonged exposure to loud noise Aging Recognition : Recognition Hearing aids Poor diction Inability to respond to verbal communication in absence of direct eye contact Accommodations : Accommodations Retrieve hearing aid Paper/ pen Maintain position so patient can read lips Use of an “amplified” listener Picture of basic needs/ procedures Accommodations : Accommodations American Sign Language (ASL) Interpreter Notify receiving facility as early as possible Accommodations : Accommodations Do not shout 80% of hearing loss is related to loss of high-pitched sounds Use low-pitched sounds directly into ear canal Do not exaggerate lip movement Visual impairments : Visual impairments Etiologies : Etiologies Congenital Injury Infection (C.M.V.) Glaucoma Degeneration of eyeball, optic nerve or nerve pathways Accommodations : Accommodations Retrieve visual aids Describe everything you're going to do Provide sensory information If ambulatory, guide by leading, not by pushing Allow guide dogs to accompany patient Speech impairments : Speech impairments Types : Types Language disorders Articulation disorders Voice production disorders Fluency disorders Language disorders : Language disorders Etiologies Stroke Head injury Brain tumor Delayed development Hearing loss Lack of stimulation Emotional disturbance Language disorders : Language disorders Recognition Slowness to understand speech Slow growth in vocabulary and sentence structure Articulation disorders : Articulation disorders Etiologies Damage to nerve pathways from brain to muscles in larynx, mouth or lips Delayed development from: hearing problems slow maturation of nervous system Recognition Speech slurred, indistinct, slow, or nasal Voice production disorders : Voice production disorders Etiologies Disorder affecting vocal cord closure Hormonal or psychiatric disturbance Severe hearing loss Voice production disorders : Voice production disorders Recognition Hoarseness Harshness Inappropriate pitch Abnormal nasal resonance Fluency disorders : Fluency disorders Etiology Not fully understood Recognition Stuttering Accommodations : Accommodations Allow patient time to respond Provide aids when available Obesity : Obesity Etiologies : Etiologies Caloric intake > Calories burned Low basal metabolic rate Genetic predisposition Accommodations : Accommodations Appropriately-sized diagnostic devices Maintain professionalism Additional assistance for lifting, moving Paraplegia/ Quadriplegia : Paraplegia/ Quadriplegia Description : Description Paraplegia Weakness or paralysis of both legs Quadriplegia Paralysis of all extremities and trunk Accommodations : Accommodations Airway/ventilation management Patients with halo traction device Ostomies: Trachea Bladder Colon May require additional assistance/ equipment Mental illness : Mental illness Description : Description Any form of psychiatric disorder Etiologies : Etiologies Psychoses Patient perceptions of reality radically different Neuroses Patient perceives reality normally but reacts to it inappropriately Recognition : Recognition Behavior not always affected May present with signs and symptoms consistent with underlying illness Accommodations : Accommodations Don't be afraid to ask about History of mental illness Prescribed medications Whether patient is taking medications as prescribed Concomitant ingestion of alcohol, other drugs Accommodations : Accommodations Solicit permission before beginning assessment Treat as patient that does not have mental illness, unless call is related specifically to the mental illness Developmental disabilities : Developmental disabilities Impaired or insufficient development of the brain Causes an inability to learn at a usual rate Down's syndrome : Down's syndrome Etiology : Etiology Chromosomal abnormality (trisomy -21) resulting in: Mild to severe mental retardation Characteristic physical appearance Recognition : Recognition Eyes slope up at outer corners; folds of skin on either side of nose cover the inner corners of eye Small face, features Large, protruding tongue Flattening of back of head Hands short, broad Accommodations : Accommodations IQ varies from 30-80 Approximately 25% have a heart defect at birth Articulation of C-1 on C-2 may be unstable Emotional impairments : Emotional impairments Etiologies Neurasthenia Anxiety neurosis Compulsion neurosis Hysteria Arthritis : Arthritis Description : Description Inflammation of joint Characterized by: Pain Stiffness Swelling Redness Types/etiologies : Types/etiologies Osteoarthritis Rheumatoid arthritis Uremic arthritis (gout) Accommodations : Accommodations Decreased range of motion/ mobility may limit physical exam Limited mobility Make equipment fit patient, not vice-versa Pad all voids Elicit current medications Cerebral palsy : Cerebral palsy Description Non-progressive disorder of movement and posture Caused by injury to brain during its early development A symptom complex rather than a specific disease Types : Types Spastic (70% of cases) Upper motor neuron involvement Abnormal stiffness and contraction of groups of muscles Hemiplegia Paraplegia Quadraplegia Diplegia (intermediate state between para-quadraplegia) Types : Types Athetoid or dyskinetic (20%) Basal ganglia involvement Involuntary, writhing movements of: Extremities (athetoid) Proximal limbs and trunk (dyskinetic) Movements