Certification Review for Rehabilitation Nurses i - SRHC

[Pages:255]Certification Review for Rehabilitation Nurses

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Certification Review for Rehabilitation Nurses

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THE REHAB NURSING SERIES

CERTIFICATION REVIEW FOR REHABILITATION NURSES WORKBOOK

Pamela Masters-Farrell, MSN, RN, CRRN

This workbook is for use with the course Certification Review for Rehabilitation Nurses, which is part of the Rehab Nursing Series

published by Rehab ClassWorks, LLC?.

Notice: The clinical information and tools used in this course are based on current literature, research, and consultation with nursing, medical, and legal authorities. To the best of our knowledge, it reflects current practice. However, appropriate information sources should be consulted, especially for new or unfamiliar procedures.

This course contains many references and resources using internet addresses. Although these sites were current at the time of the research, writing, and/or publication, many internet postings are dynamic and subject to expiration or deletion over time. Therefore, Rehab ClassWorks, LLC cannot guarantee currency of electronic references. Please check for the latest information on a cited topic using online search engines.

?2012 Rehab ClassWorks, LLC 14330 S. 2200 W. Bluffdale, UT 84065 Phone: (888) 294-0412 Fax: (801) 253-7520 Email: support@

Web Address:

All rights reserved. This document, or any part thereof, may not be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, storage in an information retrieval system or otherwise without prior written permission of Rehab ClassWorks, LLC. Purchasers of a registered multiuser license for the course are granted permission for copying of the workbook and multimedia course for use by staff covered by said license.

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THE REHAB NURSING SERIES

The Rehab Nursing Series

Second Edition

Novice, Intermediate, Advanced, and Certification Review courses for Rehabilitation Nurses

Introduction to Rehabilitation & Rehabilitation Nursing Not Documented, Not Done: Documenting Professional Rehabilitation Nursing Care

Got a Plan, Man? Patient-Centered Care Planning in Rehabilitation 1, 2, Buckle My Shoe: Functional Skill Development Take Care! Safe Patient Handling Works!

See One, Do One: Patient & Family Education in Rehabilitation A Little Romance: Providing Sexuality Education & Counseling in Rehabilitation

Down, Not Out: Providing Psychosocial Support in Rehabilitation Get Going: Mobilize Your Patients

Go HOM! Preventing Complications from Immobility Gotta Go Right Now: Bladder Management in Rehabilitation

Full of It: Bowel Management in Rehabilitation Apple a Day: Nutrition & Dysphagia Management He Said/She Said: Disorders of Communication Wandering, Confused, and Agitated: Cognition & Behavior

Rehabilitation of Stroke Rehabilitation of Brain Injury Rehabilitation of Spinal Cord Injury Cardiopulmonary Rehabilitation

Pediatric Rehabilitation

Certification Review for Rehabilitation Nurses

INTERACTIVE EDUCATION ? NOVICE TO EXPERT ? WORKING SMARTER

Registration is required for continuing education credit. Register your course by going to reg.html.

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ACKNOWLEDGEMENTS

This course could not be completed without the help and expertise of our associates and reviewers. Those desiring to be known are listed below. Their contributions are gratefully acknowledged.

Reviewers Sherry Adkins, BSN, RN, CRRN Charlene Bady, RNBC, CRRN Belinda Boyd, RN, CRRN Tanja Hagen, MS, RN, CRRN Cody Kohles, RN, CRRN Maria Benita Navarro, RN, CRRN Sheryl Pinugu, BSN, RN Carolyn Schultz, RN, CRRN

Programming: Suzanne Bawden Janet Plackemeier Editor: Pamela Masters-Farrell, MSN, RN, CRRN Art: Shantel Pilcher Planning, Research, & Development: Pamela Masters-Farrell, MSN, RN, CRRN Cheryl Micheel, BS Valerie Livingston, RN, CRRN

Visit us at to learn more about our products, course offerings, and quick tips. Visit our rehab nursing blog at . We would love to hear from you regarding your rehabilitation nursing needs and questions. Email to pam@.

