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CHAPTER 31
REHABILITATIVE CAREERS
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 31 Learning Objectives

Define at least 10 terms relating to
rehabilitative health care.

Identify the function of the rehabilitative
health care team.

Describe the role of at least five of the
rehabilitative health care team members,
including personal qualities, levels of
education, and credentialing requirements.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 31 Learning Objectives

Identify at least five methods or devices used
to improve activities of daily living for the
disabled.

Describe two types of hearing loss and two
methods of assessing defects in hearing.

Identify at least five common drug types and
the expected action of each.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Chapter 31 Learning Objectives

Identify the necessary components of a legal
drug prescription, including the personnel
qualified to write one.

Describe three other types of rehabilitative
treatments.
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Rehabilitative Careers

A rehabilitation team works closely with the
patient and family members.


Requires creativity, persistence, and ability to
work with a variety of people
Requires strong listening and verbal skills,
analytical ability, and patience
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Rehabilitative Health Careers
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Rehabilitative Careers: Educational
Cost and Earnings
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Physical Therapist

Physical therapists work to restore function,
relieve pain, and prevent disability after
disease, injury, or loss of a body part.


May specialize in different areas of practice
Education



Master’s degree preferred
Entry level position requires bachelor’s degree in
physical therapy
Licensure by state
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Physical Therapist

Specialties in physical therapy

Rehabilitation
 Community services
 Sports
 Industry
 Research
 Education
 Administration
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Physical Therapy Assistant

Provides routine treatments under the
supervision of a physical therapist:






Application of hot and cold packs
Ultraviolet and infrared light treatments
Ultrasound and electrical stimulation
Hydrotherapy
Observes patients during treatment and
records performance
Education

2 years of college-level training
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Kinesiotherapist


Works under the direction of a physician
Uses exercise to help patients strengthen and
coordinate body movements:


Maintaining muscle endurance, mobility, strength,
and coordination
Education
Bachelor’s degree in exercise physiology or
physical education
 Internship of at least 1,000 hours of training
 Certification and national registration is optional

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Orientation and Mobility
Instructors or Specialists

Help visually impaired and blind individuals to
move about independently

Methods of improving mobility
•
•
•
•

Cane
Sensors
Guide dogs
Electronic travel aids
Education


Bachelor’s degree is minimal, and a master’s
degree is preferred.
Certification is voluntary.
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Orthotist and Prosthetist

Certified orthotist (CO)




Provides services for clients with disabling
conditions of the limbs or spine
Designs, fabricates, and fits braces or
strengthening apparatus
Supervises support personnel and laboratory
activities
Education
• Baccalaureate degree
• Certification through the American Orthotic and
Prosthetic Association (AOPA)



Completion of approved program
One year of experience
Certification examination
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Orthotist and Prosthetist

Certified prosthetist (CP)



Provides care to clients with partial or total
absence of a limb and those who use an artificial
limb (prosthesis)
Designs material selection, production, instruction
on use, and evaluation of the appliance
Education
• Baccalaureate degree
• Certification through the American Orthotic and
Prosthetic Association (AOPA)



Completion of approved program
One year of experience
Certification examination
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Corrective Therapist



Conducts physical exercise programs to
prevent muscle deterioration in inactive
patients
Teaches the use of braces, crutches, and
canes
Education

Bachelor’s or master’s degree
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Elastic Stockings
FIGURE 31-2 Elastic stockings help to prevent the development of emboli.
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Pedorthist



Modifies and provides footwear to patients
with imperfectly formed feet
Follows prescriptions of a physician
No educational requirements


Can be learned through seminars
Certification recommended
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Occupational Therapist




Evaluates patients, plans the programs, and
supervises, or provides treatment
Uses activities to help a person develop,
maintain, or regain skills
Analyzes activity to determine an adaptive
skill
Education
4-year baccalaureate program
 6 months of clinical training
 Successful completion of a national examination
 Most states require licensure.

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Occupational Therapy
Assistants and Aides

Occupational therapy assistants

Instruct and assist clients to perform activities of
daily living (ADLs)
 Certification through COTA after completion of an
approved 2-year program

Occupational therapy aides

Assists with transportation, equipment assembly,
and maintenance of work areas
 Trained on the job
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Athletic Trainer

Works under the supervision of the team
physician in a variety of amateur and
professional sports and other settings



Prevents injury and performs emergency
treatment
Uses methods that include corrective exercise,
conditioning, rehabilitation, and nutrition
counseling
Education

4-year college or university program, including a
minimum of an 1800-hour internship over 2 years
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Pharmacist


Mixes and dispenses drugs according to
prescriptions
Provides information to the consumer





Side effects of medications
Food and drug interactions
Dosing schedules
Health care supplies
Education



Minimum of 5 years of college
Bachelor of science in pharmacology (BS Pharm)
or doctor of pharmacology (PharmD)
Successful completion of licensing examination
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Pharmacy Support Personnel

