Comfort - Chronic Fatigue

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A pregnant client is prescribed iron supplements to treat​ iron-deficiency anemia. Which foods should the nurse instruct the client to ingest to help with this health​ problem? A.Broccoli and potatoes B.Yogurt and milk C.Beans and meat D.Apples and bananas

A.Broccoli and potatoes Rationale: The foods that are important for the pregnant client to add for​ iron-deficiency anemia include broccoli and potatoes. Broccoli and potatoes are high in vitamin​ C, which increases iron absorption. Any foods high in vitamin C should be encouraged to be added to the diet of a client taking iron supplements.​ Yogurt, milk,​ beans, meat,​ apples, and bananas are healthy foods that provide other necessary​ macro- and micronutrients necessary to maintain a healthy pregnancy.

The healthcare provider is not sure about the cause of fatigue in a client whose symptoms are inconsistent and prescribes tests to narrow down possible causes. For which health problem should the nurse expect tests to be prescribed for this​ client? (Select all that​ apply.) A.Hormone levels B.Hypertension C.Liver dysfunction D.Kidney functioning E.Anemia

A.Hormone levels C.Liver dysfunction D.Kidney functioning E.Anemia ​Rationale: Diagnostic tests are often ordered to find the underlying cause of fatigue. Typical causes of fatigue include​ anemia; changes in​ endocrine, kidney, or liver​ function; and infection. There is no test for hypertension.

The nurse prepares an educational program on the effect of exercise on fatigue for a group of staff nurses. Which medical diagnosis should the nurse identify as responding positively to exercise as an intervention to combat​ fatigue? (Select all that​ apply.) A.Multiple sclerosis B.Fibromyalgia C.Cancer D.Obstructive sleep apnea E.Chronic fatigue syndrome

A.Multiple sclerosis B.Fibromyalgia C.Cancer D.Obstructive sleep apnea ​Rationale: Clients with​ cancer, obstructive sleep​ apnea, multiple​ sclerosis, and fibromyalgia respond positively to exercise to combat fatigue. Clients with chronic fatigue syndrome should use caution before beginning exercise.

A client is being prescribed tests for chronic fatigue syndrome. Which is a basic characteristic required in the diagnosis of this health​ problem? A.Not caused by a primary health condition B.Lasting more than​ 1-year minimum C.No response to antidepressants D.Response to certain sedatives

A.Not caused by a primary health condition ​Rationale: Chronic fatigue syndrome lasts more than 6 months​ minimum, not 1 year. It is not caused by a primary health​ condition, and it is not relieved by stress reduction. Response to medications has nothing to do with the diagnosis.

The healthcare provider prescribes erythropoietin for a client experiencing chronic fatigue. What should the nurse realize as the purpose for this​ medication? A.Stimulate red blood cell production B.Stimulate the release of stored ferritin C.Stimulate white blood cell production D.Increase the affinity of iron to hemoglobin

A.Stimulate red blood cell production ​Rationale: For a client with chronic​ fatigue, erythropoietin is used to stimulate red blood cell production. Clients with fatigue related to​ iron-deficiency anemia will receive iron supplements​ and/or erythropoietin to stimulate the production of hemoglobin and red blood cells. Erythropoietin does not stimulate white blood cells or the release of stored​ ferritin, nor does it increase the affinity of iron to hemoglobin.

The nurse prepares to complete a physical assessment of a client with fatigue. On which area will the nurse focus during this​ assessment? (Select all that​ apply.) A.Health education B.Hydration C.Body mass index D.Mobility E.Muscle strength

B.Hydration D.Mobility E.Muscle strength Rationale: The physical assessment of a client with fatigue includes assessment of​ mobility, hydration, and muscle strength. It does not measure health education or body mass index.

The nurse plans care for an adolescent female client experiencing fatigue caused by anemia. Which independent intervention should the nurse select for this​ client? (Select all that​ apply.) A.Suggest the use of a pedometer. B.Identify foods rich in​ nutrients, including iron. C.Administer medications for​ iron-deficiency anemia. D.Point out methods of good sleep hygiene habits. E.Encourage the client to take a yoga class.

A.Suggest the use of a pedometer. B.Identify foods rich in​ nutrients, including iron. D.Point out methods of good sleep hygiene habits. E.Encourage the client to take a yoga class. Rationale: Independent interventions include identifying foods rich in​ nutrients, encouraging the client to take a yoga​ class, suggesting the use of a​ pedometer, and pointing out methods of good sleep hygiene habits. Administering medications for​ iron-deficiency anemia is a collaborative intervention.

