Sleep and activity

Tom, an 84-year-old with arthritis and lung disease, takes a diuretic twice a day to remove the fluid from his lungs. He lives alone and wonders what will become of his cat once he's gone. What factors can impact his sleep? Select all that apply. A. Frequent urination B. Difficulty breathing C. Old age D. Pain E. Anxiety

A,B,C,D,E

joint mobility

- # of Degrees an articulation (where two bones meet) can move before it's restricted by surrounding tissues (ligaments/ tendons/muscles/etc). -AKA Range of Uninhibited Movement around a joint

stages of sleep

1. Lightest Sleep (NREM) 2. Slightly Deeper Sleep (NREM) 3. Deeper Sleep (NREM) 4. Delta Waves are omitted but there is not much difference between this stage and stage 3 (NREM) 5. REM

N2

10 -15 minutes

The toddler's interest in gender sexuality is characterized in what way? A. Touching his or her genitalia and being naked B. Learning how and why his or her anatomy differs from that of other children C. Playing and developing friendships with children of the opposite sex D. Spending most of his or her time with the parent of the opposite sex

A

Which statement by the nurse would be supportive in opening a dialogue about sex? A. "It's common for people to feel sexually frustrated after this type of illness." B. "You can expect changes in your libido from this medicine." C. "Next, I have to ask you about your sexual patterns." D. "Let me know whether it is difficult for you to discuss sex."

A

Hector is a 14-year-old at the clinic for his annual exam and discussion of preventive health measures. What is the priority teaching need? Make the Connection. Drag and drop proper term that is best exemplified by each case scenario. A. Self-examination B. Premenstrual Syndrome C. Douching D. Contraception E. Menopause F. Menstruation G. Body Function and Reproduction H. Preventing Sexually Transmitted Infections

A Testicular cancer most commonly affects men younger than age 30. Those in this age group should perform monthly testicular self-exams to feel for lumps, just as females should perform monthly breast self-exams. If any abnormalities are found, they should seek medication attention.

balance

A condition in which different elements are equal or in the correct proportions. There are three types of visual balance: symmetry, asymmetry, and radial.

circadian rhythm

A physiological cycle of about 24 hours that is present in all eukaryotic organisms and that persists even in the absence of external cues.

The nurse tries some relaxation techniques with the client to promote sleep. Which would be appropriate? Select all that apply. A. Aromatherapy B. Massage C. Sedatives D. Cool shower E. Manicure

A,B

Miriam is excited to go home. Which of the following are key elements of discharge planning? Select all that apply. Include her husband during instructions. A. Arise from bed slowly to prevent or reduce dizziness. B. Remove loose rugs and obstacles that may cause problems. C. Stop using the walker when she's feeling strong enough. D. Walk around the block several times a day independently.

A,B,C The inclusion of her caretaker is beneficial to support her discharge teaching plan. Although she is better, she is still weak from extended bed rest. Care must be taken upon arising and while ambulating to avoid another fall.

The nurse, Peter, knows that Mariam is at a higher risk for injury as a result of her immobility. Which assessment changes indicate a potential complication of immobility? Select all that apply. A. crackles in both lung bases B. Edema of the feet C. reddened area in the coccyx D. increased appetite E. Diarrhea

A,B,C There are many hazards resulting from immobility. Stress on the muscle and bones leads to muscle atrophy and joint stiffening. Hypoventilation leads to fluid accumulation in the alveoli of the lungs. Circulatory concerns include venous pooling, edema, and fluid in the tissue leading to skin breakdown. A person will also experience orthostatic hypotension from the pooling of blood. Metabolism slows, decreasing appetite; peristalsis decreases, leading to paralytic ileus; and urine stagnates in the bladder, increasing the risk of infection and stone formation.

