NBCOT Latest Update with Certified Solutions

NBCOT Latest Update with Certified Solutions Tonic Labyrinthine supine: will increase extensor tone, prone: will increase flexor tone integration: 6 mos Labyrinthine hold infant vertically and tilt, infant will keep head upright integration:persists Landau hold infant horizontal and prone in suspension, complete extension of head, trunk and extremities integration:12-24mos symmetric tonic neck reflex (STNR) place infant in crawling and extend head, infant flexes hips and knees integration:8-12mos Neck righting (NOB) infant in supine and turn head to one side, infant log rolls entire body integration:5 years body on body righting (BOB) infant in supine flex on hip and knee toward chest ,infant segmentally rolls upper trunk to maintain alignment integration:5 years primitive squeeze grasp 4 mos palmar grasp 5 mos radial palmar grasp 6 mos radial digital grasp 8 mos palmar supinate grasp 1-1/2 years writing tool held with fisted hand, wrist flexed and supinated digital pronate grasp 2-3 years, tool held with fingers, wrist in neutral with slight ulnar deviation and forearm pronated static tripod 31/2-4 years. tool held with crude approximation of the thumb, index and middle fingers, ring and little finger slightly flexed, grasped proximally dynamic tripod 4.5 - 6 year olds: Tool held with precise opposition of distal phalanges of thumb index and middle fingers, ring and little finger flexed to form a stable arch, wrist slightly extended glaucoma loss of peripheral vision macular degeneration loss of central vision Kleinert protocol passive flexion/active extension dorsal block splint 0-4 weeks continue splint adjust wrist to neutral tendon gliding light occupation based activities d/c splint 6- 8 weeks strength and work/leisure 8-12 weeks Duran protocol passive flexion and extension Glascow coma scale Severe <8 Moderate 9-12 Minor >13 Brown sequard ipsilateral los off motor, proprioception, discriminative touch, Contralateral loss of painand temperature anterior cord syndrome loss of motor function, pain, pinprick, and temp bilaterally below lesion. proprioception and light touch are preserved posterior cord loss of proprioception. pain temp touch preserved visual agnosia inability to recognize people and objects apraxia inability to carry out specific motor tasks ideational apraxia a lack of knowledge regarding an object's use feeding 5 mos munching occurs consisting of a phasic bite and release of soft cookie feeding 8 mos beginning of mastication with diagonal jaw movement feeding 9 mos lateral tongue movements make mastication effective. drink from cup but jaw not firm feeding 9 mos finger feeds self meals feeding 12 mos dips spoon in twists spoon on way to mouth feeding 12 mos jaw firm, rotary chewing feeding 15 mos scoops food with spoon and brings to mouth feeding 24 mos able to chew most meats and raw vegetables Rancho level I no response, total assistance rancho level II generalized response, total assist responds to painful, repeated auditory, external stimuli. response inconsistent rancho level III localized response, total assist withdraw from painful, turns for auditory, blinks w strong light. inconsistent response to simple verbal commands. response related to stimulus. rancho level IV confused agitated, max assist alert, heightened activity. mood swings, incoherent verbalizations, aggressive behavior, absent short term memory rancho level V confused, inappropriate non agitated, max assist not oriented to person place or time, non-purposeful sustained attn, unable to learn new info, may be able to perform learned tasks rancho level VI confused, appropriate mod assist inconsistently oriented x3, attend to highly familiar tasks up to 30 min w mod A, assistive memory aide, emerging awareness of appropriate response, unaware of impairments rancho level VII automatic, appropriate min assist for ADLs consistently oriented p, p, mod A for time, attend to highly familiar task w min A for 30 min, min sup for new learning w carryover, initiates ADLs can monitor accuracy, overestimates abilities, oppositional/uncooperative rancho level VIII purposeful, appropriate SBA consistently oriented x3, familiar tasks I for 1 hour, recall past and present, assistive memory device, aware of impairment but needs SBA to correct, acknowledges others needs/feelings, low frustration tolerance rancho level IX purposeful appropriate SBA on request I with tasks up to 2 hours, can think about consequences of actions, accurately estimates abilities, can self monitor social appropriateness rancho level X purposeful, appropriate: mod I can multitask, consistently appropriate social behavior, may require more time ACL I automatic actions: automatic motor responses and changes in ANS ACL II postural actions, movement associated with comfort, awareness of large objects, may help with simple tasks ACL III manual actions, beginning to use hands to manipulate objects. limited number of tasks with long terms repetitive training ACL IV goal directed actions, ability to carry simple tasks through to completion. relies on visual cues. can perform established routines but cannot cope with unexpected events ACL V exploratory actions, overt trial and error problem solving. new learning ACL VI planned actions, absence of disability. can think of hypothetical situations and do mental trial and error problem solving. brachial plexus injury flail arm splint radial nerve palsy dynamic wrist, finger, and thumb extension splint median nerve injury opponens splint (thumb spica), c-bar (holds hand in C) ulnar nerve injury static/dynamic splint to position MCPs in flexion combined median ulnar figure of eight or dynamic MCP flexion splint sci 6-7 tenodesis splint carpal tunnel syndrome wrist splint neutral cubital tunnel syndrome elbow splint at 30 degrees flexion deQuervains thumb splint, includes wrist, IP joint free Erb's palsy splint Elbow lock splint Pronator teres syndrome Elbow splint @ 90* with forearm in neutral Right cva lack of insight, left side neglect, impulsive, short attention span, left cva aphasia, apraxia, slow and cautious beneficence concern for safey and well being of recipients of services nonmaleficence refrain from actions that cause harm autonomy and confidentiality respect the right of the individual to self determination social justice provide services in a fair and equitable manner procedural justice comply with institutional rules, local, state, federal and international laws and AOTA documents veracity provide comprehensive, accurate, and objective information when representing the profession fidelity treat colleagues and other professionals with respect, fairness, discretion and integrity ASIA A complete ASIA B incomplete sensory but no motor ASIA C incomplete motor function is preserved below the neurological level muscle grade less than 3 ASIA D incomplete motor function is preserved below the neurological level muscle grade greater than or equal to 3 ASIA E normal COAST Client occupation assistance level specific conditions timeline client will be able to cut meat, independently with a rocker knife within one week.