increase with emotional tension; disappear during sleep Types : Types Ataxic (10%) Cerebellar involvement Loss of coordination and balance Unsteadiness Wide-based gait Difficulty with rapid or fine movements Etiologies : Etiologies Prepartum Cerebral hypoxia Maternal infection Kernicterus (liver failure) Postpartum Encephalitis Meningitis Head injury Accommodations : Accommodations 75% mentally retarded 25% have seizures Many with athetoid and diplegic cerebral palsy are highly intelligent Accommodations : Accommodations May require additional resources to facilitate transport May need suctioning, due to increased oral secretions If contractures present: Pad appropriately Do not force extremities to move Cystic fibrosis : Cystic fibrosis Description : Description Inherited metabolic disease of exocrine glands and eccrine sweat glands Primarily affects digestive, respiratory systems Begins in infancy Etiology : Etiology Autosomal recessive gene Both parents must be carriers Incidence Caucasians--1:2000 Blacks--1:17,000 Orientals--very rare Pathophysiology : Pathophysiology Obstruction of pancreatic, intestinal gland, bile ducts Over-secretion by airway mucus glands Excess loss of sodium chloride in sweat Recognition : Recognition History Airway obstruction, chronic cough Recurrent respiratory infections May be oxygen-dependent Frequent, foul-smelling stools Salty taste on skin Intolerance of hot environments Accommodation : Accommodation May require respiratory support, suctioning, oxygen Multiple sclerosis : Multiple sclerosis Description : Description Progressive disease of CNS Scattered patches of myelin in the brain and spinal cord are destroyed Results in multiple, varied neurologic symptoms, signs Etiologies : Etiologies Unknown Probably autoimmune disease Genetic factors influence susceptibility Women affected more often than men Recognition : Recognition Painful muscle spasms Recurrent urinary tract infections Constipation Skin ulcerations Changes of mood, from euphoria to depression Recognition : Recognition If brain affected: Fatigue Vertigo Clumsiness Muscle weakness Slurred speech Ataxia Blurred or double vision Numbness, weakness or pain in face Recognition : Recognition If spinal cord affected Tingling, numbness, or feeling of constriction in any part of the body Extremities may feel heavy and become weak Spasticity Accommodation : Accommodation Possible respiratory support Patient should not be expected to ambulate Muscular dystrophy : Muscular dystrophy Description : Description Inherited muscle disorder Slow progressive degeneration of muscle fibers Unknown Cause Recognition : Recognition History Little or no movement of muscle groups Accommodation : Accommodation Possible respiratory suport Patient should not be expected to ambulate Poliomyelitis : Poliomyelitis Description : Description Caused by virus Usually results in mild illness In more serious cases, attacks the CNS May result in paralysis or death Recognition : Recognition History Paralysis Accommodations : Accommodations If lower extremities paralyzed, patient may require catheterization If respiratory paralysis, patient may require tracheostomy Patient should not be expected to ambulate Spina bifida : Spina bifida Description : Description Congenital defect Part of one or more vertebrae fails to develop Leaves portion of spinal cord exposed Etiology : Etiology Unknown May be related to dietary deficiencies during pregnancy (folic acid) Recognition : Recognition History Often associated with: CNS infections Obstructive uropathies Hip joint dislocations Accommodations : Accommodations Patient should not be expected to ambulate, although most can Myasthenia gravis : Myasthenia gravis Description : Description Autoimmune disorder Results in acetylcholine production, binding at neuromuscular junction Muscles become weak and tire easily Eyes, face, throat, and extremity muscles most commonly affected Recognition : Recognition Drooping eyelids, double vision Difficulty speaking Chewing, swallowing may be difficult Extremity movement may be difficult Respiratory muscles may be weak Accommodations : Accommodations Airway control Assisted ventilation Patient may be unable to ambulate Culturally diverse patients : Culturally diverse patients Variables : Variables Ethnicity Religion Language Gender Homelessness Accommodations : Accommodations Obtain permission to treat when possible Beliefs may conflict with learned medical practice Attempt to recruit an interpreter Early notification of receiving facility Terminally Ill Patients : Terminally Ill Patients Hospice Care Advance directives, DNR Financial Challenges : Financial Challenges Apprehensive about seeking medical care You do not have the permission to view this presentation. 