Mobility

•A client sustains an open fracture of the left femur. A Steinman pin is inserted, and the client is placed in traction. In performing the initial assessment, the nurse finds the client has slipped down toward the foot of the bed and the traction weight is resting on the floor. The initial nursing action is to •1. remove the weight and move the client to correct the alignment of the bed •2. notify the attending physician •3. help the client use the trapeze to pull himself up in the bed •4. check the pedal pulse and capillary refill of the right foot •

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•The nurse is performing discharge teaching to a client going home with an external fixator. Which will the nurse include in the teaching? Select all that apply A. Assess pin sites for drainage and redness B. Elevate the extremity above the heart c. Move the extremity by the fixator bars d. Report to the health care provider and numbness, tingling and increase pain e. Move the extremity by placing your hand under the fracture site

A,B,C,D all are things that would be taught in discharge teaching to a client being discharged with an external fixator on an extremity. . We would also want to discuss complication or s/s of complications that we would assess for so that they would know to report to a health care provider Such as s/s of a fat embolism or DVT or s/s of compartment syndrome

A patient who fractured the right arm is unable to extend the fingers. The right hand is cool to touch, the radial pulse is weak and the pain level is 7 (on a 0 -10 scale) after receiving morphine 45 minutes ago. The nurse recognizes these findings may indicate A. fat embolism. B. sepsis. C. deep vein thrombus. D. compartment syndrome.

Answer D Assessment / application Rationale: d s/s listed are seen with compartment syndrome and this can commonly occur with arm fractures. the s/s listed are not commonly seen with fat embolism (s/s include severe anxiety, respiratory

•A client has been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? •A. fluid overload •B. Dysphagia •C. Abdominal cramping •d. anorexia

Application style question that relates to physiological adaptation and safety Answer: b Rationale: Dysphagia ( difficulty swallowing often relates to decrease muscle tone and they are at risk for malnutrition, aspiration and aspirate pneumonia

•The nurse is teaching the client with a total hip replacement on the type of chair to sit on during the postoperative recovery period. Which chair would be the correct type to recommend? •A. swivel chair •B. padded upholstered chair •C. a high back chair with arm rest •D. recliner with an attached footrest

C

The client is taking Sinemet for Parkinson's disease. What is the scientific rationale for combining carbodopa and levodopa? A.There will be fewer side effects with this combination than with carbodopa alone. B.Dopamine requires the presence of both chemicals to work. C.Carbidopa makes more levadopa available to the brain. D.Carbidopa crosses the blood brain barrier to treat PD.

C. Carbidopa makes more levodopa available to the brain

•A nurse is providing education for a client who is at risk for osteoporosis. Which of the following instructions would the nurse include? • •A. follow a keto diet (high fat) •B. Swim 30 minutes 3 times a week •C. avoid outside activities in the sun •D. Walk for 30 minutes 4 times a week

D is correct Primary osteoporosis occurs in women after menopause Secondary osteoporosis result of meds and disease that affect bone metabolism. Men more likely secondary

The client is taking Sinemet for Parkinson's. What diet will the nurse teach the patient to follow to enhance the medication's effectiveness? A.Low fat, low carbohydrate B.High protein, lactose free C.High fiber, low residue D.Low protein, high fiber •

D. Low protein, high fiber

The nurse is caring for a client admitted with a fractured humerus. The nurse assesses the client when entering the room - see assessment below •Objective •BP 100/60,HR110,RR24,T37.7 •O2 sat 85% on room air •Confused to time and place and oriented to self •Neurovascular checks intact •Subjective •" I fell like I cannot breathe" •"where am I" •Pain 5/10 What conclusions can the nurse make about the client's condition? 1. Exhibiting signs of fat embolism 2. Exhibiting signs of compartment syndrome 3. Experiencing side effects of narcotics given for pain 4. Acute renal failure

Fat embolism

•A nurse is caring for a client who is postoperative total hip arthroplasty. Which of the following laboratory values would the nurse report to the health care provider? •A. HgB 8 g/dl •B. HgB 12g/dl •C. WBC 10,600 mm •D. WBC 4,850 mm

Normal 12-18 Risky 8-11 Below 7 A hgb of 8 is considered low for both male and female . Total hips do lose blood due to reaming out the femur to place prothesis

•Place in order or sequence for climbing the stairs: •A. Shift weight from crutches to unaffected leg ( good) •B. Place body weight on crutches •C. Advance the unaffected leg (good) onto the stair •D. Bring the crutches and the affected leg(bad ) up to the stair

Order should be b, c, a, d

•The parent of a child with Duchenne's muscular dystrophy asks about the chance that a next child will have the disease. What would the nurse tell the parent? •1. Sons have a 50% chance of being affected •2. Daughters have a 1 in 4 chance of being carriers •3. Each child has a 1 in 4 chance of developing the disease •4. Each child has a 50% chance of being a carrier • •

Rationale: 1. Duchenne's is a x - linked recessive disorder. The gene is transmitted through female carriers to affect sons 50% of the time. Daughters have a 50% of being a carrier. Application , physiological adaptation question

The nurse teaches the parent of a young child with Duchenne's muscular dystrophy about the disease and its management. Which statement by the parent indicates successful teaching? 1. "My son will probably be unable to walk independently by the time he is 9 to 11 yrs old" 2. "Muscle relaxants are effective for some children: I hope they can help my son" 3. "When my son is a little older, he can have surgery to improve his ability to walk" 4. "I need to help my son be active as possible to prevent progression of the disease"

Rationale: MD is a progressive disease. Children affected usually are unable to walk independently by age 9 to 11. No effective treatments. Although children who remain active are able to avoid w/c confinement for a longer period of activity but it does not prevent progression of the disease

The nurse is caring for a client diagnosed with Parkinson's disease. The client presents with the following data: Objective: oriented to person , time , place . Tremor noted in right hand at rest. Drooling noted from right side of mouth, mask like facial expression Crackles present in bilateral lobes with non productive cough Vital signs 38.7 130/62, 76, 28 Subjective: "feeling tired and short of breath" significant other responds that they are having difficulty eating last 3 weeks with weight loss of 10 lbs and choking when drinking fluids Which of the following is the priority intervention at this time? 1. Request a speech therapy evaluation 2. Request a physical therapy evaluation 3.Place client on calorie count x 3 days 4. Place on O2 2 liters nasal cannula

answer is 1. Client requires a speech therapy evaluation . This evaluation will determine the type of consistency of diet/liquids and prevent aspiration of fluids . Physical therapy to keep the client moving is important and a calorie count could be done to see how many calories the client is taking in daily. Important related to weight loss. More data would be needed prior to placing oxygen such as an oxygen saturation rate. From the data listed of crackles and shortness of breath and slightly elevated temperature is aspirate pneumonia