Pharmacy technician

Assists the pharmacist in processing prescriptions
and distribution of medications
 Education
• 1-year vocational or community college program

Pharmacy helper

Assists the pharmacist by waiting on clients and
maintaining the inventory of supplies under the
direction of the pharmacist and technician
• On-the-job training
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Pharmacologist or Toxicologist



Works in research and product development
Pharmacologists study the clinical science of
how the drug works, and pharmacists prepare
or dispense medications
Education


Pharmacy or medical degree
Further specialization in research or product
development
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Pharmacy Support Personnel

Pharmaceutical industry worker


Produces medicines, remedies, nutritional
supplements, and health care products
Responsibilities
• Filling and examining vials and ampules
• Running machines that fill capsules

Education or training
• On-the-job training
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Speech and Language
Pathologist




Provides evaluation, treatment, and research
in communication and related disorders
Diagnoses language problems
Plans and directs treatment
Education


Master’s degree
Voluntary certification of clinical competence
• Master’s degree
• 9 months of supervised experience
• Successful completion of a national examination
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Audiologist

Audiologist

Specializes in prevention, identification,
assessment, and rehabilitation of hearing
disorders
 Responsibilities
• Testing hearing and determining level of hearing
function
• Prescribing and dispensing hearing aids

Serves as a consultant in noise pollution and
environmental influences on hearing
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Audiometrist


Screens hearing under the supervision of the
audiologist
Responsibilities

Fitting earphones
 Provides instruction
 Recording results of testing

Training

On-the-job training
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Manual Alphabet
FIGURE 31-6 A , The manual alphabet is used as a form of communication by most persons who
do not hear. (A, Courtesy the National Association for the Deaf, Silver Spring, Md.;
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Manual Alphabet
FIGURE 31-6 B, The manual alphabet is used as a form of communication by most persons who do
not hear. B, From Sorrentino SA: Mosby’s textbook for nursing assistants, ed 7, St. Louis, 2008,
Mosby.)
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Respiratory Therapist




Evaluates the patient to administer respiratory care
Operates life support equipment under the
supervision of a physician
Performs oxygen administration, incentive
spirometry, tracheotomy care, and mechanical
ventilation
Education

Vocational, community college, and university
programs
 Certification is available
 Must be licensed in all states except Alaska and
Hawaii
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Rate of Oxygen Flow
FIGURE 31-3 The rate of oxygen flow is ordered by the physician and is
determined by the method of administration.
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Incentive Spirometer
FIGURE 31-4 An incentive spirometer is used to help improve
the depth of each inspiration.
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
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Respiratory Therapy Technician

Administers routine respiratory care under the
supervision of a therapist


Duties include cleaning and storing equipment
Education
• 1-year community college programs
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Other Rehabilitative Personnel

Industrial rehabilitation specialist

Includes vocational rehabilitation, manual arts,
and horticultural therapies
• Works to prevent physical deterioration of skills

Education
• Bachelor’s degree

Rehabilitation teacher


Works with the blind and visually impaired adults
Teaches use of community resources and
management of activities
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Art Therapist

Art therapist

Uses art activities to help patient express
communication
 Responsibilities
• Planning activities
• Providing instruction
• Observing and recording behavior

Education
• Master’s degree
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Dance and Movement Therapist


Teaches movement to improve the emotional
and physical rehabilitation of an individual
Education



Master’s degree in art and psychology
Clinical training
Licensure
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36
Recreational Therapist

Plans, organizes, and directs medically
approved recreation programs in hospitals
and other institutions according to needs of
patients


Record observations
Education

Community college and university recreational
therapy programs
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37
Other Rehabilitative Personnel

Music therapist

Plans, organizes, and directs music activities and
learning experiences for patients
• Analyzes and records patient’s reactions to the
activities

Education
• Bachelor’s degree

Radiation technologist


Plans and administers the treatment of radiation
therapy
Education
• 2-year community college or 4-year college
program
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38
Dialysis Technician

Dialysis technician

Sets up and runs artificial kidneys for patients
requiring treatment
 Must be familiar with sterile technique
 Responsibilities
• Monitoring vital signs
• Performing venipuncture to start dialysis
 Education
• On-the-job training
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39
Perfusionist, or Extracorporeal
Circulation Technician

Under the direction of the surgeon, manages
the heart-lung machine during surgery and
respiratory failure

Responsibilities
• Regulating blood circulation and composition
• Monitors the oxygen and carbon dioxide content of
the blood
• May induce hypothermia by cooling the blood

May administer blood products, anesthetic agents
and drugs
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40
Perfusionist, or Extracorporeal
Circulation Technician

Education




1 year of college work in basic science
1- to 2-year perfusionist program (usually
associated with a medical school)
Certification through the American Board of
Cardiovascular Perfusion
Licensure is required in several states
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41
Pharmacology

Pharmacology

Study of drugs, their actions, dosages, side
effects, indications, and contraindications
 Food and Drug Administration (FDA) is part of the
federal government that oversees prescription and
administration of drugs.
 Drug Enforcement Administration (DEA) is
responsible for the enforcement of the drug laws.
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Pharmacology


Controlled Substance Act of 1970 enacted to
regulate drugs capable of causing
dependence
Medications have generic, chemical, and
trade names.