A client has a diagnosis of insomnia. Which factors can create this disorder? Select all that apply. A. Chronic stress B. Severe anxiety C. Chronic depression D. Generalized pain E. Environmental noise

A,B,C,D

The nurse is educating a group of teens about contraception. What options are available? Select all that apply. A. Birth control pills B. Spermicides C. Depo-Provera injections D. Diaphragm E. Intrauterine device

A,B,C,D,E

Which interventions promote nighttime sleep in the hospitalized client? Select all that apply. A. Aromatherapy B. Daily naps C. Back massage D. Clustering care E. Watching television

A,C,D

Parasomnias

Abnormal behaviors such as night terrors sleepwalking sleep talking bruxism enuresis

Light sleep and slowing brain and body processes are associated with which stage of NREM sleep? a. I b. II c. III d. IV

B

Sleep process

Awake - NREM stage 1 - NREM stage 2 - NREM stage 3 - NREM stage 4 - NREM stage 3 - NREM stage 2 -REM -

A client is being transferred from the bed to a stretcher for surgery using a transfer board. What should be the nurse's first action? A. Lower the stretcher below the level of the bed. B. Explain the procedure to the client. C. Place the client in the prone position. D. Place the bed in the lowest position.

B

A nurse is caring for a 25-year-old client who is quadriplegic. Which treatment would be a priority to decrease the risk of joint contracture and promote joint mobility? A. Active ROM B. Passive ROM C. Turning every 2 hours D. Applying a trochanter roll

B

The client is being educated about the use of crutches after a cast was applied to his left ankle. What directions by the nurse are most important before discharge? A. "Be careful of slippery floors and puddles." B. "Let me see you use the crutches to walk around the nurses' station." C. "Keep the crutches close to you during the night in case you need to get up." D. "Don't lean or swing on the crutches.

B

The nurse is assessing the sleep patterns of a client who has not been sleeping well, leading to fatigue and frustration. How could the nurse best evaluate the situation? A. Suggest sleep medicine and then see whether the situation improves. B. Have the client keep a sleep diary. C. Visit their environment to determine whether it's conducive to sleep. D. Ask the client's significant other about concerns that he or she sees.

B

To maintain proper posture, is important to A. Sleep on the softest mattress possible B. avoid arching shoulders forward when siting C. keep your knees locked when standing upright D. Keep your stomach mucles relaxed to prevent back spasms

B

Which client teaching would be most therapeutic for someone with a sleep disturbance? A. Give yourself at least 10 minutes to fall asleep. B. Do not go to bed feeling upset about a conflict. C. Avoid eating carbohydrates before going to sleep. D. Catch up on sleep by napping or sleeping in when possible.

B

Which factor has a positive effect on the quality of sleep? A. Sleeping in a quiet environment B. Sleeping hours that synchronize with the circadian rhythm C. Spending additional time in stage II of the sleep cycle D. Sleeping in a dark environment

B

Which intervention in the immobile client's plan of care best helps develop muscle strength? A. Consume a diet high in protein. B. Perform AROM each hour. D. Use overbed trapeze to pull self up in bed. E. Log-roll client every 2 hours.

B

Which statement by the client indicates emotional distress from immobility? A. "I'm looking forward to being out of bed." B. "I don't even care if I get cleaned up or not." C. "I'm getting 6 to 7 hours of sleep each night." D. "There's nothing good on television."

B

Susan commonly misses a day or two of work each month because of severe headaches and cramping prior to her menstrual cycle. What is the priority teaching need? A. Self exam B. Premenstrual syndrome C. Douching D. Contraception E. Menopause F. Preventing STI G. Menstruation H. Body function and reproduction

B Premenstrual syndrome (PMS) is a result of changing hormones and impacts each female differently. The nurse should educate the client about nonpharmacological treatments that can improve the symptoms. Examples include getting adequate sleep; eating small, frequent meals; reducing sugar, caffeine, alcohol, and salt in the diet; taking vitamins and mineral supplements; and exercising. Some women benefit from selective serotonin reuptake-inhibiting drugs if the nonpharmacological treatments are ineffective.