An older client reports feeling tired most of the time. Which response indicates that the nurse understands the relationship of fatigue in an older​ client? A.​"I would like to review your diet and exercise​ routine." B.​"An infection may be the cause of your​ fatigue." C.​"It is normal to experience fatigue when you are​ older." D.​"I would like to review your TSH​ levels."

A.​"I would like to review your diet and exercise​ routine." Rationale: Poor nutritional intake and lack of exercise can contribute to fatigue in the older adult. There is no assessment data available that supports an abnormal TSH level or infection. While it is normal for an older adult to experience​ fatigue, it is important to assess the client for the underlying cause of fatigue before assuming it is due to age.

The nurse reviews collected data and suspects that a client is experiencing chronic fatigue. Which finding supports this health​ problem? (Select all that​ apply.) A.Quick resolution B.No response to night of sleep C.Mental or physical exhaustion D.Temporary condition E.No response to sedatives

B.No response to night of sleep C.Mental or physical exhaustion ​Rationale: Chronic fatigue produces mental or physical​ exhaustion, with no response to a night of sleep. It does not involve sedatives or other medications. It is not a temporary​ condition, nor does it resolve quickly.

An older adult client with difficulty ambulating and nocturia reports an onset of fatigue since taking a new medication for high blood pressure. Which is a likely contributor to this​ client's fatigue? A.Hypotension effect B.Hypertension medication C.Lack of mobility D.Ongoing nocturia

B. Hypertension Medication ​Rationale: A likely contributor to the fatigue would be the new hypertension medication. The report of fatigue did not indicate hypotension. Ongoing nocturia and lack of mobility have been a stable​ situation, rather than a recent change.

The nurse completes the assessment of a client with chronic fatigue syndrome. Which nursing diagnosis should the nurse identify as being appropriate for this​ client? (Select all that​ apply.) A.Fluid​ Volume: Excess B.Activity Intolerance C.Sleep Deprivation D.​Injury, Risk for E.​Coping: Readiness for Enhanced

B.Activity Intolerance C.Sleep Deprivation E.​Coping: Readiness for Enhanced Rationale: Nursing diagnoses appropriate for a client with chronic fatigue syndrome include​ Coping: Readiness for​ Enhanced; Activity​ Intolerance; and Sleep Deprivation. The other diagnoses are not associated with chronic fatigue syndrome.​ (NANDA-1 ©2014)

The nurse has recommended exercise to a client with a complaint of fatigue. The client​ states, "Exercising does not make sense when I am feeling so tired. All I want to do is just relax on the​ couch." Which response by the nurse provides the most accurate​ information? A.​"A high-intensity program will help combat your​ fatigue." B.​"A mild to moderate exercise program has proven to be effective in reducing​ fatigue." C.​"A moderate exercise program is a form of cognitive behavioral​ therapy." D.​"Exercising will help you sleep throughout the night so you are refreshed in the​ morning."

B.​"A mild to moderate exercise program has proven to be effective in reducing​ fatigue." ​Rationale: The response by the nurse that provides the most accurate information is​ "A mild to moderate exercise program has proven to be effective in reducing​ fatigue." A sedentary lifestyle can lead to fatigue and other health complications. Clients who report persistent fatigue should be encouraged to begin a healthcare​ provider-approved mild to moderate exercise regimen. Higher intensity exercise does not appear to produce a greater reduction in​ fatigue, so clients should be instructed to avoid intense workouts that may increase feelings of fatigue. An exercise program is not a form of cognitive behavioral therapy and exercise may not necessarily help the client sleep throughout the night.

A client having a routine physical​ states, "I​ don't understand why I am so tired—I only work​ 8-hour days sitting at my desk and rest when I get home. What can I do to increase my energy​ level?" Which intervention should the nurse select to address the​ client's feeling of​ fatigue? A.Refer the client to an alternative healthcare provider. B.Request a sleep study from the healthcare provider. C.Collaborate with the healthcare provider to implement a graded exercise program. D.Request a referral to a neurologist.

C.Collaborate with the healthcare provider to implement a graded exercise program. ​Rationale: The client with a sedentary position and lifestyle may benefit from a graded exercise program. This type of exercise program gradually builds up stamina for​ exercise, which will contribute to the feeling of increased energy. It is not necessary to request a referral to a neurologist. A sleep study is prescribed for clients to rule out a sleep disorder and is not necessary at this point in time. A nurse does not make referrals to alternative healthcare providers.

