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Certification Review for Rehabilitation Nursesi

Certification Review for Rehabilitation Nursesii

THE REHAB NURSING SERIES CERTIFICATION REVIEW FORREHABILITATION NURSES WORKBOOKPamela Masters-Farrell, MSN, RN, CRRNThis workbook is for use with the course Certification Review forRehabilitation 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 ourknowledge, it reflects current practice. However, appropriate information sources should beconsulted, especially for new or unfamiliar procedures.This course contains many references and resources using internet addresses. Although thesesites were current at the time of the research, writing, and/or publication, many internetpostings are dynamic and subject to expiration or deletion over time. Therefore, RehabClassWorks, LLC cannot guarantee currency of electronic references. Please check for thelatest information on a cited topic using online search engines. 2012 Rehab ClassWorks, LLC 14330 S. 2200 W. Bluffdale, UT 84065Phone: (888) 294-0412 Fax: (801) 253-7520 Email: support@rehabclassworks.comWeb Address: http://www.rehabclassworks.comAll rights reserved. This document, or any part thereof, may not be reproduced or transmittedin any form or by any means, electronic or mechanical, including photocopying, recording,storage in an information retrieval system or otherwise without prior written permission ofRehab ClassWorks, LLC. Purchasers of a registered multiuser license for the course aregranted permission for copying of the workbook and multimedia course for use by staffcovered by said license.Certification Review for Rehabilitation Nursesiii

THE REHAB NURSING SERIES The Rehab Nursing SeriesSecond EditionNovice, Intermediate, Advanced, and Certification Review courses forRehabilitation Nurses Introduction to Rehabilitation & Rehabilitation NursingNot 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 RehabilitationA Little Romance: Providing Sexuality Education & Counseling in Rehabilitation Down, Not Out: Providing Psychosocial Support in Rehabilitation Go HOM! Preventing Complications from ImmobilityGotta Go Right Now: Bladder Management in Rehabilitation Full of It: Bowel Management in RehabilitationApple a Day: Nutrition & Dysphagia Management Get Going: Mobilize Your PatientsHe Said/She Said: Disorders of CommunicationWandering, Confused, and Agitated: Cognition & Behavior Rehabilitation of Brain Injury Rehabilitation of Spinal Cord Injury Cardiopulmonary Rehabilitation Rehabilitation of StrokePediatric RehabilitationCertification Review for Rehabilitation NursesINTERACTIVE EDUCATION · NOVICE TO EXPERT · WORKING SMARTERRegistration is required for continuing education credit. Registeryour course by going to www.rehabclassworks.com/reg.html.Certification Review for Rehabilitation Nursesiv

ACKNOWLEDGEMENTSThis course could not be completed without the help and expertise of our associates andreviewers. Those desiring to be known are listed below. Their contributions are gratefullyacknowledged.ReviewersProgramming:Sherry Adkins, BSN, RN, CRRNSuzanne BawdenCharlene Bady, RNBC, CRRNJanet PlackemeierBelinda Boyd, RN, CRRNEditor:Tanja Hagen, MS, RN, CRRNPamela Masters-Farrell, MSN, RN, CRRNCody Kohles, RN, CRRNArt: Shantel PilcherMaria Benita Navarro, RN, CRRNPlanning, Research, & Development:Sheryl Pinugu, BSN, RNCarolyn Schultz, RN, CRRNPamela Masters-Farrell, MSN, RN, CRRNCheryl Micheel, BSValerie Livingston, RN, CRRNVisit us at www.rehabclassworks.com to learn more about our products, course offerings, andquick tips. Visit our rehab nursing blog at http://www.rehabclassworks.com/Blog.htm. Wewould love to hear from you regarding your rehabilitation nursing needs and questions. Emailto pam@rehabclassworks.com.Certification Review for Rehabilitation Nursesv

TABLE OF CONTENTSGetting Started . xMain Menu . xContinuing Education Hours . xiUsing the Course . xiFunctions of the Navigation Bar in the Computer Course . xiiOther Features .xiiiChapter 1 Overview .1Chapter Objectives or What is Your Job? . 1Preparation . 2My Study Plan . 2The Exam—Getting Ready for Test Day . 3Additional Resources . 4Evaluate Your Current Status . 5Principles & Philosophy .6Chapter 2 The Impact of History & Legislation on the Practice of Rehabilitation .7What is Your Job in this Chapter?. 7The Impact of History . 8Chapter 3 Foundations of Rehabilitation Nursing .13What is Your Job in this Chapter?. 13World Health Organization Definitions . 14Defining Rehabilitation Nursing . 14Roles of Rehabilitation Nurses . 15Values & Moral Principles . 16Spiritual Distress . 18Chapter 4 Nursing Theories Applicable to Rehabilitation .19What is Your Job in this Chapter?. 19Who? What? . 20Gordon’s Functional Health Patterns . 21Other Theorists . 22Wellness . 22Chapter 5 The Economics of Healthcare.24What is Your Job in this Chapter?. 24Funding Sources . 25Living Expenses . 26Special Populations & Team Issues .29Chapter 6 Rehabilitation Teams & Teamwork .30What is Your Job in this Chapter?. 30Team Membership . 31Types of Teams . 32The Continuum of Care . 33Coordination of Care . 34Certification Review for Rehabilitation Nurses: Table of Contentsvi

