Ch. 32 Physical Activity & Mobility

A 15-year-old patient complains of left ankle pain after being tackled while playing football. He asks the nurse what tests he needs to have to determine whether he has a strain or a fracture. How should the nurse reply?

"Sprains, strains, and fractures have similar symptoms at first; you will need an x-ray of the joint to be certain."

A teenage boy was hospitalized 3 weeks ago. He has been confined to bed throughout his hospital stay because of a crushed pelvis. His parents tell the nurse, "Our son is just staring off into space; he won't talk to us. We are worried because he has not even listened to his iPod, watched television, or played his video games for 2 days. That is so unlike him." What is the best response the nurse can make?

"Your son had a major injury, and his immobility might be causing him to feel isolated and depressed."

A healthy 32-year-old man wants to start a fitness program to increase his muscle tone and muscle strength. What advice should the nurse offer him? "The U.S. Department of Health and Human Services recommends:

150 to 300 minutes or more of moderate-intensity physical activity per week"

A patient has started a fitness program. What program features illustrate that he has started a well-rounded program? Select all that apply.

Flexibility, Balance exercises, Resistance training, and Aerobic conditioning

A woman with a high-risk pregnancy with triplets is in preterm labor; she is on strict bedrest for 5 days. During this time, she has not had a bowel movement, although she normally passes stool daily. She describes feeling bloated and uncomfortable. What information should the nurse give the patient when explaining constipation?

Immobility often causes constipation.

An older patient with newly diagnosed osteoporosis asks the nurse to explain her health problem. Which of the following is the correct description of osteoporosis?

Loss of bone density that increases the risk of fracture

What would be the most appropriate goal for a frail, elderly patient with a nursing diagnosis of Risk for Injury after hip surgery?

Remain free from injury or falls throughout hospital stay.

What is the correct method for turning an adult patient who recently sustained a spinal cord injury?

Request help from another nurse to perform the logrolling technique.

Identify the most appropriate nursing diagnosis for promoting the safety of a frail, elderly patient after hip replacement surgery who also has a history of emphysema.

Risk for Injury related to medical condition

Which of the following patients would you expect to be at risk for decreased activity? Select all that apply.

Someone living in a skilled nursing facility, Healthy adult who works as a computer programmer, and Obese child who enjoys video games

Which of the following actions represent proper body mechanics for nurses providing care as well as teaching patients about safe body movements? Select all that apply.

Stand with the body in alignment and erect posture., Use a wide base of support with your feet at shoulder width., and Keep objects close to your body when carrying them.

When caring for a patient with osteoporosis, which of the following is the most important action to take to minimize progression of the disease?

Start a weight-bearing exercise program.

The nurse planning the care of a frail, malnourished, immobile patient recognizes which of the following as the best treatment to protect the patient's integument?

Turning the patient at least every 2 hours

The nurse attempts to transfer a totally dependent patient from a stretcher to a bed. What is the best step to reduce the musculoskeletal risk factors?

Use transfer roller sheet when transferring.

A man has been admitted to the hospital unit with a medical diagnosis of Chronic Obstructive Pulmonary Disease (COPD). He is receiving supplemental oxygen at 2 L/min via nasal cannula. Which positioning technique will best assist him with his breathing?

fowlers position

A patient is on strict bedrest for 5 days. During this time, she has not had a bowel movement, although she normally passes stool daily. She describes feeling bloated and uncomfortable. A nursing diagnosis that would best address a patient who is on bed rest is Constipation related to:

immobility

Which of the following is true of synarthroses? Joints are:

immovable

The nurse teaching a patient about ways to regain strength after a period of prolonged immobility advises the patient to seek assistance from a physical therapist. Which type of exercise is performed using specialized apparatuses that use resistance at a constant, preset speed?

isokinetic

A nurse is assessing a healthy, older adult patient for an exercise program to be offered at the local hospital. During the evaluation, the nurse notes the following vital signs: P = 72, RR = 16, BP = 132/70. After 3 minutes of moderate-intensity running on the treadmill, the patient becomes short of breath and states, "I have to stop. I can't do this anymore." The nurse measures his vital signs again: P = 152, RR = 40, BP = 172/98. She instructs him to rest. Vital signs return to baseline after 15 minutes. The nurse should recognize his symptoms as associated with which of the following?

limited activity tolerance

Which of the following body systems must interact to produce mobility and locomotion? Select all that apply.

muscles, skeleton, and nervous system

The nurse providing care to the patient with a fracture explains how bones heal. Which type of cells repair damaged bone and build new bone to keep the skeleton strong?

osteoblasts

A nurse is caring for a 25-year-old male quadriplegic patient. Which of the following treatments would the nurse perform to decrease the risk of joint contracture and promote joint mobility?

passive ROM

The nurse assessing the mobility of a patient with Parkinson's disease might expect to observe which type of gait?

propulsive

A nurse has been asked to design an exercise program with the goal of increasing a client's muscular strength and endurance. Which exercise program would specifically focus on meeting that goal?

resistance training

The nurse is helping the patient to perform leg exercises after surgery to prevent thrombophlebitis. Which type of muscle is the patient using for these exercises?

skeletal

An 82-year-old patient is unsteady on her feet when walking about the room. She reports feeling a little sore but has no complaints of weakness. What is the appropriate piece of equipment to use when helping her ambulate?

transfer belt

A 32-year-old with a high spinal cord injury has been admitted to the hospital for antibiotic therapy to treat pneumonia. He lives independently and has developed strong upper-body strength to maximize his independence. Which transfer device should be used when transferring him from the bed to his wheelchair?

transfer board

The nurse is instructing a patient about the need to replace fluid before, during, and after exercise to avoid dehydration. On what basis should she teach the patient to determine the amount of fluid to consume? Select all that apply.

Duration of exercise and Environmental temperature

The nurse is helping an 82-year-old patient to ambulate in the hallway. Suddenly she states, "I feel so light-headed and weak," as her knees begin to buckle. The nurse's best action at this time would be to:

Assist the patient to slide down his leg as he guides her to a seated or lying position

What action is most important in limiting the nurse's risk of back injuries?

Avoid manual lifting by using assistive devices as often as possible.

According to the U.S. Department of Health and Human Services 2008 Physical Activity Guidelines for Americans, which of the following statements about the benefits of physical activity is correct?

Combining aerobic and muscle-strengthening activities promotes better health.

When encouraging a fitness program for healthy older adults, what must the nurse consider?

Older adults at risk for falling should do activities that maintain or improve balance.

Which course of action taken by her patient with osteoporosis would allow the nurse to know that her teaching was effective?

Participating in an aerobic barbell strength class at the gym three times a week

A patient fractured her right ulna 8 weeks ago and has just had her cast removed. The orthopedic surgeon prescribes isometric exercises for the right arm. Which of the following exercises complies with the surgeon's orders?

Press the right hand against a wall; hold this position for 6 to 8 seconds, and repeat 5 to 10 times.

A frail, elderly man is admitted to the hospital after a fall at home resulted in a left hip fracture. After surgery, he is to begin ambulating with a walker but must avoid weight bearing on his left lower leg. What is the best intervention to help him use his walker?

arm resistance training

The nurse planning care for a patient after severe head trauma and long-term unresponsiveness considers which effect of immobility affecting the lungs? Select all that apply.

atelectasis and pooled secretions

To achieve balance, body mass must be distributed around which point?

center of gravity