The nurse completes the health history with a client who is pregnant and works as a computer mainframe programmer. For which nonmodifiable risk factor is this client prone to experiencing​ fatigue? A.Medications B.Stressful job C.Female gender D.Physical inactivity

C.Female gender ​Rationale: Being a woman is a nonmodifiable risk factor for fatigue. A stressful​ job, medications, and physical inactivity are modifiable risk factors for fatigue.

The home care nurse is planning nursing interventions for a client with chronic fatigue syndrome who is unable to get out of bed most of the time. Which intervention should be delayed until the​ client's condition​ improves? A.Encourage the client to participate in decision making. B.Teach effective coping techniques. C.Help the client to surpass the previous​ day's exercise. D.Include the family in the​ decision-making process.

C.Help the client to surpass the previous​ day's exercise. Rationale: Considering that the client is unable to get out of bed most of the​ time, helping the client to surpass the previous​ day's exercise is unrealistic. The other interventions are appropriate for this​ client's current health status.

The nurse is caring for a client who reports chronic fatigue. Which test aids in determining whether the​ client's fatigue is caused by an underlying biological​ factor? A.White blood cell​ (WBC) count B.Chemistry panel C.Hematocrit and hemoglobin tests D.Magnetic resonance imaging​ (MRI)

C.Hematocrit and hemoglobin tests ​Rationale: Hematocrit and hemoglobin lab tests will determine whether the client has​ iron-deficiency anemia, leading to fatigue. While the client may have the additional tests​ performed, the other tests do not help to determine the cause of the​ client's fatigue.

The nurse encourages the parents of a child with fatigue to keep a journal about the​ child's behavior. Which items should the parents include in that​ diary? (Select all that​ apply.) A.Temper tantrums B.Favorite toys C.Morning wake time D.Breakfast and other meals E.Evening sleep time

C.Morning wake time D.Breakfast and other meals E.Evening sleep time ​Rationale: The​ child's diary should include the time the child falls asleep and wakes​ up, as well as breakfast and other meals. Temper tantrums and favorite toys are not relevant to record.

The nurse is caring for a client experiencing chronic fatigue. The client​ states, "I​ don't know why I cannot get this under​ control, I feel​ useless." Which can the nurse implement in the plan of care to increase the​ client's self-worth? A.Assess the​ client's social support network. B.Establish a rapport with the​ client's family and encourage them to participate in the plan of care. C.Facilitate the process of setting​ long-term goals with the client. D.Encourage the client to become involved in the decision making.

D.Encourage the client to become involved in the decision making. Rationale: For clients with chronic​ conditions, inadequate coping mechanisms may contribute to prolonged feelings of fatigue.​ Therefore, the nurse should encourage the client to be involved in the​ decision-making process to increase their feelings of​ self-worth. Assessing the​ client's social support network and establishing a rapport with the​ client's family and encouraging them to participate in the plan of care are important to address ineffective coping.​ Short- and​ long-term goals are important to establish. The​ short-term goals will provide the client a sense of accomplishment.

A female client seeks medical attention for​ fatigue, weight​ gain, muscle​ weakness, and joint stiffness. Which etiology is most likely associated with the​ client's clinical​ manifestations? A.​Iron-deficiency anemia B.Chronic fatigue C.Chronic fatigue syndrome D.Hypothyroidism

D.Hypothyroidism ​Rationale: The etiology most likely associated with this​ client's symptoms is hypothyroidism. Hypothyroidism can be confirmed with a laboratory test and treated with a thyroid hormone supplement. Chronic fatigue is mental or physical exhaustion associated with a chronic condition or situation that is not resolved​ quickly, such as a chronic illness or poor lifestyle.​ Iron-deficiency anemia is not associated with weight gain or muscle weakness. Other mental health and physiological disease processes must be ruled out prior to diagnosing a client with chronic fatigue syndrome.

A client at 10​ weeks' gestation is experiencing fatigue. What information should the nurse provide to this client about this health​ problem? A.​"You are not sleeping well during this stage of the​ pregnancy, which can contribute to the​ fatigue." B.​"The fatigue you are feeling will continue throughout the​ pregnancy." C.​"The fatigue you are experiencing is due to the rapid growth of the​ fetus." D.​"The fatigue should lesson in your second​ trimester."

D.​"The fatigue should lesson in your second​ trimester." ​Rationale: The fatigue in the first trimester is due to the fact that the body uses large amounts of energy to build the placenta. Hormonal changes can also contribute to fatigue. The fatigue should lesson in the second​ trimester, and if it​ persists, it may be a sign of iron deficiency anemia. The fetus experiences rapid growth in the third​ trimester, contributing to physical stress and disrupted​ sleep, which results in fatigue. Sleep disruption in the first trimester is not the primary cause of fatigue.


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