Term
|
Definition
infection caused by microbial life, the person himself or herself harbors, e coli |
|
|
Term
professionalism and dignity.. |
|
Definition
always orient the patient, re orient reorient reorient...don't ever say, "it's going to be okay." |
|
|
Term
what are the aims of teaching and counseling?? |
|
Definition
maintaining and promoting health, preventing illness, restoring health, facilitating coping |
|
|
Term
focuses of patient education.. |
|
Definition
preparation for receiving care, preparation before discharge from healthcare facility, documentation of patient education activity |
|
|
Term
|
Definition
tune into patient, edit pt. information, act on every teaching moment, clarify often, honor the patient as partner |
|
|
Term
|
Definition
cognitive (change diet), psychomotor (wound care), affective (renewed confidence) |
|
|
Term
for teaching older adults.. |
|
Definition
identify learning barriers, extra time, plan short teaching sessions, accomadate sensory deficits, reduce distractions |
|
|
Term
|
Definition
creativity, optimism, planning, expert information |
|
|
Term
lecture, panel, discovery, written materials.. |
|
Definition
|
|
Term
role modeling, discussion, audiovisual materials.. |
|
Definition
|
|
Term
demostration, discovery, printed materials.. |
|
Definition
|
|
Term
|
Definition
review for accuracy, sign orders with name title page #, date and note time orders signed |
|
|
Term
purposes of recording data |
|
Definition
facilitate pt care, serve as a financial and legal record, help in clinical research, support decision analysis |
|
|
Term
|
Definition
Na, K, Ca, Mg, hydrogen ions |
|
|
Term
|
Definition
chloride, bicarbonate, phosphate, sulfate, protein ions |
|
|
Term
movement of fluid through capillary walls depends on.. |
|
Definition
hydrostatic pressure, osmotic pressure |
|
|
Term
pressure exerted on the walls of blood vessels.. |
|
Definition
|
|
Term
pressure exerted by the protein in the plasma.. |
|
Definition
|
|
Term
regulation of fluid is controlled by |
|
Definition
osmosis, diffusion, filtration, active transport |
|
|
Term
geriatric considerations in fluid balance.. |
|
Definition
reduced cardiac renal and resp function, decreased fluid percentage, medication usage, presence of concomitant conditions |
|
|
Term
|
Definition
increased serum sodium levels |
|
|
Term
|
Definition
vomiting, diarrhea, gi suctioning, sweating, decreased intake, and inability to gain access to fluid |
|
|
Term
|
Definition
diabtes insepidus, adrenal insufficiency, osmotic diuersis, hemmorhage, coma, and third space shifts |
|
|
Term
|
Definition
rapid weight loss, decreased skin turgor, oliguria, concentrated urine, postural hot, rapid and weak pulse, increased temp, cool and clammy skin, vasoconstriction, lassitude, thirst, nausea muscle weakness, and cramps |
|
|
Term
laboratory data for FVD.. |
|
Definition
elevated BUN in relation to serum, creatinine, increased hematocrit, possible serum electrolyte changes |
|
|
Term
Nursing management for FVD.. |
|
Definition
monitor I&O, skin and tongue turgor, mucosa, urinary output, and mental status |
|
|
Term
the most sensitive indicator of fluid balance is.. |
|
Definition
|
|
Term
|
Definition
heart failure, renal failure, and cirrhosis of the liver |
|
|
Term
contributing factors to FVE.. |
|
Definition
excessive dietary sodium, or sodium containing IV solutions |
|
|
Term
|
Definition
edema, distended neck veins, abnormal lung sounds crackles, tachycardia, increased BP pulse pressure, and CVP, increased weight, increased UO shortness of breath and weezing |
|
|
Term
|
Definition
asses symptoms, fluid restrictions and patient teaching related to sodium and fluid restrictions, promote rest, |
|
|
Term
categories of IV solutions.. |
|
Definition
colloids and crystalloids |
|
|
Term
|
Definition
do not cross capillary membranes, remain in vascular space |
|
|
Term
for colloidals, need to assess. |
|
Definition
increased BP, dyspnea, bounding pulses |
|
|
Term
|
Definition
albumin, dextran, hetastarch |
|
|
Term
|
Definition
