Ma. Christina B.

Celdran Oraa, RN MAN

Is an observation to gather data while the client is

performing common or routine activities

P H Y S I C A L AC T I V I T I E S O F DA I LY L I V I N G ( PA D L )
Describe a typical day for you, starting from the time you wake up to the time you go to bed.

Do you need assistance with any activities of daily living? (if yes) is assistance readily available?
Do you socialize, meet, or talk with people outside your house on a daily basis? Does your schedule change on certain days or on weekend? Describe.

Metro Manila Development Screening Test

To determine early serious developmental delays Dr. William K. Frankenburg Modified and standardized by Dr. Phoebe D. Williams DDST

to MMDST
Developed for health professionals (MDs, RNs, etc)

It is not an intelligence test

For testing developmental delays in infant and children

Children 6 years and below

Evaluates 4 aspects of development

ASPECTS OF DEVELOPMENT
:

Personal-Social tasks which indicate the childs ability to get along with people and to
take care of himself

Fine-Motor Adaptive tasks which indicate the childs ability to see and use his hands
to pick up objects and to draw

Language tasks which indicate the childs ability to hear, follow directions and to speak
Gross-Motor tasks which indicate the childs ability to sit, walk and jump

 MMDST manual test Form bright red yarn pom-pom rattle with narrow handle eight 1-inch colored wooden blocks (red, yellow, blue green)

small clear glass/bottle with 5/8 inch opening small bell with 2 inch-diameter mouth rubber ball 12 inches in circumference cheese curls pencil

in Activities Daily Living

Most appropriate instrument to assess functional status as a

measurement of the clients ability to perform activities of daily living

independently. Clinicians typically use the tool to detect problems in performing activities of daily living and to plan care accordingly

The instrument is most effectively used among older

adults in a variety of care settings, when baseline

measurements, taken when the client is well, are compared to

periodic or subsequent measures.

STRENGTHS AND LIMITATIONS

It does not assess more advanced activities of daily living.

is sensitive to changes in declining health status, it is

limited in its ability to measure small increments of change

seen in the rehabilitation of older adults.

The Index ranks adequacy of performance in the six functions of:

Bathing Dressing Toileting Transferring

6 - full function 4 moderate impairment 2 or less - severe functional impairment.

Continence
feeding.

BARTHEL INDEX

GENERAL
The Index should be used as a record of what a patient does NOT as a record of what a patient could do.

The main aim is to establish degree of independence from any

help. The need for supervision renders the patient not independent.

A patient's performance should be established using the best available evidence. Asking the patient, friends/relatives, and nurses will be the usual source. Usually the performance over the preceding 24 48 hours is important, but occasionally longer periods will be relevant.

 Bowels (preceding week) 0 - If needs enema from nurse, then 'incontinent.' 1 - Occasional' = once a week. 2 - continence 'Occasional' = less than once a day. A catheterized patient who can completely manage the catheter alone is registered as 'continent.' Grooming (preceding 24 48 hours) Refers to personal hygiene: doing teeth, fitting false teeth, doing hair, shaving, washing face. Implements can be provided by helper.

Bladder (preceding week)

 Toilet use
Should be able to reach toilet/commode, undress sufficiently, clean self, dress, and leave.

'With help' = can wipe self and do some other of above.

Feeding Able to eat any normal food (not only soft food). Food cooked and served by others, but not cut up. 'Help' = food cut up, patient feeds self. Transfer From bed to chair and back. 'Dependent' = NO sitting balance (unable to sit); two people to lift.

 Major help' = one strong/skilled, or two normal people. Can sit up. 'Minor help' = one person easily, OR needs any supervision for safety. Mobility Refers to mobility about house or ward, indoors. May use aid. If in wheelchair, must negotiate corners/doors unaided. 'Help' = by one untrained person, including supervision/moral support. Dressing Should be able to select and put on all clothes, which may be adapted. 'Half' = help with buttons, zips, etc. (check!), but can put on some garments alone.

Stairs Must carry any walking aid used to be independent.

Bathing Usually the most difficult activity. Must get in and out unsupervised, and wash self. Independent in shower independent' if unsupervised /unaided.

RATIONALE
This tool is valuable for evaluating patients with earlystage disease, both to assess the level of disease and to determine the patient's ability to care for him- or herself.

These skills are considered more complex than the basic

activities of daily living as measured by the Katz Index of

ADLs The instrument is most useful for identifying how a person is functioning at the present time, and to identify improvement or deterioration over time.

Women are scored on all 8 areas of function; historically, for men, the areas of food preparation, housekeeping, laundering are excluded. Clients are scored according to their highest level of functioning in that category. A summary score ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 through 5 for men.

This instrument is intended to be used among older adults, and can be used in community or hospital settings.

The instrument is not useful for institutionalized older adults.

It can be used as a baseline assessment tool and to compare

baseline function to periodic assessments.

