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Chapter 9
GI, Endocrine, Immunological, integumentary
17
Writing
Post-Graduate
06/16/2014

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Term
Dysphagia & Swallowing
Definition
Structures involved - oral facial musculature, pharyngeal and laryngeal structures, piriform sinuses, vocal folds, bronchiolesbronchi, lungs, esophagus
Facial paralysis
Motor planning
Sensory impairments
Weakness
pneumonia
Symptoms - Coughs after eating or drinking, flushed appearance, gasping for air
Term
ASSESS for Dysphagia
Definition
Assess level of alertness, following direction, orientation
Sensory and motor components
manage own secretials
different food textures
Modified barium swallow
Flexible endoscopic esophageal swallow (FEES)
Disruption in daily occupations and life roles
OT: Family centered intervention to determine acceptable dinner interaction, developing new roles, etc. education and training
Term
GERD
Definition
Included are lower esophageal sphincter and gastric sphincter
Symptoms, heartburn, swallowing, Barium swallow, flexible endoscopy, sleeping with head elevated, stress management, diet modification, drug therapy
Term
Small bowel obstruction
Definition
OT: self care, decreased mobility, colostomy maybe,
Term
Neurogenic Bowel
Definition
Sympathetic nerve impairment - With SCI T-6 level and above -
loss of anal sphincter control, incontinence, rise in blood pressure - autonomic dysreflexia.
Term
Kidney disease
Definition
Risks - diabetes, HTM, Lupus
Diet, meds, exercise, stress reduction, smoking cessation, meds,
Treatment of ESRD - hemodialysis, peritoneal dialysis, transplant
Impacts Motor function, fatigue, muscle pain, edema, weakness,
Sensory - neuropathy, vision loss, cognitive dysfunction
Perceptual, dementia, stroke
Psychological - Anxiety, dperession, mood
Self - Care, etc. sexual dysfunction, A/E, decreased mobility, increase in self-care steps, trouble with housekeeping, needs assist for community mobility, cooking habits, personal finances, leisure sports, social contexts and cultural contact.
Term
Cancer
Definition
Risks - Hereditary, environmental, habit,
Prevention - checkups, tests, scans etc.
Stages
medical Treatment
Rehabilitation - Pre-op. Functional assessment, client and caregiver education.
Post - Op - intervention planning based on guidelines from labs, post-op precautions
Convalescence - Rehab of motor, sensory, cognitive, neurobehavioral and psychological, development of health
End-of Life- Hospice Care
Term
Scleroderma
Definition
Rheumatic connective tissue disease associated with impaired immune response
Vascular, Fibrotic, Autoimmunity
Term
AIDS
Definition
Risks
Unprotected sex, contact with blood or body fluids,
Avoid sex, blood procedures, breast feeding, hygiene, urine, feces, tears
It attacks lymphatic system - T-cells
Acute infection - Asymptomatic disease - Sympotmatic and Advanced
Symptoms - enlarged lymph nodes, fatigue, weight lose, geral malaise, fever, diarrhea, cognitive impairment, affective changes, sensory chages, basic ADL impairments, myelopathy, peripheral neuropathy, visual impairment
Drug therapy and Chemotherapy
Term
Hepatitis
Definition
Viral Infection
Type A, Type B, and C,
Decreased tolerance in activity.
Term
MRSA
Definition
Usually mild infections
Have a weakened immune system, confinement, living in close quarters, resists antibiotics,
Redness, drainage, fever, chest pain, etc.
Prevention - wash hands, keep cuts covered, avoid communal bathing, cleanliness
Term
Immunological System Disorder
Definition
Counsel people to screen, set goals, provide support like with chronic illness, social support, counseling, drug therapy,
OT: Self care adaptations, energy conservation, work capacity evaluations, leisure sports, rest,
Use PIZZA assessment for people with aids, for home care use COPM
follow ADA guidelines for schools
Term
Diabetes
Definition
Type I - Autoimmune
Type II - non-insulin dependent
Fatigue, urinary disturbance, vision issue, poor health, hypo and hyper - glycemic events
Do exercise, education, psych and emotional support, lifestyle readjustment, protective issues for peripheral neuropathy, wound management.
Term
Hypoglycemia
Definition
Vagueness, dizziness, tachycardia, pallor, weakness, diaphoresis, seizures, coma
give hard candy fruit juice or honey
Call for help if unconscious
Term
Hyperglycemic crisis
Definition
Ketoacidosis, - dehydration, rapid and weak pulse, acetone breath,
hyperosmolar coma - stupor, thirst, polyuria, neurologic abnormalities
Call for help or get insulin
Term
Bariatric Issues
Definition
Obese BMI over 30
BMI over 40 morbidly obese
Prevention: Education, habit intervention, focus on occupational needs
OT: Lifestyle redesign, equipment needs, activity participation
Comorbid - Cardiopulmonary, altered biomechanics, pressure ulcers, lymphedema, cellulities, hyperthermia, risk of practicioner injury
Term
Pressure Ulcers
Definition
Predisposition - immobility, weight loss, edema, sensory, circulatory, obesity, dehydration, skin changes, cognitive issues
Deep tissue injury - purple or maroon colr of skin
Stage I - nonblanchable redness over localized area , may be painful, itchy, blanching,
Stage II - partial thickness loss of dermis, shallow open ulcer can be shiny or dry, blister,
Stage 3 - full thickness tissue loss with subcutaneous fat, can be shallow or deep
Stage 4 - full thickness with bone, tendon or muscle visible - can be shallow or deep, osteomyelitis is possible
Unstageable - Wound is now eschar
Interventions:
Group 1 - W/c cushions, mattresses
Group 2 - dynamic electric-powered devices
Group 3 - dynamic electric powered devices
Train pt. in weight shifting and positioning and skin care
Weight shifts 30 min/30 sec 60 min/60 seconds
Check skin
Adequate intake of fluid, dressing, activities.
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