plasma protein, increases plasma oncotic pressure, treatment of shock.. |
|
|
Term
|
Definition
plasma volume expander, short lived.. |
|
|
Term
|
Definition
clotting time, plasma volume expander. |
|
|
Term
precautions of blood products.. |
|
Definition
|
|
Term
|
Definition
replace clotting factor, correct coagulation deficiencies.. |
|
|
Term
|
Definition
cross capillary membrane, differing tonicity of fluids- isotonic, hypotonic, hypertonic.. |
|
|
Term
isotonic crystalloid solutions.. |
|
Definition
expands the ECF, no fluid shift, treatment hypotension secondary to hypovolemia, precautions |
|
|
Term
|
Definition
solute concentration inside the cell is equal to the solution outside the cell |
|
|
Term
|
Definition
fluids deficits, hypernatremia, insensible losses, maintenance IV |
|
|
Term
|
Definition
renal and cardiac disease |
|
|
Term
|
Definition
solute concentration inside the cell is HIGH, water rushes into cells, cells inflate and eventually burst. |
|
|
Term
|
Definition
replace cellular fluid and provide free water for excretion of body wastes, used for Na and Cl depletion, gastric fluid loss |
|
|
Term
Hypotonic IV solutions pose a risk of.. |
|
Definition
hypovolemia, increased intracranial pressure, contraindication: stroke, head trauma, neurosurgery, liver disease or burn |
|
|
Term
|
Definition
water is trasported out of cell, solute concentration inside cell is lower.. CELLS SHRINK! |
|
|
Term
cardiac patients with renal or cardiac disease will not be able to handle.. |
|
Definition
increased fluids that result from hypertonic solutions |
|
|
Term
parenteral nutrition includes.. |
|
Definition
protein, glucose, trace elements, and minerals, specific formulation, lipids, fats |
|
|
Term
sodium normal... hyper/hyponatremia, above below |
|
Definition
|
|
Term
potassium normal... hyper/hypokalemia |
|
Definition
|
|
Term
|
Definition
debilitating disease lasting more than 2 weeks, 10% body weight loss, serum albumin below 3.5, excessive N loss, renal or hepatic failure.. non function of GI tract 5-7 days |
|
|
Term
hyperkalemia management>5 |
|
Definition
monitor ECG IV sodium bicarbonate, limit dietary potassium |
|
|
Term
nursing management for hyperkalemia >5 |
|
Definition
assess serus potassium levels, mix well IVs, medication effect and initiate K dietary restriction |
|
|
Term
T wave peaks, and P wave looks flat in.. |
|
Definition
|
|
Term
|
Definition
|
|
Term
hypocalcemia <8.5 mg is caused by.. |
|
Definition
hypoparathyroidism, malabsorption, pancreatitis, alkalosis, massive transfusion of citrated blood, renal failure, meds.. |
|
|
Term
hypocalcemia <8.5 mg manifestations.. |
|
Definition
tetany, circumoral numbness, paresthesia, hyperactice DTRs, Trousseaus sign, Chovsteks sign, seizures, abnormal clotting and anxiety |
|
|
Term
purpose of musculoskeletal system.. |
|
Definition
protection of vital organs, mobility and movement, facilitate return of blood to heart, production of RBCs, reservoir for immature blood cells, and vital minerals |
|
|
Term
|
Definition
206, long short, flat irregular bones |
|
|
Term
|
Definition
posture, gait, bone integrity, joint function, muscle strength and size, skin and neurovascular status |
|
|
Term
|
Definition
|
|
Term
|
Definition
mature bone cells that function in bone maintenance located in lacunae |
|
|
Term
|
Definition
multinuclear cells function in destroying, reabsorbing, and remodeling bone. howship's lacuna |
|
|
Term
what regulates bone formation? |
|
Definition
stress and weight bearing, vitamind/calcitriol, PTH, calcitonin, estrogen, blood supply |
|
|
Term
diangostic tests for bone density/health |
|
Definition
xrays, ct, bone desitometry, bone scan, mri, arthroscopy, serum lab work- Ca and estrogen |
|
|
Term
Risk factors for osteoprosis.. |
|
Definition
Age, Caucasian/asian, low bone mass/small stature, low BMI, sedentary, meds-corcticosteroids, smoking, diet, menopause |
|
|
Term
what does bone density screening measure? |
|
Definition
peripheral bones, wrist heel or finger |
|
|
Term
|
Definition
measures spine hip or total body bone density |
|
|
Term