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

Sleep . 97Care of Patients: Stroke (CVA), Traumatic Brain Injury (TBI), & Spinal Cord Injury(SCI) .99Chapter 14 Care of Patients: Stroke .100What is Your Job in this Chapter?. 100Stroke Risk . 101Types of Stroke . 102Acute Management . 103Rehabilitative Care . 103Mobility and Activity . 104Neurophysiological Care . 104Perceptual Deficits . 109Swallowing Impairments . 111Alterations in Nutrition . 114Fluid Balance Deficit . 114Bowel Elimination . 115Urinary Elimination . 116Impaired Communication . 118Risk of Injury . 120Altered Sexuality Patterns . 120Psychosocial Issues . 121Risk of Caregiver Role Strain . 123Community Living . 123Chapter 15 Care of Patients: Brain Injury .124What is Your Job in this Chapter?. 124Acute Management . 126Recovery . 128Cognitive Processes . 128Impairment in Mobility . 132Altered Nutrition . 132Altered Elimination . 133Risk for Injury . 133Altered Sexuality Patterns . 134Risk of Caregiver Role Strain . 134Community Living . 135Chapter 16 Care of Patients: Spinal Cord Injury .136What is Your Job in this Chapter?. 136Classification of Spinal Cord Injuries . 137Spinal Fracture and Neurological Deficits . 138Spinal Cord Injury Syndromes . 138Acute Management . 140Rehabilitative Care . 141Alterations in Respiratory Function . 141Venous Thromboembolism (VTE) . 145Poikilothermia . 146Autonomic Dysreflexia . 147Orthostatic Hypotension . 147Skin Integrity . 148Managing Elimination Needs . 154Maximizing Physical Function . 159Functional Skills . 161Sexuality . 163Community Living . 164Safety . 165Appendix . 166Care of Patients: Other Neurological Diagnoses .167Chapter 17 Care of Patients: Other Neurological Diagnoses .168Chapter Objectives or What is Your Job? . 168Multiple Sclerosis (MS) . 169Certification Review for Rehabilitation Nurses: Table of Contentsviii

Amyotrophic Lateral Sclerosis (ALS) . 170Guillain-Barré (GB) . 171Postpolio Syndrome . 172Parkinson’s Disease (PD) . 172Cerebral Palsy . 174Spina Bifida . 176Care of Patients: Other Diagnoses .179Chapter 18 Care of Patients: Cancer .180Chapter Objectives or What is Your Job? . 180Chapter 19 Care of Patients: Burns.183Chapter Objectives or What is Your Job? . 183Percentage of Body Surface Involved . 184Systemic Consequences of Burn Injuries . 185Rehabilitation of Burn Injuries . 185Pain Management . 187Nutrition . 187Positioning . 188Exercise and Mobilization . 189Adaptation & Community Reentry . 189Chapter 20 Care of Patients: Amputation .191What is Your Job in This Chapter? . 191Co-morbidities . 192Care of the Patient with Amputation . 193Chapter 21 Care of Patients: Osteoarthritis, Rheumatoid Arthritis, & Chronic Pain 197What is Your Job in This Chapter? . 197Osteoarthritis . 198Joint Replacements . 199Rheumatoid Arthritis . 200Energy Conservation . 201Pain . 203Chronic Pain . 204Pain Management Strategies . 205Chapter 22 Care of Patients: Osteoporosis .208What is Your Job in This Chapter? . 208Fractures . 211Chapter 23 Care of the Patient: Cardiopulmonary .213What is Your Job in This Chapter? . 213Prevention . 214Obstructive Pulmonary Disease . 214Restrictive Pulmonary Disease . 215Cardiac Disease and Pulmonary Function . 215Sleep Apnea . 218Immobility & Disuse Syndrome. 218Cardiac Rehabilitation. 221Coronary Artery Circulation . 221Cardiac Rehabilitation: Acute Care . 221Cardiac Rehabilitation: Inpatient . 222Cardiac Rehabilitation: Outpatient. 222Answer Key .225Certification Review for Rehabilitation Nurses: Table of Contentsix