An OTR® is working with a client in the active phase of C6 spinal cord injury. What piece of durable medical equipment would be BEST suited for assisting in the client's community mobility?A. Power recliner with standard arm driveB. Lightweight folding wheelchairC. Power recliner with head controlD. Manual rigid wheelchair
A: At C6, wrist extension is still preserved at some functional level, allowing for the control of a power recliner with standard arm drive.B: Although a C6 client might use a lightweight wheelchair (with adapted wheels) indoors, the client will likely require total assist with this type of chair in the community.C: Head controls are not necessary for propulsion as because a client with C6 injury has shoulder, arm, and some wrist movement.D: A manual rigid wheelchair would not promote community mobility because it is cumbersome to transport and would be difficult for the client to propel.
During an initial screening with a client who had a recent TBI, the OTR® asks the client to arrange picture cards in an order that will tell a story. This client arranges the cards in an incorrect sequence. What action should the OTR® take based on the client's performance during this task?A. Further assess neurobehavioral skills and abilities.B. Select intervention tasks that require sequencing.C. Identify modifications for the client to use during self-care.D. Administer a standardized test of cognitive abilities.
A: Because the screening was based on a picture card sequencing task, gathering additional information on the client's neurobehavioral skills and abilities related to task performance would be most beneficial.B, C: The OTR® has not gathered enough data through the evaluation process to implement an intervention plan.D: The OTR® may decide that administering a cognitive assessment may be necessary; however, assessing the client's neurobehavioral skills and abilities will provide more essential information for establishing functional goals through the evaluation process and planning for intervention.
A client who had a CVA is now being discharged from a hospital setting to home. The client continues to show signs of right-sided weakness and decreased balance. What referral for occupational therapy services is MOST appropriate for the OTR® to make?A. At home with a home health OTR®B. In an outpatient centerC. In the acute-care hospitalD. In a subacute rehabilitation hospital
A: The client is being discharged to home; therefore, continuing occupational therapy services in that setting is most appropriate.B: If the client continues to experience weakness and decreased balance, travel may be complicated. Thus, an outpatient center may not be a safe alternative.C, D: A subacute rehabilitation and acute-care hospital are not appropriate referrals because the client is going home.
A young adult patient who has a C5-C6 spinal cord injury is preparing for discharge from the inpatient rehabilitation facility. The patient plans to live at home and receive assistance from the spouse and hired caregivers. Which referral should be initiated prior to discharge from the facility?A. Vocational counselingB. Outpatient rehabilitationC. Independent living centerD. Driver's rehabilitation
B: Patients are often referred to outpatient rehabilitation once they have met their inpatient rehabilitation goals. Patients with spinal cord injury continue to gain strength and increase independence during the first year of injury, so continuing intervention in another setting is most appropriate.A, D: The outpatient rehabilitation therapist will address community integration needs of the patient, including referrals to vocational counseling and driver's rehabilitation.C: An independent living center is not needed in this situation because the patient is returning home with spouse and hired caregivers.