normal mineral bone density lab value |
|
Definition
|
|
Term
low bone mass lab value-osteopenia |
|
Definition
|
|
Term
|
Definition
|
|
Term
severe osteoporosis lab value.. |
|
Definition
|
|
Term
estrogen helps bones by.. |
|
Definition
|
|
Term
|
Definition
|
|
Term
how do biphosphanates work? |
|
Definition
inhibit osteoclastic reabsorption |
|
|
Term
qualifications for biphosphanate.. |
|
Definition
pt must be able to sit upright for 30 minutes, take med on empty stomach |
|
|
Term
how long is the half life of biphosphanates? |
|
Definition
extremely long, up to one year |
|
|
Term
|
Definition
selective estrogen receptor modulators, EVISTA |
|
|
Term
|
Definition
reduces # of osteoclasts, may cause DVT or hot flashes |
|
|
Term
PTH med, Forteo, does what? |
|
Definition
stimulates osteoblastc activity to build bone matrix, can cause orthostatic hypotension |
|
|
Term
Side effects of PTH/Forteo |
|
Definition
paget's disease of bone, hx radiation treatment, hypercalcemia, use cautiously with warfarin |
|
|
Term
stages of fracture healing 6 |
|
Definition
fracture hematoma, granulation tissue, callus formation, ossification, consolidation, remodeling |
|
|
Term
5 neurovascular checks for fracture assesment |
|
Definition
pain, pulses, pallor, paraesthesia, paralysis |
|
|
Term
postop care for internal fixation.. |
|
Definition
encourage early mobilization, coughing and deep breathing |
|
|
Term
avoiding hip dislocation.. |
|
Definition
affected leg should not cross the center of the body, hip should not bend more than 90 degrees, affected leg should not turn inward |
|
|
Term
having a dislocated hip w ACI (active clinical issues)... |
|
Definition
increases risk for readmittance and DEATH. |
|
|
Term
|
Definition
compression of structures, edema leads to pressure within the closed compartment, resulting in obstructed circulation |
|
|
Term
signs and symptoms of compartment synrdome.. |
|
Definition
pain distal to injury-passiveROM- inability to extend digits, parasthesia, pallor, coolness, and absent pulses |
|
|
Term
treatment for compartment syndrome.. |
|
Definition
DO NOT elevate or apply ice, remove casts, fasciotomy, amputation assessment of urine output |
|
|
Term
|
Definition
fascia is cut to relieve pressure |
|
|
Term
fractures of the pelvis, long bone, etc can cause what? |
|
Definition
|
|
Term
|
Definition
infection caused by microorganism that is acquired from outside the host |
|
|
Term
|
Definition
infection that occurs as a result of a treatment or diagnostic procedure |
|
|
Term
|
Definition
the natural habitat of the organism |
|
|
Term
|
Definition
point of escape for organism |
|
|
Term
|
Definition
point at which organisms enter a new host |
|
|
Term
|
Definition
incubation, prodromal, full stage of illness, convalescent period |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
you should wear a mask for.. |
|
Definition
suspected AFB disease.. who knows. |
|
|
Term
surgical masks are required for droplet precautions when.. |
|
Definition
you're within 3 feet of patient |
|
|
Term
with neutropenic patients, you should.. |
|
Definition
avoid standing water in room and fresh fruits and veggies.. restrict visitors with colds or illnesses |
|
|
Term
tests for latex reactions.. |
|
Definition
RAST, skin prick, glove challenge. who knows. |
|
|
Term
safety precautions for latex allergies.. |
|
Definition
written warning, remove wall mounted BP cuffs, sharp containers, injection caps, IV tubing, urinary caths |
|
|
Term
effects of psychological and physical isolation.. |
|
Definition
loneliness, sensory deprivation, altered body image, low self esteem, fear |
|
|
Term
exposure to needle stick, blood, or body fluid.. |
|
Definition
wash the exposed area, report the incident, report client's name and type of exposure, obtain consenting blood test, post exposure prophylaxis, get blood test results |
|
|
Term
|
Definition
perceives solidity of objects: size, shape and texture |
|
|
Term
four conditions to receive data.. |
|
Definition
stimulus, receptor, nervous pathway to brain, functioning brain to receive and translate impulse sensation |