A nurse works three 12-hour shifts each week from 7 p.m. to 7 a.m. He finds that during his days off he wants to sleep all day, then he's up most of the night. What could improve his sleeping pattern? Select all that apply. A. Staying up all night and sleep all day on his days off B. Sleeping in a dark room C. Taking a barbiturate to induce sleep D. Developing a regular sleep routine E. Staying up all day after work

B,D

A client tells the nurse she is frustrated with how she feels before each menstrual cycle. What suggestions could the nurse make to improve the symptoms? Select all that apply. Three balanced meals a day Regular exercise Increase caffeine intake Avoid alcohol Avoid salt

B,D,E

Mariam is an active 69-year-old. She leads the pool aerobic exercise group in the senior retirement community that she and her husband moved to 3 years ago. She walks 2 miles each morning and eats a healthy, balanced diet. She is from a family with longevity and trusts she will have good health well into her 90s. As Mariam is walking to her exercise class, she steps off the curb and falls. She is taken to the emergency room and diagnosed with a fractured hip. She must be on bedrest and in traction for a week before surgery is scheduled. During that time, the pain is significant and she requires a large amount of pain medicine. Which factors contribute to her immobility? Select all that apply. a. Age b. Injury c. Nutritional status d. Abuse of body e. Stress

B,E Many things impact a person's mobility, including age, with young and old at highest risk; being obese or very frail; nutritional status; wear and tear, such as experienced by a manual laborer or athlete; stress level; environmental factors; and health status. Mariam is older but very active, so her age is not impacting her immobility, the injury is. The stress of hospitalization and the need for pain medicine are both decreasing her mobility.

A teenage client was hospitalized 3 weeks ago after a motor vehicle accident in which he crushed his pelvis. He remains on bedrest. His parents tell the nurse, "Our son is just staring off into space and won't talk to us. He doesn't want to listen to his music or watch television. That is so unlike him." What is the nurse's best response? A. "I will inform his doctor and see whether we can get your son started on an antidepressant medication." B. "He is at a critical time in his life; teens are often moody, and being in the hospital with an injury will only make that worse." C. "Your son had a major injury, and his immobility might be causing him to feel isolated and depressed." D. "He is bored because he has been in the hospital for 3 weeks; I'll try to find something new for him to do."

C

An 18-year-old comes to the clinic requesting birth control pills. When discussing sexual health, what action should the nurse take first? A. Urge the teen to practice healthy sexual behaviors. B. Inform her about the risk of pregnancy and STIs. C. Assess the teen's knowledge of sexuality and reproduction. D. Provide detailed information about birth control pills.

C

Shari comes to the clinic and says she feels "unclean down there" and that over-the-counter products are not helping the odor. What is the priority teaching need? A. Self exam B. Premenstrual syndrome C. Douching D. Contraception E. Menopause F. Preventing STI G. Menstruation H. Body function and reproduction

C Some women douche often, which washes away the normal flora of the vagina and increases the risk for an infection. Many also believe that douching is a way to prevent pregnancy after intercourse, which is not true. Douching is not necessary. If Shari continues to have odor after cleaning her perineum, she should seek medical attention.

The nurse is educating a client about the douching. What should be included in the conversation? Select all that apply. Works well for vaginal odor Must be at room temperature Increases risk of infection Does not prevent pregnancy Washes away the normal flora

C,D,E

An older adult client suffered left-sided paralysis from a stroke. Which are the best actions for this client? Select all that apply. A. Monitor for constipation. B. Encourage an even gait when walking in place. C. Assess the extremities for swelling and muscle atrophy. D. Encourage taking deep breaths frequently to hyperinflate the lungs. E. Teach the use of a two-point crutch technique for ambulation.