Generic name is the common name of the drug.
Chemical name is based on the composition of the
substance.
Manufacturer’s name is the trade name.
Trade name is registered and patented with the
U.S. government.
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43
Common Drug Types and Actions
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Common Drug References


United States Pharmacopeia-Dispensing
Information (USP-DI)
Physician’s Desk Reference (PDR)

Cross-referenced in sections that list drugs by
•
•
•
•
Manufacturer
Brand name
Generic name
Drug classification
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45
Prescriptions

Valid when written on a printed form containing

Name and address of patient
 Date of the prescription
 The superscription (Rx)
 List of ingredients (inscription)
 Directions of preparation (subscription)
 Directions for use (sig.)
 Physician’s signature

Latin abbreviations and terms are used for
prescriptions.
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46
Medication Label

Medication is labeled with the





Patient’s name
Medication name
Dosage
Method of administration (route)
Intervals for administration
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47
Drug Administration Methods
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48
Speech Pathology




Ten million people in the United States have
speech and language problems.
Aphasia is the loss of the ability to speak and
may be caused by a stroke, head injury, or
laryngeal cancer.
Speech disorders may result from congenital
problems, illness, or injury.
Manual or sign language is learned if the
speech disorder is severe or permanent.
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49
Hearing



More than 17 million people in the United
States have hearing loss in one or both ears.
An audiometer is used to test hearing.
Complete audiograms test bone conduction
and air conduction.


Results can help determine conductive hearing
loss or sensorineural hearing loss.
A tympanogram provides information about
the flexibility of the eardrum.
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50
Respiratory Therapies

Breathing treatments




Intermittent positive-pressure breathing (IPPB)
Chest physical therapy (CPT)
Gasses used medicinally include oxygen,
compressed air, and some air mixtures.
A blood gas analyzer measures the amount of
oxygen, carbon dioxide, and pH value of the
blood.
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51
Respiratory Therapies

Oxygen administration by




Nasal cannula or prongs
Mask
Tent
Nebulizers are used to administer water or
medication into the lungs.
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52
Application of Heat and Cold


Used to allow increased movement of the
joints
Application by




Aquamatic pads
Ice bags
Water baths
Application must be done carefully because
tissue may be damaged.
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53
Application of Heat and Cold
FIGURE 31-9 Applications of heat and cold should never touch the skin directly.
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54
Crutch Walking


Patient must be measured for proper fit while
wearing walking shoes.
Methods (gaits) of using crutches

Four-point
 Two-point
 Three-point
 Tripod
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55
Medication Calculations

Dose must be calculated using a conversion
formula.

Accuracy of the conversion should be verified
with another worker.
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Conversion Units for Medications
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Testing Hearing

Patient is seated in a quiet room and wears
audiometer earphones.

Machine is set to test each ear separately.

It detects sounds at 20 decibels (dB) and higher at
a frequency of 1000 hertz (Hz).
 Procedure can be repeated at higher and lower
frequencies.
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58
Assistive Devices
FIGURE 31-10 A, Patients with disabilities can learn to perform activities of daily living independently by using
assistive devices. (From Sorrentino SA: Mosby’s textbook for nursing assistants, ed 7, St. Louis, 2008, Mosby.)
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
59
Assistive Devices
FIGURE 31-10 B, Patients with disabilities can learn to perform activities of daily living independently
by using assistive devices. (From Sorrentino SA: Mosby’s textbook for nursing assistants, ed 7, St.
Louis, 2008, Mosby.)
Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
60
Summary

The function of the rehabilitative health care
team is to provide services designed to
overcome disabilities.

The role of the physical therapist is to restore
function, relieve pain, and prevent disability
after illness or injury. The orthotist designs
and makes braces. The occupational
therapist helps patients live independently.
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61
Summary

Five methods or devices used to improve
activities of daily living include the use of
canes, elastic stockings, guide dogs, braces,
and prosthetic limbs.

Two types of hearing loss are conductive and
sensorineural.
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62
Summary

Five commonly used drugs types are
analgesics, antacids, antihistamines,
decongestants, and sedatives.

Components of a legal drug prescription
include the name and address of the patient,
date of the prescription, the superscription
(Rx), list of ingredients (inscription), directions
for preparation (subscription), directions for
use (sig.), and physician’s signature.
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63
Summary

Three rehabilitative treatments



Respiratory therapy
Athletic training
Radiation therapy
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