|
|
Term
factors effecting sensory stimulation.. |
|
Definition
developmental considerations, culture, personality and lifestyle, stress, medications |
|
|
Term
|
Definition
reticular activating system |
|
|
Term
|
Definition
extends from hypothalamus to medulla, mediates arousal, monitors and regulates incoming sensory stimuli |
|
|
Term
what is the optimal arousal state? |
|
Definition
|
|
Term
unconcsious states include.. |
|
Definition
|
|
Term
if you're not asleep, stupor or coma.. |
|
Definition
you're conscious. includes delirium, locked in syndrome, etc. |
|
|
Term
factors affecting sensory alterations |
|
Definition
sensory overload, sensory deprivation, sleep deprivation, cultural care deprivation |
|
|
Term
sensory deprivation causes.. |
|
Definition
environment with little or monotonous stimuli, impaired ability to receive stimuli, inability to process stimuli |
|
|
Term
|
Definition
so much sensory, brain cant process! feels out of control, focus on reducing distressing stimuli |
|
|
Term
pt outcomes for sensory alteration.. |
|
Definition
develop a stimulating environment, level of arousal enabling brain to perceive stimuli, intact functioning of senses, Orientation X3 |
|
|
Term
preventive measures against sensory alterations.. |
|
Definition
decrease patient discomfort, offer comfort, be aware of need for sensory aids, enlist aid of family members, encourage physical activity, provide stimulation |
|
|
Term
with blind/visually impaired patients you should.. |
|
Definition
teach self care behaviors, acknowledge your presence in room, speak in a normal tone, explain reason for touching person before doing so, keep call light within reach, orient person to surroundings |
|
|
Term
assisting the blind continued.. |
|
Definition
orient person to room arrangement, assist w ambulation, provide diversion using other senses, tell them when you're leaving |
|
|
Term
communicating with a pt who is confused... |
|
Definition
use frequent face to face contact to communicate, speak calmly, simply, and directly, orient x 3, offer explanations, reinforce reality |
|
|
Term
when communicating with an unconscious patient... |
|
Definition
SPEAK NORMALLY, be careful what is said, assume the person can hear you, speak to the person before touching, keep environmental noises at low level |
|
|
Term
|
Definition
maintain composition of body fluids, filter and exrcrete blood constituents not needed-and retain those that are, |
|
|
Term
the nephrons of the kidneys.. |
|
Definition
remove end products of metabolism and regulate fluid balance; urine |
|
|
Term
factors that effecting urination.. |
|
Definition
developmental, food and fluid intake, psychological variables?, activity and muscle tone, meds and pathological conditions |
|
|
Term
what are some diseases associated with renal problems? |
|
Definition
congenital UT abnormalities, polycystic kidney disease, UTI, kidney stones, High BP, D-mell, gout, connective tissue disorders |
|
|
Term
what meds effect urination? 3 |
|
Definition
diuretics, cholinergics, analgesics and tranqs |
|
|
Term
how do diuretics effect urine? |
|
Definition
prevents reabsorption of water and certain electrolytes in tubules |
|
|
Term
how do cholinergic medications effect urine? |
|
Definition
stimulate contraction of detrusor? muscle, producing urination |
|
|
Term
analgesics effect urination via.. |
|
Definition
suppressing the CNS, diminish effectiveness of neural reflex |
|
|
Term
anticoagulants make your pee.. |
|
Definition
|
|
Term
diuretics make your pee.. |
|
Definition
|
|
Term
pyridium (azo) make your pee.. |
|
Definition
|
|
Term
|
Definition
|
|
Term
levodopa makes your pee.. |
|
Definition
|
|
Term
urinary assessment should include.. |
|
Definition
voiding patterns, past history of problems, phy ex of urinary system, skin hydration, urine, compare with diagnostic results |
|
|
Term
|
Definition
check for costovertebral tenderness |
|
|
Term
|
Definition
palpate and percuss the bladder, or use bedside scanner |
|
|
Term
urethral meatus assessment.. |
|
Definition
