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Explain Treatment of Patients with TBI - Correct Answer -There is a wide range of severities
of patients with TBIs and because of this there is a large range of treatment approaches
that can be used.
-There is also a variety of settings we can see these patients in. For example, a patient in a
coma may be seen in an acute care facility, LTAC, skilled nursing, etc. For more milder
patients, you may see them in an acute rehab setting or an outpatient setting.
In Treatment for Patients with TBI ___ is key - Correct Answer Interdisciplinary cooperation
is key
Expand on Interdisciplinary cooperation is key - Correct Answer Cognitive communicative
interventions for adults with dramatic brain injuries require the collaboration of many
professionals, including physicians, nurses, neuropsychologist, speech language
pathologist, occupational therapist, physical therapist, clinical psychologist, social
workers, vocational counselors, and others.
Find ways to work with the PT, OT, physical medicine, social work, rec therapy, etc.
Whatever the patient needs we need to try to work with these providers to service the
patient in the best way possible. You can say "this is something I am working on in my
sessions, can you incorporate it in yours as well?"
These patients need a lot of different types of therapy from many different disciplines.
Especially important in the early stages of a patient's recovery, when medical, physical,
and behavioral impairments are most severe.
Define Interdisciplinary cooperation is key - Correct Answer "...rehabilitation of patients
with traumatic brain injuries must be interdisciplinary in the truest sense of the word. There
must be ongoing communication among team members (not just with a central leader),
care planning that cuts across disciplines, and coordination by a professional who is an
expert in the cognitive and behavioral problems of head-injured persons." (Kay and Silver,
1989, p. 147)
Treatment may include: - Correct Answer -Sensory stimulation and orientation
,Treatment of Patients with TBI Questions
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-Behavior management
-Pharmacologic intervention
-Pharmacologic intervention
Explain Sensory Stimulation - Correct Answer Mainly for patients that are comatose or
semi-comatose
Targets stimulation of all the senses in a methodical manner to increase awareness and
attempt to minimize long-term effects (Davis and White, 1995)
Patient is repeatedly exposed to auditory, visual, tactile olfactory and taste stimuli
Purposes of Sensory Stimulation intervention: - Correct Answer -Increase patient's
responsiveness to the environment
You are looking for some type of consistent response, it does not need to be the same
response from each patient. You hope that it faciliates the patients return to
consciousness.
-Facilitate the patient's return to consciousness
Expand on Patient is repeatedly exposed to auditory, visual, tactile olfactory and taste
stimuli - Correct Answer Targets all of the senses in a methodical manner to hopefully
increase their awareness and mimimize the long-term negative effects of a coma.
Gerber says that the purpose of sensory stimulation is an attempt to highten arousal
whenever arousal is limited or even nonexistent.
Sensory stimulation is an uncomplicated labor-intensive procedure, and most adults of
average intelligence can learn it in two or three training sessions. Consequently, speech
language pathologists often collaborate with other caregivers and with relatives or
significant others to provide stimulation. The SLP may provide controlled stimulation
according to a systematic schedule, record the results of the simulation, review records of
the patient's responses simulation to determine whether changes in the patient's
, Treatment of Patients with TBI Questions
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responsiveness are taking place and collaborate with other team members in making
appropriate changes in the stimulation program.
The SLP often begins treatment then trains a caregiver to do.
Our job is to teach, provide controlled stimulation according to a schedule-we want it to be
conducted in a systematic manner, record responses so that we can track progress and
provide changes when necessary.
We have to have a physcians order to do this,
When sensory stimulation programs begin, most reflected belief in two principles: -
Correct Answer -Begin stimulation as soon as possible after the patient enters coma,
provided he or she is medically stable.
-Stimulate as often as practical to mamimize input into the patient's brain.
Wood, Winkowsk, Miller and associates, (1992) list 3 principles of sensory stimulation -
Correct Answer -All forms of nursing care involve stimulation of some kind
-Patients with disorders of consciousness have limited information processing capabilities
-The amount of sensory stimulation on which a patient is exposed must be carefully
regulated
Wood and associates (1991) noted that a sensory-regulated environment should include
the following: - Correct Answer -Low ambient noise levels
We want to be sure we keep the door closed because the noise in the hallway can get out,
turn the TV off, etc.
-Appropriate interstimulus intervals during therapy and nursing care to assist the patient's
information processing
You want to have intervals when they are getting the nursing care to make sure the nurse is
talking to the patient so the patient is getting the auditory stimuli even when participating in
routine activities.