Activity Flashcards
A nurse is developing an exercise program for a patient who has COPD. Which instructions would the nurse include in a teaching plan for this patient? Select all that apply.
a. Teach the patient to avoid sudden position changes that may cause dizziness.
b. Recommend that the patient restrict fluid intake until after exercise.
c.Instruct the patient to push a little further beyond fatigue each session.
d. Tell the patient to avoid exercising in very cold or very hot temperatures.
e. Encourage the patient to modify exercise if weak or ill.
f. Recommend that the patient consume a high-carb, low-protein diet.
a, d.
Teaching points for excercising for a patient with COPD include avoiding sudden position changes that may cause dizziness and avoiding extreme temperatures.
The nurse should also instruct the patient to remain adequately hydrated, respect fatigue as a sign of activity intolerance and not push to the point of exhaustion, and avoid exercise if weak or ill. Older adults should consume a high-protein, high-calcium, and Vitamin D enriched diet.
A nurse is providing active-assistive range-of-motion exercises for a patient who is recovering from a stroke. During the session, the patient reports that they are “too tired to go on.” What actions are appropriate at this time? Select all that apply
a. Stop performing the exercises
b. Decrease the number of repititions performed.
c. Reevaluate the plan of care.
d. Move to the patient’s other side to perform exercises.
e. Encourage the patient to finish the exercises, then rest.
f. Assess the patient for additional symptoms of intolerance.
a, c, f
When a patient reports fatigue during range-of-motion exercises, the nurse should stop the activity, reevaluate the plan of care, and assess the patient for further symptoms indicating the activity is not tolerated.
The exercises can be rescheduled for times of the day when the patient is feeling more rested, or spaced out at different times of the day.
A nurse assists a patient with ambulation for the first time following a knee replacement. Shortly after beginning to walk, the patient tells the nurse that they are dizzy and feel like they might fall. Place these nursing actions in the order in which the nurse should perform them to protect the patient.
a. Grasp the gait belt.
b. Stay with the patient and call for help.
c. Place feet wide apart with one foot in front.
d. Gently slide the patient down to the floor, protecting their head.
e. Pull the weight of the patient backward against your body.
f. Rock your pelvis out on the side of the patient.
c, f, a, e, d, b
When a patient is being moved or ambulated and starts to fall, the nurse places their feed wide apart with one foot in front, rocks their pelvis out toward the side of the patient, grasps the gait belt, supports the patient by pulling the patient’s weight backward against their body, gently slides the patient down their body toward the floor while protecting the patient’s head, and remains with the patient while calling for help.
A nurse caring for patients in a pediatric office assesses children’s achievement of developmental milestones. Which patient finding requires follow up with the pediatrician?
a. 4-month-old infant who is unable to roll over.
b. 6-month-old infant who is unable to hold head up.
c. 11-month-old infant who cannot walk unassisted.
d. 18-month-old toddler who cannot jump.
b
By 5 months, head control is usually achieved. An infant usually rolls over by 6 to 9 months. By 15 months, most toddlers can walk unassisted. By 2 years, most toddlers can jump.
A nurse is caring for a patient with lower extremity paralysis. Which action will the nurse take to prevent external rotation of the hip and foot?
a. Use a trochanter roll.
b. Apply SCDs.
c. Obtain a prescription for antiembolism stockings.
d. Have the patient maintain low-Fowler’s position.
e. Have the patient cross their arms on their chest and place a pillow between their knees.
f. Place a cervical collar on the patient’s neck and gently roll them to the other side of the bed.
a
The trochanter roll is used to support the hips and legs to prevent external rotation. SCDs and antiembolism stockings are used to prevent DVT. Fowler’s position allows for foot rotation and increases sacral pressure.
A nursing student asks the primary nurse why an immobile patient developed two urinary tract infections in the past 6 months. How does the nurse best explain the patient’s risk for UTI?
a. Improved renal blood supply to the kidneys.
b. Urinary stasis
c. Decreased urinary calcium
d. Acidic urine formation
b
In a nonerect patient, the kidneys and ureters are level, limiting or delaying urinary drainage from the kidney pelvis to the ureter and bladder. The resulting urinary stasis favors the growth of bacteria that can promote urinary tract infections. Regular exercise, not immobility, improves the blood flow to the kidneys. Immobility predisposes the patient to bone demineralization, resulting in increased urinary calcium levels and alkaline urine, contributing to renal calculi and urinary tract infection, respectively.
A nurse on a medical-surgical unit notes a patient with pneumonia and is experiencing dyspnea. What action will the nurse take to improve the dyspnea?
a. Encourage the patient to ambulate
b. Suggest the patient use music or television as distraction.
c. Place the patient in Fowler’s position.
d. Tell the patient to take several deep breaths, then hold their breath for 5 seconds.
c
High Fowler’s position promotes maximal lung expansion and is the position of choice during episodes of dyspnea. Encouraging ambulation during distress will increase dyspnea. Distracting the patient is not addressing the underlying cause of dyspnea, which is activity. Holding the breath increases demands on the heart.