inspect for signs of infection, discharge, or odor |
|
|
Term
skin assessment for urinary assessment.. |
|
Definition
asses for color, texture, turgor, and excretion of wastes |
|
|
Term
|
Definition
assess for color, odor, clarity and sediment |
|
|
Term
when measuring urine output.. |
|
Definition
void in container, put into measuring container, measure at eye level, document on appropriate form, discard urine unless specimen is needed. |
|
|
Term
pts at risk for uti's.. 6 |
|
Definition
sexually active women, women who use diaphragms (gross), postmenopausal women, urinary caths, diabets mellitus, elderly |
|
|
Term
What are reasons for catheterization.. |
|
Definition
relieving urinary retention, obtaining sterile specimen, emptying bladder before, during, or after surgery, monitoring critically ill patients |
|
|
Term
what is suprapubic catherization.. |
|
Definition
exactly what it sounds like.. AWFUL! inserted above pubis. |
|
|
Term
Urinary Incontinence/UI caused by an increase in intra abdominal pressure.. |
|
Definition
|
|
Term
UI caused by urine being lost during abrupt and strong desire to void |
|
Definition
|
|
Term
UI caused by urge and stress incontinence |
|
Definition
|
|
Term
UI caused by overdistention and overflow of bladder.. |
|
Definition
|
|
Term
UI caused by factors outside the urinary tract.. |
|
Definition
|
|
Term
UI caused by emptying the bladder without sensation of need to void.. |
|
Definition
|
|
Term
UI caused by continuous, unpredictable loss of urine.. |
|
Definition
|
|
Term
factors that may compromise the immune system..4 |
|
Definition
infection, neutropenia (chemo) meds, nutrition |
|
|
Term
predisposing conditions for infection.. |
|
Definition
indwelling devices(caths), skin/mucous membranes(burns), neutropenia, HIV, very young and very old |
|
|
Term
pulmonary infections affect risk of other infections bc.. |
|
Definition
decreased cough reflex, decreased elastic recoil of lungs, decreased activity of cilia, abnormal swelling reflexes |
|
|
Term
|
Definition
incomplete emptying of bladder, decreased sphincter control, bladder-outlet obstruction, reduction renal blood flow |
|
|
Term
skin infections are bad bc.. |
|
Definition
loss of elasticity, increased dryness, thinning epidermis, slowing cell replacement, decreased vascular supply |
|
|
Term
|
Definition
|
|
Term
abnormal neutrophil levels mean.. |
|
Definition
60-70% increase, common in infections that produce pus |
|
|
Term
increased lymphocytes are common in.. |
|
Definition
chronic bacterial and viral infections |
|
|
Term
increased eosinophils means.. |
|
Definition
allergic rxn or parasitic infections |
|
|
Term
increased basophils mean.. |
|
Definition
usually unaffected by infection |
|
|
Term
when inflammation is present there will be.. |
|
Definition
elevated erythrocyte sedimentation rate |
|
|
Term
presence of a pathogen can be found in.. |
|
Definition
|
|
Term
the most important actions to prevent the spread of infection, other than handwashing.. |
|
Definition
clean less soiled places first, then more soiled.. avoid raising dust, use PPE |
|
|
Term
major differences between reg. isolation and droplet.. |
|
Definition
droplet- wear surg mask, maintain separation of at least 3 ft for other patients and visitors, place mask on pt. |
|
|
Term
who can people on droplet isolation be roomed with? |
|
Definition
another person with the same pathogen |
|
|
Term
ppl with neutropenia normally become infected by.. |
|
Definition
pathogens within their own bodies |
|
|
Term
|
Definition
droplet isolation, TB, Varicella, rubeola, suspected AFB disease in patient |
|
|
Term
for patients on droplet isolation, the room should be.. |
|
Definition
negative air pressure, 6-12 air changes per hour, discharge air outside or monitor filtration if air is recirculated |
|
|
Term
|
Definition
<7.35, low bicarbonate <22,Eq/L |
|
|
Term
symptoms of metabolic acidosis |
|
Definition
increased respirations (get rid of excess Co2), tachycardia |
|
|
Term
who is at risk for developing metabolic acidosis? |
|
Definition
diabetics, ppl who consume toxins.. |
