Deck 47: Burns and Burn Rehabilitation

Question 1

An OT practitioner is treating a client who has been hospitalized with acute burns to the face,neck,chest,and bilateral upper extremities.The therapist wants to initiate immediate antideformity positioning.Which position would not be appropriate?

A) Using a pillow behind the client's head
B) Using armboards to place shoulders in 90 degrees of abduction
C) Using a towel roll beneath the thoracic spine
D) Using splints to place elbows in extension

Answer 1

A
Pillows behind the client's head would actually encourage neck flexion deformity instead of preventing it.The antideformity position would be with the neck in neutral or slight extension.

Question 2

An occupational therapy (OT)practitioner is treating a client who had a split thickness skin graft (STSG)5 days ago after a release of an anterior elbow flexion contracture.At this time the therapist should begin which of the following?

A) Gentle passive range of motion (ROM) exercises
B) Gentle active ROM exercises
C) Gentle strengthening exercises
D) Gentle compression devices

Answer 2

B
After a typical 3- to 5-day period of immobilization,postoperative treatment of an STSG begins with gentle active ROM exercises to avoid shearing of the new graft.Passive ROM,resistive exercises,and compression are initiated later,once the graft is more stable and able to tolerate more stress.

Question 3

An OT practitioner is evaluating a client whose primary complaint is the inability to raise her arm to reach high cabinets and shelves.The therapist notes a very tight mature scar band crossing the client's posterior axilla that is limiting full shoulder motion.What should the therapist do?

A) Initiate stretching exercises for shoulder flexion.
B) Explore assistive devices or compensatory strategies to reach items.
C)
C) Fit the client with a clavicular strap.
D) A and

Answer 3

B
Restructuring of collagen linkage in immature scars is possible with positioning,splinting,pressure,and exercise.In this scenario the key word is mature.The therapist must be able to recognize when scar maturation has occurred.Mature scars are no longer amenable to change through therapy intervention and require surgery to reverse contracture.At this stage the therapist should focus therapy efforts on maximizing the client's ability to perform occupations despite the client's existing motion limitations.

Question 4

An OT practitioner is evaluating the ROM of a client with an acute full thickness burn to the dorsum of the hand.The therapist is concerned about the integrity of the extensor tendons and should take which of the following actions?

A) Measure passive composite finger flexion.
B) Measure active composite finger flexion.
C) Measure metacarpophalangeal (MP) flexion with the interphalangeal joints in extension.
D) Refrain from performing all hand joint measurements until the burn has healed.

Question 5

An OT practitioner is treating a client with burns to the chest and upper extremities sustained 6 weeks ago.The client is exhibiting new stiffness and deep pain in the elbow at the end of elbow flexion range.The therapist suspects development of heterotopic ossification and should take which of the following actions?

A) Discontinue all elbow ROM until pain resolves.
B) Initiate dynamic elbow flexion splinting.
C) Have client perform active elbow ROM exercises within pain-free range.
D) Perform more aggressive passive stretching into elbow flexion.