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TABLE OF CONTENTS

Getting Started ...........................................................................................................x Main Menu ................................................................................................................ x Continuing Education Hours ....................................................................................... xi Using the Course ...................................................................................................... xi Functions of the Navigation Bar in the Computer Course............................................... xii Other Features ........................................................................................................xiii

Chapter 1 Overview ....................................................................................................1 Chapter Objectives or What is Your Job?.......................................................................1 Preparation ...............................................................................................................2 My Study Plan ...........................................................................................................2 The Exam--Getting Ready for Test Day ........................................................................3 Additional Resources ..................................................................................................4 Evaluate Your Current Status ......................................................................................5

Principles & Philosophy ..............................................................................................6 Chapter 2 The Impact of History & Legislation on the Practice of Rehabilitation ........7

What is Your Job in this Chapter?.................................................................................7 The Impact of History.................................................................................................8 Chapter 3 Foundations of Rehabilitation Nursing .....................................................13 What is Your Job in this Chapter?............................................................................... 13 World Health Organization Definitions ........................................................................ 14 Defining Rehabilitation Nursing.................................................................................. 14 Roles of Rehabilitation Nurses ................................................................................... 15 Values & Moral Principles .......................................................................................... 16 Spiritual Distress ..................................................................................................... 18 Chapter 4 Nursing Theories Applicable to Rehabilitation ..........................................19 What is Your Job in this Chapter?............................................................................... 19 Who? What?............................................................................................................ 20 Gordon's Functional Health Patterns ........................................................................... 21 Other Theorists ....................................................................................................... 22 Wellness ................................................................................................................. 22 Chapter 5 The Economics of Healthcare....................................................................24 What is Your Job in this Chapter?............................................................................... 24 Funding Sources ...................................................................................................... 25 Living Expenses ....................................................................................................... 26 Special Populations & Team Issues ..........................................................................29 Chapter 6 Rehabilitation Teams & Teamwork ...........................................................30 What is Your Job in this Chapter?............................................................................... 30 Team Membership ................................................................................................... 31 Types of Teams ....................................................................................................... 32 The Continuum of Care............................................................................................. 33 Coordination of Care ................................................................................................ 34

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Goals ..................................................................................................................... 36 Conflict................................................................................................................... 36 Teams of the Future ................................................................................................. 37 Chapter 7 Meeting Standards: Quality Improvement & Program Evaluation.............38 What is Your Job in this Chapter?............................................................................... 38 Quality ................................................................................................................... 39 Outcomes ............................................................................................................... 40 Evidence-Based Practice ........................................................................................... 41 Chapter 8 Populations with Special Needs: Growth & Development .........................43 What is Your Job in this Chapter?............................................................................... 43 Growth & Development ............................................................................................ 44 Developmental Pattern ............................................................................................. 44 Types of Development .............................................................................................. 44 Developmental Tasks ............................................................................................... 45 Erikson's Psychosocial Development ........................................................................... 45 Piaget's Cognitive Stages .......................................................................................... 45 Impact of Disability .................................................................................................. 46 Special Issues: Healthcare ........................................................................................ 47 Special Issues: Functional Skill Development .............................................................. 48 Special Issues: Psychosocial...................................................................................... 48 Public Laws ............................................................................................................. 49 Chapter 9 Populations with Special Needs: Effects of Aging .....................................50 What is Your Job in this Chapter?............................................................................... 50 Psychosocial Stages of Development .......................................................................... 51 Physiological Aspects of Aging ................................................................................... 51 Psychosocial Issues in Rehabilitation .......................................................................53 Chapter 10 Psychosocial Issues in Rehabilitation .....................................................54 What is Your Job in this Chapter?............................................................................... 54 Psychosocial Issues Common to Rehabilitation Patients ................................................ 56 The Process of Change ............................................................................................. 57 Adapting to Disability ............................................................................................... 58 Initial Impact .......................................................................................................... 58 Defense Mobilization ................................................................................................ 61 Initial Realization ..................................................................................................... 62 Retaliation .............................................................................................................. 64 Reintegration .......................................................................................................... 65 Patient/Family Education & Community Reentry......................................................70 Chapter 11 Patient & Family Education ....................................................................71 What is Your Job in this Chapter?............................................................................... 71 Assessing Readiness to Learn .................................................................................... 72 Knowledge Deficit .................................................................................................... 73 Teaching................................................................................................................. 73 Compassion Fatigue ................................................................................................. 75 Chapter 12 Community Reentry................................................................................76 What is Your Job in this Chapter?.............................................................................. 76 Community Living Skills............................................................................................ 77 Return to Work........................................................................................................ 79 Diversional Activity Deficit ........................................................................................ 80 Anatomy & Physiology Review .................................................................................81 Chapter 13 Anatomy & Physiology Review ...............................................................82 What is Your Job in this Chapter?............................................................................... 82 Brain Strain ............................................................................................................ 83 Spinal Cord ............................................................................................................. 87 Autonomic Nervous System ...................................................................................... 90 Cardiopulmonary System .......................................................................................... 90 Swallowing ............................................................................................................. 92 Bowel Elimination .................................................................................................... 93 Urinary Elimination .................................................................................................. 94 Skin ....................................................................................................................... 96