|
|
Term
|
Definition
HIGH PH, >7.45, high bicarbonate >26 meq/L |
|
|
Term
symptoms of metabolic alkalosis.. |
|
Definition
respiratory depression (tries to retain Co2), tachycardia, excessive acid losses |
|
|
Term
risks for metabolic alkalosis |
|
Definition
loss of acidic gastric juices, ng tubes, vomiting |
|
|
Term
what may hyperkalemia occur with? |
|
Definition
|
|
Term
what may hypokalemia occur with? |
|
Definition
|
|
Term
respiratory acidosis ph.. |
|
Definition
low pH, <7.35 PaCo2 > 42 mmg HG |
|
|
Term
symptoms of respiratory acidosis.. |
|
Definition
feeling of fullness in head, increased HR, respirtory rate, and Bp, |
|
|
Term
people at risk for resp. acidosis.. |
|
Definition
COPD, poor ventilation increases retention of CO2 |
|
|
Term
respiratory alkalosis ph.. |
|
Definition
|
|
Term
symptoms of respiratory alkalosis.. |
|
Definition
always due to hyperventilation, symptoms include lightheadedness, inability to concentrate, parasthesia, |
|
|
Term
what helps avoid loss of too much Co2 |
|
Definition
breathing through a paper bag |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
fatique, anorexia, nausea, vomiting- dysrhytmias (can be lethal) |
|
|
Term
dysrhythmias from hypokalemia can be fatal.. |
|
Definition
|
|
Term
|
Definition
5.0.. manifestations.. cardiac changes, dysrhthmias, bradycardia, muscle weakness w potential respiratory impairment, chest pain, paresthesia (limb falling asleep) anxiety GI issues |
|
|
Term
what should you avoid in cases of hyperkalemia? |
|
Definition
salt substitutes, and high K food, banana, tomato, eggplant, strawberries, cauliflower and bell peppers |
|
|
Term
what is the most obvious indicator for a patient with a fluid imbalance.. |
|
Definition
|
|
Term
|
Definition
edema, distended neck veins, abrnomal lung sounds, tachycardia, increased weight, BP and CVP, fluid retention, third spacing |
|
|
Term
|
Definition
pain pulse pallor parasthesia paralysis |
|
|
Term
what can cause hypokalemia.. |
|
Definition
di ya reh tickkkks like Lasix cause K depletion |
|
|
Term
compartment syndrome is bad bc, why does it happen?.. |
|
Definition
patient could lose limb, cast was put on incorrectly |
|
|
Term
what are deformities of the hand fingers, and wrist cause by injury to the muscles in forearm called? |
|
Definition
Volkmann's ischemic contracture |
|
|
Term
symptoms of compartment synrdome.. |
|
Definition
pain distal to injury, pain w passive ROM, inability to extend digits, paresthesia, pallor, coolness, dimished/absent pulses |
|
|
Term
you should never do what to a limb w compartment syndrome? |
|
Definition
elevating or applying ice is BAD |
|
|
Term
|
Definition
chest pain, tachnypea, dypsnea, cyanosis, decreased PaO2, tachycardia, mental status change, petechia, lower extremity fractures |
|
|
Term
treatment for fat emboli.. |
|
Definition
ICU, fluid maintenance, acidosis, immbobilization, oxygen, CDB exercises |
|
|
Term
nursing interventions for patient w hip/femur surgery.. |
|
Definition
neurovascular checks, check for infcetion, SKIN CARE IS PRIMARY, pain |
|
|
Term
postop nursing care for patient with an ORIF.. |
|
Definition
suture and drain care, incisiona assessment, skin integrity-5ps, pain control |
|
|
Term
for a client with internal fixation/hip surgery |
|
Definition
hip abduction pillow, inbetween legs strapped, to prevent adduction or turning to affected side |
|
|
Term
primary nursing diagnosis for pt with open fracture. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
what med would not be given to a bed ridden patient? |
|
Definition
biphosphonates (for osteoporosis, inhibit osteoclast resorption) |
|
|
Term
|
Definition
used to immobilize, position and align the lower extremity in the treatment of contractures and diseases of hip and knee. |
|
|
Term
why are bucks traction devices used? |
|
Definition
used for hip fractures that cannot go directly into surgery bc of factors like low potassium levels |
|
|
Term
with a bucks traction, make sure.. |
|
Definition
weights are not touching the floor, styrofoam straps- prevent muscles spasms |
|
|