A nurse is assisting a post-operative patient with conditioning exercises to prepare for ambulation. Which instructions from the nurse are appropriate for this patient? Select all that apply.
a. Do full body pushups in bed six to eight times daily.
b. Breathe in and out smoothly during the quadricep-setting exercises.
c. Place the bed in the lowest position or use a footstool for dangling.
d. Dangle on the side of the bed for 30 to 60 minutes.
e. Allow the nurse to bathe you completely to prevent fatigue.
f. Perform quadriceps two to three times per hour, four to six times a day.
b, c, f
Breathing in and out smoothly during the quadricep-setting exercises maximizes lung inflation. The patient should perform quadricep-setting exercises two to three times per hour, four to six times a day, or as ordered. The patient should never hold their breath during exercise drills because this places a strain on the heart. Pushups are usually done three or four times a day and involve only the upper body. Dangling for a few minutes is done to adjust to the upright position; dangling for 30 to 60 minutes is impractical for the nurse to supervise and may prove unsafe. The nurse should place the bed in the lowest position or use a footstool for dangling. The nurse should also encourage the patient to be as independent as possible to prepare for return to normal ambulation and ADLs.
A nurse is caring for a patient who is on bedrest following a spinal injury. Which action is appropriate to prevent foot drop?
a. Maintain the supine position with supination on the feet.
b. Ask the family to bring high-top sneakers to maintain foot dorsiflexion.
c. Encourage hyperextension of the feet with adaptive devices or splints.
d. Use pillows to keep the feet in the abducted position.
b
To prevent foot drop the nurse should support the feet in dorsiflexion using a footboard and/or high top sneakers for further support. Supination involves lying patients on their back or facing a body part upward, and hyperextension is a state of exaggerated extension. Abduction involves lateral movement of a body part away from the midline of the body. These positions do not prevent foot drop.
A nurse is instructing a patient recovering from a stroke on proper use of a cane. What information will the nurse include in the teaching plan?
a. Support weight on the stronger leg and cane and advance weaker foot forward.
b. Hold the cane in the same hand of the leg with the most severe deficit.
c. Stand with as much weight distributed on the cane as possible.
d. Avoid using the cane to rise from a sitting position, as this is unsafe.
a
The proper procedure for using a cane is to (1) stand with weight distributed evenly between the feet and cane; (2) support weight on the stronger leg and the cane and advance the weaker foot forward, parallel with the cane; (3) support weight on the weaker leg and cane and advance the stronger leg forward ahead of the cane; (4) move the weaker leg forward until even with the stronger leg and advance the cane again as in step 2. The patient should keep the cane within easy reach and use it for support to rise safely from a sitting position.
A patient has a fractured left leg, which has been casted. Following teaching from the physical therapist for using crutches, the nurse reinforces which teaching point with the patient?
a. Lean on the crutches using the axillae to bear body weight.
b. Keep elbows close to the sides of the body.
c. When rising, extend the uninjured leg to prevent weight bearing.
d. To climb stairs, place weight on affected leg first.
b
The patient should keep the elbows at the sides, prevent pressure on the axillae to avoid damage to nerves and circulation, extend the injured leg when rising to prevent weight bearing, and advance the unaffected leg first when climbing stairs.
A nurse working in a long-term care facility uses proper principles of ergonomics when moving and transferring patients to avoid back injury. Which action should be the focus of these preventive measures?
a. Carefully assessing the patient care environment
b. Using two nurses to lift a patient who cannot assist
c. Wearing a back belt to perform routine duties
d. Properly documenting the patient lift
a
Preventive measures should focus on careful assessment of the patient care environment so that patients can be moved safely and effectively. Using lifting teams and assistive patient handling equipment rather than two nurses to lift increases safety. The use of a back belt does not prevent back injury. The methods used for safe patient handling and mobility should be documented but are not the primary focus of interventions related to injury prevention.
A nurse is assisting a patient who is 2 days postoperative from a cesarean section dangle in preparation for sitting in a chair. After assisting the patient to stand up, the patient’s knees buckle and she tells the nurse she feels faint. What is the appropriate nursing action?
a. Supporting the patient as she stands, waiting a few moments, then continuing the move to the chair
b. Calling for assistance and continuing the move with the assistance of another nurse
c. Lowering the patient back to the side of the bed and pivoting her back into bed
d. Having the patient sit down on the bed and dangle her feet before moving
c
If a patient becomes faint and their knees buckle when moving from bed to a chair or ambulating, the nurse should stop the activity, as the patient has demonstrated a clear risk for falling. The nurse should lower the patient back to the side of the bed, pivot her back into bed, cover her, and raise the side rails. Assess the patient’s vital signs and for the presence of other symptoms. When vital signs are stable, another attempt can be made with the assistance of another staff. Instruct the patient to remain in the sitting position on the side of the bed for several minutes to allow the circulatory system to adjust to a change in position and prevent hypotension related to a sudden change from the supine position.
A patient who injured the spine in a motorcycle accident is receiving rehabilitation services in a short-term rehabilitation center. The nurse caring for the patient tells the AP not to place the patient in which position?
a. Side-lying
b. Fowler’s
c. Sims’
d. Prone
d
While placing the patient in the prone position for 30 minutes two or three times daily helps prevent knee and hip flexion contractures, it is contraindicated in patients who have spinal problems. The pull of gravity on the trunk when the patient lies prone produces a marked lordosis or forward curvature of the lumbar spine.
A nurse is using the Katz Index of Independence in Activities of Daily Living (ADLs) to assess the mobility of a hospitalized patient. During the patient interview, the nurse documents the following patient data: “Patient bathes self completely but needs help with dressing. Patient toilets independently and is continent. Patient needs help moving from bed to chair. Patient follows directions and can feed self.” Based on this data, which score would the patient receive on the Katz index?
a. 2
b. 4
c. 5
d. 6
b
The total score for this patient is 4. On the Katz Index of Independence in ADLs, one point is awarded for independence in each of the following activities: bathing, dressing, toileting, transferring, continence, and feeding.