Operates telephone on own initiative; looks up

and dials numbers....................................................1

Dials a few well-known numbers............................1 Answers telephone, but does not dial...................1 Does not use telephone at all...................................0

Takes care of all shopping needs independently.........1

Shops independently for small purchases ..................0

Needs to be accompanied on any shopping trip .. 0

Completely unable to shop .........................................0

Plans, prepares, and serves adequate meals independently...1

Prepares adequate meals if supplied with ingredients........0

Heats and serves prepared meals or prepares meals but does not maintain adequate diet ........................0 Needs to have meals prepared and served ....................0

Maintains house alone with occasion assistance (heavy work)...1 Performs light daily tasks such as dishwashing, bed making..1
Performs light daily tasks, but cannot maintain acceptable level of cleanliness 1

Needs help with all home maintenance tasks ....................1 Does not participate in any housekeeping tasks.................0

Does personal laundry completely...................................1 Launders small items, rinses socks, stockings, etc .........1 All laundry must be done by others .................................0

 Travels independently on public transportation or drives own care.........1 Arranges own travel via taxi, but does not otherwise use public transpo..1 Travels on public transportation when assisted or accompanied by

another....1
Travel limited to taxi or automobile with assistance of another....0 Does not travel at all ...............0

.Is responsible for taking medication in correct

dosages at correct time ........................................1

Takes responsibility if medication is prepared in advance in separate dosages................................0 Is not capable of dispensing own medication...................0

 Manages financial matters independently (budgets, writes checks, pays rent and bills, goes to bank); collects and keeps track of income..1 Manages day-to-day purchases, but needs help with banking, major purchases, etc ................................1 Incapable of handling money ............................................0

IADL with four scales that measured domains of functional status,

Physical Classification(6-point rating of physical health),

Mental Status Questionnaire (10-point test of orientation and memory), Behavior and Adjustment rating scales (4-6-point measure of intellectual, person, behavioral and social adjustment),

and the PSMS (6-item ADLs).

:
The identification of new disabilities in these functional domains warrants intervention and further assessment to prevent ongoing decline

and to promote safe living conditions for older adults.

If using the Lawton IADL tool with an acute hospitalization, nurses should communicate any deficits to the physicians and social

workers/case managers for appropriate discharge planning.

ASSIGNMENT VIDEO PRESENTATION 4 TO5 GROUPS

Gravida (G) - number of pregnancy

Para (P) past pregnancy that have reached viability Nulligravida Abortion Miscarriage

Past Obstetrics History Types of deliveries Problems with infertility Multiple births Dates of previous Abortions pregnancies Maternal, fetal and Infant weight neonatal complications Length of labor

Womans perception of past pregnancy, labor and delivery for herself and effect on her family

 Appearance and evaluation of color. Pulse Grimace or reflex irritability. Activity Respiratory effort

 Auscultate the heart rate for 1 full minute Measure the degree of respiratory effort

Evaluate muscle tone by attempting to strengthen each proximity individually.

Evaluate the newborns reflex irritability. Use a flicking motion of two fingers against the newborns sole to reflex irritability

Inspect the newborns color.

The following list illustrates the content of a complete review of systems

Average weight, weight loss Gain general state of health sense of well-being

Strength

ability to conduct usual

activities

exercise tolerance

SKIN/BREAST
Rash, itching Pigmentation Breast lumps

Tenderness
Swelling

moisture or dryness
changes in hair growth or loss

nipple discharge

nail changes

E Y E S / E A R S / N O S E / M O U T H / T H R OA T

Headaches

Vision double vision tearing blind spots pain

Vertigo
lightheadedness, injury

E Y E S / E A R S / N O S E / M O U T H / T H ROA T
Nose bleeding Colds Obstruction discharge Dental difficulties

Neck stiffness Pain

Tenderness
masses in thyroid or other

gingival bleeding, dentures

areas

CARDIOVASCULAR
Precordial pain, substernal distress, palpitations., syncope dyspnea on exertion Orthopnea
nocturnal paroxysmal dyspnea

Edema Cyanosis Hypertension heart murmurs varicosities, phlebitis, claudication

RESPIRATORY
Pain

cough
hemoptysis, tuberculosis fever or night sweats

shortness of breath
Wheezing Stridor

respiratory infections

GASTROINTESTINAL
Appetite Dysphagia Indigestion

Jaundice
constipation or diarrhea abnormal stools flatulence Hemorrhoids recent changes in bowel

abdominal pain
Heartburn nausea, vomiting

hematemesis,

habits

GENITOURINARY
dysuria,

Urgency
frequency infections

acute retention or incontinence

nocturia, hematuria, polyuria, oliguria, Stones color of urine,

Nephritis hesitancy change in size of stream dribbling

Libido potency,
genital stores, discharge venereal disease

MUSCULOSKELETAL
Pain limitation of motion,

Swelling
redness

muscular weakness,
Atrophy

heat of muscles or joints,

Cramps

NEUROLOGIC/PSYCHIATRIC
Convulsions Paralyses Predominant mood "nervousness" (define)

Tremor
Incoordination

emotional problems
previous psychiatric care unusual perceptions,

parathesias

A L L E RG I C / I M M U N O L O G I C LY M P H A T I C / E N D O C R I N E
Reactions to drugs,
Anemia

Food and insects,

skin rashes

bleeding tendency, previous

transfusions and reactions, Rh incompatibility

trouble breathing

GRACIAS A TODOS!!
Video Presentation is due on Friday
April 28, 2012 At 11:00am; Nursing Office