Which of the following would be the MOST important safety factor to consider if you have a patient that exhibits significant unilateral hypotonicity?

According to Rood, heavy joint compression:

Carla recently suffered a stroke that resulted in total right side hemiparesis. As part of your initial evaluation, you assess patient bed mobility. Patient is moderate assist x1 to come sitting edge of bed from supine. Once seated with feet on the floor, patient is noted to fully extend unaffected arm and lean toward affected side losing her ability to sit up safely without assistance. What is happening with your client? 

Mr. Smith is a 59 year old man who suffered a Cerebral Vascular Accident (CVA) three weeks ago.  He previously worked as a trucker and is the sole support of his family (a teenage daughter and wife).  They live in a modest home in the suburbs. Mr. Smith displays right sided hemiplegia with mild expressive aphasia. His ROM is limited in wrist, elbow, and shoulder flexion due to mild spasticity. Beginning isolated movements or combinations of movements are evident, in addition to associated reactions; however, he cannot maintain elbow extension with arm raised about 90 degrees of flexion.  He displays a mild right visual field inattention, but otherwise visual perception is intact. Sensation of his right UE is mildly impaired. He has difficulty with eating and writing as he is right handed.  He needs mod assist for UB and LB dressing and functional transfers.  He displays spasticity in right LE as well, but this is mild. Mr. Smith has difficulty with balance and leans to the right when sitting and standing. Mr. Smith needs physical and verbal cues to maintain upright posture. Mr. Smith’s IADL status has not yet been assessed. Mr. Smith’s goal is to return to driving. He becomes depressed at times due to his inability to express himself clearly as well as concern for supporting his family.  His wife and daughter are having a difficult time coping with his illness, but are supportive and willing to work with Mr. Smith.   Answer the following 7 questions based on this case.

BONUS (1 point) Briefly explain something significant that you learned from content for this first exam and how it will influence your future practice.     

You are working with a patient who had a stroke three days ago. She initially demonstrated complete flaccidity through the right upper extremity and is not starting to experience some synergistic patterns. Your patient is upset and tearful about her condition and asks you, “Will I ever get any better?” You are able to educate your patient that the largest amount of recovery usually takes place within _____ and progress may still be made through the first _____. Fill in the blanks: 

You are reviewing the chart for Tim, a 59 year old male post-stroke. You are planning to ask some initial questions about history and obtain information about baseline function. From there you will move into assessing Tim’s ability to complete functional mobility (including bed mobility and transfers) and ADLs (including dressing, toileting, and showering). Your approach to observe the client attempting functional mobility and ADL tasks reflects which of the following evaluative approaches? Select the BEST answer. 

CASE SCENARIO: Sarah is four (4) years old and was diagnosed at age eight months with cerebral palsy.  She currently attends public preschool Monday through Friday afternoons, and receives additional Speech, OT and PT services at the local outpatient clinic.  She lives at home with her mother, father and 18-month-old sister.  Her condition is currently characterized by: Right sided spasticity Poor balance in sitting, standing and walking Lack of symmetrical use of hands and feet at midline Flexor patterning on the right side Resistance to passive stretch on right side in the mid-range of motion Reach-Grasp-Release skills at the six month level on the right with “thumb tuck” and age-typical reach-grasp-release on the left Tendency to tighten right upper extremity when reaching with her left Tendency to “drag” the right body side when walking Borderline to mild intellectual impairment on recent cognitive testing Please answer the remaining questions based on “Sarah” scenario above.

The oil in a vacuum pump should be changed after each time it is used.

The best method of leak checking is when the refrigeration system is ____.