C,E

Sleep promote nursing intervention

Cluster care to avoid sleep disruption create restful and comfortable environment promote comfort and relaxations support bedtime routines or rituals offer food that promotes sleep maintain safety of client teach about sleep hygiene administer/ complete client teaching about sleep-inducing medication

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Alcoholic drink before bedtime PROMOTES COMPROMISES HAS NO IMPACT

Compromises Alcohol should be avoided, especially in the evening. Although it may induce sleepiness initially, it interferes with the sleep cycle and can cause disruptive sleep. Clients should also avoid caffeine-containing foods and beverages after the evening meal. Limiting all fluids in the evening may prevent sleep patterns from being disturbed by the need to urinate.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Taking naps before noon each day PROMOTES COMPROMISES HAS NO IMPACT

Compromises Napping, regardless of the time of day, can lead to nighttime insomnia. The exception is for the client who is ill. In this case, extra rest is necessary for healing.

sleep

Cyclical states/altered consciousness Decreased motor activity/perception Selective response to external stimuli

The nurse is conducting a sexual history with a client scheduled for cardiac surgery who has voiced concern about resuming sexual activities after surgery. Which statement by the nurse is best? A. "You can have sexual intercourse after your surgery, but there are predictable risks." B. "Your partner will be nervous about resuming sexual activities as well, but that is normal." C. "In about 2 months, you will be able to return to your normal sexual patterns." D. "You are expressing a very normal concern; perhaps we could discuss your feelings further."

D

Mariam has returned from surgery and is prescribed to begin increasing activity. Peter is prepared to help her get up for the first time. What is the most important action before beginning? A. Obtain a walker B. Obtain a gait belt C. Remove all obstacles D. Obtain additional assistance E. Determine level of motivation

D Mariam has been on bedrest for a week, had surgery, and is likely under the influence of anesthesia or pain medicine. She is at high risk for dizziness, weakness, and falling, so the nurse needs additional assistance before attempting to help her out of bed.

Juanita comes to the clinic for an annual examination. She shares that she prefers to be with women, but is open to threesomes with both male and female partners. Her goal is to "have fun" and not get pregnant. What is the priority teaching need? A. Self-examination B. Premenstrual Syndrome C. Douching D. Contraception E. Menopause F. Menstruation G. Body Function and Reproduction H. Preventing Sexually Transmitted Infections

D In order to prevent an unwanted pregnancy, it is important to consider contraceptive options. The only 100% effective method of contraception is abstinence. Options for Juanita could include withdrawal, spermicides, oral contraceptives, Depo-Provera injections, intrauterine device, diaphragm, hormonal implant, or sterilization. Juanita should also be instructed on condom use because these forms of contraception will not prevent an STI.

What suggestions can the nurse make to help improve an adult client's sleep? Select all that apply. A. Drink a glass of wine just before bed. B. Eat a large meal 1 hour before bedtime. C. Perform mild exercises 30 minutes before bed. D. Consume a small glass of warm milk at bedtime. E. Take a warm bath or shower before bedtime.

D,E

Miranda, a woman in her late 40s, comes to the clinic saying she is having difficulty sleeping and is experiencing night sweats. What is the priority teaching need? A. Self exam B. Premenstrual syndrome C. Douching D. Contraception E. Menopause F. Preventing STI G. Menstruation H. Body function and reproduction

E Menopause is the time in a woman's life when hormonal changes cause the menstrual cycle to stop. Symptoms include vaginal itching and dryness, hot flashes, sleep disturbances, and behavior changes. Hormone replacement therapy and natural remedies help alleviate symptoms.

A nurse has agreed to speak to her daughter's Girl Scout troop about their changing bodies. The girls are all 10 years old. What is the priority teaching need? A. Self exam B. Premenstrual syndrome C. Douching D. Contraception E. Menopause F. Preventing STI G. Menstruation H. Body function and reproduction

G Young girls need to understand what is happening as their bodies change during adolescence, and menstruation is an important part of that discussion. Knowing what to expect and how to manage the situation is critical. In addition, answering the girls' questions can help dispel common myths.