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Special Patients aSGuest1013 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 160 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: October 15, 2008 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: drnitinchaudhari (30 month(s) ago) hey really nice video but i am not able to download this video so please do some faver and make it downloadable . thanks Saving..... Post Reply Close Saving..... Edit Comment Close By: drnitinchaudhari (30 month(s) ago) o k Saving..... Post Reply Close Saving..... Edit Comment Close By: drnitinchaudhari (30 month(s) ago) guguihiojok,mdfgf Saving..... Post Reply Close Saving..... Edit Comment Close By: drnitinchaudhari (30 month(s) ago) nice one Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Special Patients : Special Patients Hearing impairments : Hearing impairments Hearing impairments : Hearing impairments Types Conductive deafness Sensorineural deafness Etiologies : Etiologies Conductive deafness (curable) Infection Injury Earwax Etiologies : Etiologies Sensorineural deafness (many incurable) Congenital Birth injury Medication-induced Viral infection Tumors Prolonged exposure to loud noise Aging Recognition : Recognition Hearing aids Poor diction Inability to respond to verbal communication in absence of direct eye contact Accommodations : Accommodations Retrieve hearing aid Paper/ pen Maintain position so patient can read lips Use of an “amplified” listener Picture of basic needs/ procedures Accommodations : Accommodations American Sign Language (ASL) Interpreter Notify receiving facility as early as possible Accommodations : Accommodations Do not shout 80% of hearing loss is related to loss of high-pitched sounds Use low-pitched sounds directly into ear canal Do not exaggerate lip movement Visual impairments : Visual impairments Etiologies : Etiologies Congenital Injury Infection (C.M.V.) Glaucoma Degeneration of eyeball, optic nerve or nerve pathways Accommodations : Accommodations Retrieve visual aids Describe everything you're going to do Provide sensory information If ambulatory, guide by leading, not by pushing Allow guide dogs to accompany patient Speech impairments : Speech impairments Types : Types Language disorders Articulation disorders Voice production disorders Fluency disorders Language disorders : Language disorders Etiologies Stroke Head injury Brain tumor Delayed development Hearing loss Lack of stimulation Emotional disturbance Language disorders : Language disorders Recognition Slowness to understand speech Slow growth in vocabulary and sentence structure Articulation disorders : Articulation disorders Etiologies Damage to nerve pathways from brain to muscles in larynx, mouth or lips Delayed development from: hearing problems slow maturation of nervous system Recognition Speech slurred, indistinct, slow, or nasal Voice production disorders : Voice production disorders Etiologies Disorder affecting vocal cord closure Hormonal or psychiatric disturbance Severe hearing loss Voice production disorders : Voice production disorders Recognition Hoarseness Harshness Inappropriate pitch Abnormal nasal resonance Fluency disorders : Fluency disorders Etiology Not fully understood Recognition Stuttering Accommodations : Accommodations Allow patient time to respond Provide aids when available Obesity : Obesity Etiologies : Etiologies Caloric intake > Calories burned Low basal metabolic rate Genetic predisposition Accommodations : Accommodations Appropriately-sized diagnostic devices Maintain professionalism Additional assistance for lifting, moving Paraplegia/ Quadriplegia : Paraplegia/ Quadriplegia Description : Description Paraplegia Weakness or paralysis of both legs Quadriplegia Paralysis of all extremities and trunk Accommodations : Accommodations Airway/ventilation management Patients with halo traction device Ostomies: Trachea Bladder Colon May require additional assistance/ equipment Mental illness : Mental illness Description : Description Any form of psychiatric disorder Etiologies : Etiologies Psychoses Patient perceptions of reality radically different Neuroses Patient perceives reality normally but reacts to it inappropriately Recognition : Recognition Behavior not always affected May present with signs and symptoms consistent with underlying illness Accommodations : Accommodations Don't be afraid to ask about History of mental illness Prescribed medications Whether patient is taking medications as prescribed Concomitant ingestion of alcohol, other drugs Accommodations : Accommodations Solicit permission before beginning assessment Treat as patient that does not have mental illness, unless call is related specifically to the mental illness Developmental disabilities : Developmental disabilities Impaired or insufficient development of the brain Causes an inability to learn at a usual rate Down's syndrome : Down's syndrome Etiology : Etiology Chromosomal abnormality (trisomy -21) resulting in: Mild to severe mental retardation Characteristic physical appearance Recognition : Recognition Eyes slope up at outer corners; folds of skin on either side of nose cover the inner corners of eye Small face, features Large, protruding tongue Flattening of back of head Hands short, broad Accommodations : Accommodations IQ varies from 30-80 Approximately 25% have a heart defect at birth Articulation of C-1 on C-2 may be unstable Emotional impairments : Emotional impairments Etiologies Neurasthenia Anxiety neurosis Compulsion neurosis Hysteria Arthritis : Arthritis Description : Description Inflammation of joint Characterized by: Pain Stiffness Swelling Redness Types/etiologies : Types/etiologies Osteoarthritis Rheumatoid arthritis Uremic arthritis (gout) Accommodations : Accommodations Decreased range of motion/ mobility may limit physical exam Limited mobility Make equipment fit patient, not vice-versa