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Sleep ..................................................................................................................... 97 Care of Patients: Stroke (CVA), Traumatic Brain Injury (TBI), & Spinal Cord Injury (SCI) ........................................................................................................................99 Chapter 14 Care of Patients: Stroke .......................................................................100

What is Your Job in this Chapter?............................................................................. 100 Stroke Risk ........................................................................................................... 101 Types of Stroke ..................................................................................................... 102 Acute Management ................................................................................................ 103 Rehabilitative Care................................................................................................. 103 Mobility and Activity ............................................................................................... 104 Neurophysiological Care ......................................................................................... 104 Perceptual Deficits ................................................................................................. 109 Swallowing Impairments......................................................................................... 111 Alterations in Nutrition ........................................................................................... 114 Fluid Balance Deficit ............................................................................................... 114 Bowel Elimination .................................................................................................. 115 Urinary Elimination ................................................................................................ 116 Impaired Communication........................................................................................ 118 Risk of Injury ........................................................................................................ 120 Altered Sexuality Patterns....................................................................................... 120 Psychosocial Issues ................................................................................................ 121 Risk of Caregiver Role Strain ................................................................................... 123 Community Living .................................................................................................. 123 Chapter 15 Care of Patients: Brain Injury...............................................................124 What is Your Job in this Chapter?............................................................................. 124 Acute Management ................................................................................................ 126 Recovery .............................................................................................................. 128 Cognitive Processes ............................................................................................... 128 Impairment in Mobility ........................................................................................... 132 Altered Nutrition .................................................................................................... 132 Altered Elimination................................................................................................. 133 Risk for Injury ....................................................................................................... 133 Altered Sexuality Patterns....................................................................................... 134 Risk of Caregiver Role Strain ................................................................................... 134 Community Living .................................................................................................. 135 Chapter 16 Care of Patients: Spinal Cord Injury .....................................................136 What is Your Job in this Chapter?............................................................................. 136 Classification of Spinal Cord Injuries ........................................................................ 137 Spinal Fracture and Neurological Deficits .................................................................. 138 Spinal Cord Injury Syndromes ................................................................................. 138 Acute Management ................................................................................................ 140 Rehabilitative Care................................................................................................. 141 Alterations in Respiratory Function ........................................................................... 141 Venous Thromboembolism (VTE) ............................................................................. 145 Poikilothermia ....................................................................................................... 146 Autonomic Dysreflexia ............................................................................................ 147 Orthostatic Hypotension ......................................................................................... 147 Skin Integrity ........................................................................................................ 148 Managing Elimination Needs.................................................................................... 154 Maximizing Physical Function .................................................................................. 159 Functional Skills .................................................................................................... 161 Sexuality .............................................................................................................. 163 Community Living .................................................................................................. 164 Safety .................................................................................................................. 165 Appendix .............................................................................................................. 166 Care of Patients: Other Neurological Diagnoses .....................................................167 Chapter 17 Care of Patients: Other Neurological Diagnoses ...................................168 Chapter Objectives or What is Your Job?................................................................... 168 Multiple Sclerosis (MS) ........................................................................................... 169

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