Nathan and Monica are teens who are in love. Their relationship is becoming more physical, and they tell the nurse they like to lie next to each other while undressed. What is the priority teaching need? A. Self exam B. Premenstrual syndrome C. Douching D. Contraception E. Menopause F. Preventing STI G. Menstruation H. Body function and reproduction

H. The nurse cannot assume that everyone has the same level of sexual knowledge, despite age and educational background. Before beginning the teaching session, determine what Nathan and Monica do know about their bodies and reproduction. The nurse should use visual aids to discuss body functions and reproduction. Legal considerations should also be taken into account given their young age.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Watching television before bedtime PROMOTES COMPROMISES HAS NO IMPACT Check Answer

Has no impact The nurse should support and encourage normal bedtime rituals. For some people, watching television may be relaxing, for others it is not. Ask what their sleep routines are at home, such as reading, drinking warm milk, praying, or meditating. For children, determine whether they have an object they normally sleep with that will provide comfort. Next

Benefits of exercise

Improves cardiovascular health Increases muscle tone and flexibility Enhances immune system Promotes weight loss Decreases stress/increases overall feeling of well-being

activity and exercise

Involves mobility Interaction of bones, muscles, and nervous system Involves body mechanics: the way people move Body alignment (posture) Balance Coordination Joint mobility

Types of exercises

Isometric Isotonic Isokinetic Aerobic Anaerobic

Factors Affecting Mobility and Activity

Lifespan Nutrition Lifestyle Stress External environment Disease

reticular activating system

Located in the upper brain stem; responsible for maintenance of consciousness, specifically one's level of arousal.

Rest

Mild to no activity Relaxation; stress-free Leads to feeling refreshed

Effects of immobility

Muscle atrophy Joint dysfunction Atelectasis/pneumonia Venous stasis Increased coagulability Orthostatic hypotension Glucose intolerance Pressure ulcers constipation paralytic ileus UTI renal calculi depression Sleep disturbances disorientation

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Clustering care to allow periods of rest during the day PROMOTES COMPROMISES HAS NO IMPACT

Promotes Clustering care means completing assessment, hygiene activities, medications, and procedures at one time to avoid multiple trips into the client's room that may disturb his or her rest. Unless the client's condition is unstable, task timing is flexible and should be planned to avoid awakening the client when possible.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Offer cool cloths, back rubs, and oral fluids for comfort at bedtime PROMOTES COMPROMISES HAS NO IMPACT

Promotes CORRECT. Basic comfort care is important for alleviating discomfort and will provide more restful sleep. The nurse should determine whether the client is having any discomfort such as pain, itching, or nausea that can be corrected before it is time to sleep. Pain medicines are important and should be offered at regular intervals and at bedtime to avoid interrupting sleep patterns.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Using earplugs and room-darkening devices PROMOTES COMPROMISES HAS NO IMPACT

Promotes Sleep is less likely to be interrupted if noise and light are blocked. If someone sleeps in the same room as a person who snores or has untreated sleep apnea, this strategy can be especially beneficial. Darkening devices may include darkening curtains, removal of night-lights and cell phones, and eye-covering sleep masks.

principles of body mechanics

Proper alignment Wide base of support Avoid bending and twisting Squat to lift Keep objects close when lifting Raise beds Push vs. lift Get help

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Transfer client to another bed if she says she's uncomfortable Promotes compromises has no impact

has no impact It is difficult for people to sleep in a strange bed and in a different environment. To provide a more comfortable environment, the nurse should regularly straighten linens to free them of wrinkles, assist in finding comfortable positioning, keep linens and gown free of moisture, and keep the room dark, quiet, and at a comfortable temperature.