Pad all voids Elicit current medications Cerebral palsy : Cerebral palsy Description Non-progressive disorder of movement and posture Caused by injury to brain during its early development A symptom complex rather than a specific disease Types : Types Spastic (70% of cases) Upper motor neuron involvement Abnormal stiffness and contraction of groups of muscles Hemiplegia Paraplegia Quadraplegia Diplegia (intermediate state between para-quadraplegia) Types : Types Athetoid or dyskinetic (20%) Basal ganglia involvement Involuntary, writhing movements of: Extremities (athetoid) Proximal limbs and trunk (dyskinetic) Movements increase with emotional tension; disappear during sleep Types : Types Ataxic (10%) Cerebellar involvement Loss of coordination and balance Unsteadiness Wide-based gait Difficulty with rapid or fine movements Etiologies : Etiologies Prepartum Cerebral hypoxia Maternal infection Kernicterus (liver failure) Postpartum Encephalitis Meningitis Head injury Accommodations : Accommodations 75% mentally retarded 25% have seizures Many with athetoid and diplegic cerebral palsy are highly intelligent Accommodations : Accommodations May require additional resources to facilitate transport May need suctioning, due to increased oral secretions If contractures present: Pad appropriately Do not force extremities to move Cystic fibrosis : Cystic fibrosis Description : Description Inherited metabolic disease of exocrine glands and eccrine sweat glands Primarily affects digestive, respiratory systems Begins in infancy Etiology : Etiology Autosomal recessive gene Both parents must be carriers Incidence Caucasians--1:2000 Blacks--1:17,000 Orientals--very rare Pathophysiology : Pathophysiology Obstruction of pancreatic, intestinal gland, bile ducts Over-secretion by airway mucus glands Excess loss of sodium chloride in sweat Recognition : Recognition History Airway obstruction, chronic cough Recurrent respiratory infections May be oxygen-dependent Frequent, foul-smelling stools Salty taste on skin Intolerance of hot environments Accommodation : Accommodation May require respiratory support, suctioning, oxygen Multiple sclerosis : Multiple sclerosis Description : Description Progressive disease of CNS Scattered patches of myelin in the brain and spinal cord are destroyed Results in multiple, varied neurologic symptoms, signs Etiologies : Etiologies Unknown Probably autoimmune disease Genetic factors influence susceptibility Women affected more often than men Recognition : Recognition Painful muscle spasms Recurrent urinary tract infections Constipation Skin ulcerations Changes of mood, from euphoria to depression Recognition : Recognition If brain affected: Fatigue Vertigo Clumsiness Muscle weakness Slurred speech Ataxia Blurred or double vision Numbness, weakness or pain in face Recognition : Recognition If spinal cord affected Tingling, numbness, or feeling of constriction in any part of the body Extremities may feel heavy and become weak Spasticity Accommodation : Accommodation Possible respiratory support Patient should not be expected to ambulate Muscular dystrophy : Muscular dystrophy Description : Description Inherited muscle disorder Slow progressive degeneration of muscle fibers Unknown Cause Recognition : Recognition History Little or no movement of muscle groups Accommodation : Accommodation Possible respiratory suport Patient should not be expected to ambulate Poliomyelitis : Poliomyelitis Description : Description Caused by virus Usually results in mild illness In more serious cases, attacks the CNS May result in paralysis or death Recognition : Recognition History Paralysis Accommodations : Accommodations If lower extremities paralyzed, patient may require catheterization If respiratory paralysis, patient may require tracheostomy Patient should not be expected to ambulate Spina bifida : Spina bifida Description : Description Congenital defect Part of one or more vertebrae fails to develop Leaves portion of spinal cord exposed Etiology : Etiology Unknown May be related to dietary deficiencies during pregnancy (folic acid) Recognition : Recognition History Often associated with: CNS infections Obstructive uropathies Hip joint dislocations Accommodations : Accommodations Patient should not be expected to ambulate, although most can Myasthenia gravis : Myasthenia gravis Description : Description Autoimmune disorder Results in acetylcholine production, binding at neuromuscular junction Muscles become weak and tire easily Eyes, face, throat, and extremity muscles most commonly affected Recognition : Recognition Drooping eyelids, double vision Difficulty speaking Chewing, swallowing may be difficult Extremity movement may be difficult Respiratory muscles may be weak Accommodations : Accommodations Airway control Assisted ventilation Patient may be unable to ambulate Culturally diverse patients : Culturally diverse patients Variables : Variables Ethnicity Religion Language Gender Homelessness Accommodations : Accommodations Obtain permission to treat when possible Beliefs may conflict with learned medical practice Attempt to recruit an interpreter Early notification of receiving facility Terminally Ill Patients : Terminally Ill Patients Hospice Care Advance directives, DNR Financial Challenges : Financial Challenges Apprehensive about seeking medical care