functional quadriplegia

Is anyone trying to capture " functional quadriplegia" for someone who is morbidly obese?
I have a patient with a BMI of 91.0. nursing notes reflect bedbound, cannot do any of her care, 4 person assist bed to bed transfer.....

Just a thought.
Thanks in advance!

Lona McNamara, RN, BSN, CCM

Comments

  • Yes we would ask for functional Quad
  • the Braden Scale, used by nursing to predict a patients risk for developing pressure ulcers could be helpful in supporting  the diagnosis of functional quadriplegia, the two measures are mobility- completely immobile or very limited and Activity- bedfast (confined to bed) or chairfast (ability to walk severely limited or nonexistent. cannot bear own weight and/or must be assisted into chair or wheelchair). remember all the documentation in the medical record should support the diagnosis.

  • Excellent point offering context and clinical support.
  • Absolutely.  If you can support with clinical indicators and treatment/monitoring/eval ---go fo it. 
  • I use the criteria that the patient must be fully dependent upon care personnel for feeding, toileting, bathing, grooming, mobility, and any other ADL’s required.  Consider the level of care a truly quadriplegic patient requires.  The care of a functionally quadriplegic patient must be identical.  The risk for infections, pressure ulcers, etc. should be identical for a functionally quadriplegic.   If you can prove that standard, go for it. 


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