Benefits to sleep

increase mental performance improves learning helps store long term memory restore energy improves coping strengthens immune system

coordination

The ability to use two or more body parts together

anaerobic exercise

intense short bursts of activity in which the muscles work so hard that they produce energy without using oxygen

N1

light sleep. 5 minutes

Tendons

muscle to bone

NREM

non-rapid eye movement sleep; encompasses all sleep stages except for REM sleep

N3 sleep

people experience the deepest stage of sleep

Insomina

recurring problems in falling or staying asleep

sleep apnea

a sleep disorder characterized by temporary cessations of breathing (10 sec) during sleep and repeated momentary awakenings

circadian disorder

abnormality in sleep/wake times -jet lag -night shift -rotating shifts

factors that affect sleep

age lifestyle factors -physical activity -food and alcohol -medication -caffeine -sleep habits Illness environmental factors - tempature and humidity -noise and light - noxious odor -comfort and bedding

ligaments

bones to bone

Isotonic

cause muscle contraction and change in muscle length. Walking, aerobics, moving arms and legs against light resistance

Narcolepsy

chronic condition with recurrent attacks of uncontrollable drowsiness and sleep

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Going to bed when you feel tired PROMOTES COMPROMISES HAS NO IMPACT

compromises Rather than waiting to become tired, it is helpful to follow a regular routine by going to bed at the same time each night. This includes maintaining the same bedtime on days off from work or school.

exercise

contraction/relaxation of muscles increase muscle tone and strength 150-300 minutes/ week of moderate and vigorous intensity exercise recommended

REM

describes sleep in which vivid dreams typically occur; this type of sleep increases as the night progresses while stage 4 sleep decreases

Hyperinsomlance disorder

excessive sleepiness needs more than 7 hours of sleep

isokinetic exercise

exercise involving muscle contractions with resistance varying at a constant rate

restless leg syndrome

sleep disorder in which the sufferer has uncomfortable sensations in the legs when trying to fall asleep that are relieved by moving the legs

aerobic exercise

sustained exercise that increases heart and lung fitness; may also alleviate depression and anxiety

Her first walk in the hallway went well with the assistance of two staff members. Which statements should the nurse include upon returning Miriam to bed? Select all that apply. A. "Do not try to get up by yourself." B. "Perform active range-of-motion [AROM] activities hourly when in bed." C. "That was good; we'll try again before discharge." D. "Tell me about the severity of the pain you are having now." E. "I'll bring the bedpan if you need it."

A,B,C,D Safety is important for all clients. Because Miriam has gotten up once, she may feel she can do so independently, which would be unsafe. The use of AROM will work best to build her muscle strength. Ambulation should take place regularly, including trips to the bathroom and activity in the hallway several times a day with assistance. Pain assessment is important before and after activity in the postoperative client.

Shoshana, a sexually active young woman, has a difficult time discussing her sexuality with the nurse. What could be some reasons for this? Select all that apply. A. Her culture considers sex outside of marriage wrong. B. She's never had an open discussion about sex. C. She is embarrassed about her sexual activity. D. Her church supports pro-life. E. She's been treated for STIs.

A,B,C,E

As the days slowly pass, Mariam begins to develop the psychological effects of immobility. What should the nurse be assessing for? Select all that apply. A. Apathy toward self-care B. Depression C. Sleep disturbances D. Restlessness E. Disorientation

A,B,C,E Immobility leads to isolation, regardless of where it takes place. Psychological effects of immobility include depression, anxiety, hostility, sleep disturbances, changes in ability to perform self-care, disorientation, apathy, altered body concept, and inability to concentrate, recall sequential events, and solve problems.

