Rehabilitation Reflection

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I completed my long term rehabilitation rotation at the Baylor Institute for Rehabilitation (BIR) in Dallas. The patient that I was assigned to accompany was a 73-year-old Caucasian male. TK was transferred on March 9, 2010 from Medical City of Dallas Hospital following his craniotomy secondary to a Cerebral Vascular Accident (CVA) that occurred on February 28, 2010. He was also has a history of Hypertension (HTN). As I approached TK he was resting in bed with his head elevated watching TV. I asked the client if this would be an appropriate time to interview him. At first he was hesitant but after a few questions he became responsive during the rest of the interview process. TK was well groomed. Half of his hair had been shaved off with a c-shaped wound on his scalp. The hair he did have was brushed nicely to the side. His hygiene appearance showed he was clean shaven and wore a clean gown. When asked him if he knew why he was here at BIR and he stated because he had a stroke. During my observation it did not appear that his CVA had caused any damage to his cognitive skills however his motor skills were affected. TK has left sided weakness. I observed that it affected his muscles on his left side causing his head to turn to the right. The physical therapist (PT) would slowly turn his head and massage the contracted muscles, they would tape the muscle to prevent it from contracting for his head to stay center.

The cognitive function of this client was determined using the Mini-Mental State Exam (MMSE). The exam was conducted before his physical therapy treatment and he was cooperative throughout the exam. He received twenty six of the thirty points allowed for this exam. TK scored five points for being able to accurately ...

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...de teaching to the patient and family signs and symptoms of complications of CVA to report to the health care provider (HCP). Such as risk for deep vein thrombosis (DVT) and Pneumonia. Teach PT ways to move affected extremity to prevent injury. Encourage the PT after periods of exercise to surround himself in an relax full environment to facilitate recuperation. Keep a voiding diary to establish a voiding pattern and to void at prescribe intervals to assist PT in adapting a new toileting schedule. Teach the PT to consciously hold urine until the schedule toileting time to improve muscle tone. To improve PT’s self esteem teach his wife to praise PT’s progress towards reaching goals. Have wife participate in setting realistic goals to achieve higher self esteem. Monitor for situations that trigger low self esteem to help him in coping strategies. (Lewis, 2007)

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