Question

1. Please list how you would assist a patient in the following situation using DIPPS. The patient who refuses a bath, The person who has dementia., The patient cannot tolerate the bathing position: The person urinates or defecates: Hardened secretions or stool on the patient’s body: A patient who has an erection: A patient experiencing chest pain (angina):

2. Mr. Foren has recently had a stroke on his left side. The care plan states that Mr. Foren should participate in active ROM exercises- exercises he can do himself. How can you encourage him to help himself exercise his affected and unaffected side? Please look over the types of joint movements, watch the videos and review important guidelines that must be followed before answering this question.

3. Discuss the limitations and scope of practice issues for Personal Support Workers and why Personal Support Workers can only encourage the individual to do their own range of motion exercises which are done with activities of everyday living.

Answer 1

Answers

1.DIPPS an acronym for the five principles of compassionate care: dignity, independence, preferences, privacy and safety.

As the patient preference for bathing . Whether he or she want to have bath . Ensure proper safety for the elderly patient. Time should be taken in consideration. Some like morning others may like in evening.

For the patient with dementia

• Orient the client to surrounding to avoid the trauma
• Ensure proper safety with violence

The person who has difficulty in bathing positions make him sleep comfortably in supine or sitting postion and assist him in bathing .

Use diapers or catheters if the patient frequently defecate or urinate .

Cover the patient properly and try to clean it with his permission by explaining what you are doing with him.

Give him enough time to settle with erection. Wait until the erection goes back to normal . It is common with people to get erections. Until that give the patient privacy .

If the patient has chest pain inform to the higher authority for the proper medical management.  

2.Physical inactivity is a risk factor for stroke, so exercising can help prevent a recurrent stroke.

Following are a few exercises for stroke:

• SIT TO STAND : exercise to strengthen the muscles of you legs .
• SUPPORTED MINI SQUATS : exercise to strengthen the muscles of your legs to help with walking, endurance when walking and rising up from a seated position.
• Dynamic weight shifts : exercise to work on weight shifting, balance and core control.
• Crumbling piece of paper : works on fine motor skills of hand
• Supported Reach and grasp : it is good exercise if you have problem reaching out the object .
• Standing hip abduction with support .

Passive exercise is defined as movement of the body without the
effort of the patient. It doesn’t require the expenditure of energy in
order to induce movement and as a result has not been encouraged
as a training method to improve aerobic capacity in the hemiplegic
stroke patient. Passive exercise occurs with physical assistance
through either health care provider (i.e., a nurse, or
a physical therapist) or through use of a machine. More frequently,
the term “passive” has been applied to stretching techniques whereby
a partner or machine applies external force to induce or enhance a
stretch [17]. For continuous movement of a specific joint through
a prescribed range of motion this will be accomplished through use
of a machine which provides Continuous Passive Motion (CPM).
Alternatively, passive arm or leg cycle- ergometry can be used to
engage more muscle groups and joints specifically applied to either
the upper or lower body respectively.

3.Personal support workers may work withThis is a great exercise to work on weight shifting, balance and core control. nursing or allied health Professionals to give care for the patient .

Their work is supervised by the delegate who retains the responsibility of the patient. The activities delivered by the support worker may encompass a range of basic clinical or care skills required to support patients (such as washing and dressing or basic baseline observations relating to temperature and blood pressure), activities that are part of package of physiotherapeutic care and activities that are part of wider rehabilitation of patients.

Scope depends upon:

• The individual contract of employment .
• Depends on employer policy.
• The extent to which he is educated
• The job description were they are .

Limitations are :

• Limited to delegate activities
• Cannot advice medication