The client's spouse is concerned about the fatigue her husband is experiencing from inadequate sleep. What are some complications that can occur? Select all that apply. A. Falls B. Decreased mental focus C. Early death D. Poor coping skills E. Decreased activity

A,B,D,E

Which findings in the immobile client are complications related to immobility? Select all that apply. A. Lung fluid B. Decreasing appetite C. Muscle growth D. Constipation E. Bladder infection

A,B,D,E

Peter develops an immobility plan of care for Mariam. What should be included? Select all that apply. A. Position to allow for lung expansion B. Massage calves and legs each shift C. Encourage visitors D. Eat a healthy balanced diet E. Turn every 2 hours

A,C,D,E

A client is admitted to the hospital with chronic obstructive pulmonary disease (COPD). He is receiving supplemental oxygen via nasal cannula. Which position will best assist his breathing? A. Fowler's B. Sims' C. Lateral D. Supine

A.

Two nurses are planning to transfer a comatose client from the bed to a stretcher. Which device should be used? A. Transfer board B. Transfer belt C. Footboard E. Scoot sheet

A.

For which sleep disorder would the nurse most likely need to include safety measures in the client's plan of care? a. Snoring b. Enuresis c. Narcolepsy d. Hypersomnia

C

Which statement by a teenage client would indicate that teaching about the detection of STIs has been effective? A. "A healthcare provider can tell whether you have an STI just by looking at your genitals." B. "The doctor has to biopsy the tissue to find out whether a person has an STI." C. "A genital swab culture can be done at the office or clinic to determine whether a person has an STI." D. "The color of the drainage from the vagina or penis can determine whether a STI is present."

C

the nurse is caring for a hospitalized client who normally works the night shift at his job. The client states " I don't know what is wrong with me. I have been napping all day and cant seem to think clearly" The nurse best response is A. you are sleep deprived, but that will resolve in a few days B. you are experiencing hypersomnia, so it will be important for you to walk in the hall more often. C. there has been a disruption in your circadian rhythms, What can I do to help you sleep better at night? D. I will notify the doctor and ask him to prescribed a hypertonic medication to help you sleep

C

Upon discharge, Miriam is instructed to continue using a walker until the follow-up visit with her surgeon in 2 weeks. What instructions need to be included with the use of the walker? A. Advance the walker far ahead of your body and walk toward it. B. Slide the walker with each step. C. Move your weaker leg forward as your walker moves forward. D. Stand well behind the back legs. E. Size does not matter; any size walker will work.

C A walker should be the proper fit based on the person's height. It is important that she does not have to lean over or reach up to reach the device. A person should stand between the back legs, not too far behind the walker. Pick up the walker and advance with each step. It should not be pushed ahead. The weaker leg should move with the walker and the walker should be picked up, not slid, unless it has wheels.

Walter, a 72-year-old widower, is enjoying meeting new women in his senior community. He shares with the nurse that he hasn't had this type of sex life since before he was married.What is the priority teaching need?A. Self examB. Premenstrual syndromeC. DouchingD. ContraceptionE. MenopauseF. Preventing STIG. MenstruationH. Body function and reproduction

F Sexually transmitted infections (STIs) are a worldwide health concern. Having multiple partners increases the risk of STIs (as does intercourse with a person who has multiple partners). The best prevention for infections is the proper use of condoms. Walter needs to understand that STIs occur in the senior community and be aware of how to correctly use a condom.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Natural or homeopathic aids PROMOTES COMPROMISES HAS NO IMPACT

Promotes Many sleep medications can become habit-forming and are not recommended for long-term use. Some natural or homeopathic aids can help with sleep, but the side effects must be considered before recommending them.

For each scenario, decide whether the action promotes, compromises, or has no impact on sleep/rest. Guided relaxation exercise PROMOTES COMPROMISES HAS NO IMPACT

Promotes Relaxation is often the key to falling asleep. The nurse can assist the client through exercises of guided imagery, progressive muscle relaxation, and music therapy. Other forms of relaxation include massage, aromatherapy, or a warm bath or shower.

N4

REM

Mobility

the quality or state of being able to move about freely

body alignment

the way the head, trunk, arms, and legs are aligned with one another; posture

Isometric

tightening or tensing of muscles without moving body parts. This increases muscle tension but do not change the length of muscle fibers.