Activity/exercise Flashcards
The nurse is providing care to a patient who is bedridden. The nurse raises the height of the bed. What is the rationale for the nurse’s action?
a. Narrows the nurse’s base of support.
b. Allows the nurse to bring feet closer together.
c. Prevents a shift in the nurse’s base of support.
d. Shifts the nurse’s center of gravity farther away from the base of support.
ANS: C
Raising the height of the bed when performing a procedure prevents bending too far at the waist and shifting the base of support. Balance is maintained by proper body alignment and posture through two simple techniques. First, widen the base of support by separating the feet to a comfortable distance. Second, increase balance by bringing the center of gravity closer to the base of support.
The nurse is evaluating care of a patient for crutches. Which finding indicates a successful outcome?
a. The top of the crutch is three to four finger widths from the armpit.
b. The elbows are slightly flexed at 30 to 35 degrees when the patient is standing.
c. The tip of the crutch is 4 to 6 inches anterior to the front of the patient’s shoes.
d. The position of the handgrips allows the axilla to support the patient’s body weight.
ANS: C
When crutches are fitted, the tip of the crutch is 4 to 6 inches anterior to the front of the patient’s shoes, and the length of the crutch is two to three finger widths from the axilla. Position the handgrips so the axillae are not supporting the patient’s body weight. Pressure on the axillae increases risk to underlying nerves, which sometimes results in partial paralysis of the arm. Determine correct position of the handgrips with the patient upright, supporting weight by the handgrips with the elbows slightly flexed at 20 to 25 degrees.
The patient reports being tired and weak and lacks energy. Upon assessment, the nurse finds that patient has gained weight, and blood pressure and pulse are elevated after climbing stairs. Which nursing diagnosis will the nurse add to the care plan?
a. Fatigue
b. Ineffective coping
c. Activity intolerance
d. Decreased cardiac output
ANS: C
You consider nursing diagnoses of Activity intolerance or Fatigue in a patient who reports being tired and weak. Further review of assessed defining characteristics (e.g., abnormal heart rate and verbal report of weakness and the assessment findings occurring during the activity of climbing the stairs) leads to the definitive diagnosis (Activity intolerance). There is no data to support ineffective coping or decreased cardiac output.
A nurse is assessing a patient with activity intolerance for possible orthostatic hypotension. Which finding will help confirm orthostatic hypotension?
a. Blood pressure sitting 120/64; blood pressure 140/70 standing
b. Blood pressure sitting 126/64; blood pressure 120/58 standing
c. Blood pressure sitting 130/60; blood pressure 110/60 standing
d. Blood pressure sitting 140/60; blood pressure 130/54 standing
ANS: C
Orthostatic hypotension results in a drop of 20 mm Hg systolic or more in blood pressure when rising from sitting position (110/60). 120 to 140 means the blood pressure increased rather than dropped. 126 to 120 is only a six points’ difference. 140 to 130 is only a 10 points’ difference.
The nurse is teaching a patient how to use a cane. Which information will the nurse include in the teaching session?
a. Place the cane at the top of the hip bone.
b. Place the cane on the stronger side of the body.
c. Place the cane in front of the body and then move the good leg.
d. Place the cane 10 to 15 inches in front of the body when walking.
ANS: B
Have the patient keep the cane on the stronger side of the body. A person’s cane length is equal to the distance between the greater trochanter and the floor. The cane should be moved first and then the weaker leg. For maximum support when walking, the patient places the cane forward 15 to 25 cm (6 to 10 inches), keeping body weight on both legs. The weaker leg is then moved forward to the cane, so body weight is divided between the cane and the stronger leg.
The nurse is preparing to transfer an uncooperative patient who does not have upper body strength. Which piece of equipment will be best for the nurses to obtain?
a. Drawsheet
b. Full body sling
c. Overhead trapeze
d. Friction-reducing slide sheet
ANS: B
Using a mechanical lift and full body sling to transfer an uncooperative patient who can bear partial weight or a patient who cannot bear weight and is either uncooperative or does not have upper body strength to move from bed to chair prevents musculoskeletal injuries to health care workers. The nurse should not attempt to move the patient with a drawsheet. The patient does not have upper body strength so an overhead trapeze is not appropriate. A friction-reducing slide sheet that minimizes shearing forces is not as effective as a full body sling.
The nurse is teaching a patient how to sit with crutches. In which order will the nurse present the instructions starting with the first step?
- Place both crutches in one hand.
- Grasp arm of chair with free hand.
- Completely lower self into chair.
- Transfer weight to crutches and unaffected leg.
a. 4, 1, 2, 3
b. 1, 4, 2, 3
c. 1, 2, 4, 3
d. 4, 2, 1, 3
ANS: B
A patient is sitting in a chair with crutches. Both crutches are held in one hand. The patient then transfers weight to the crutches and the unaffected leg. Next, the patient grasps the arm of the chair with the free hand and begins to lower self into chair. Finally, the patient completely lowers self into chair.
The nurse is caring for a group of patients. Which patient will the nurse see first?
a. A patient with chronic obstructive pulmonary disease doing stretching exercises
b. A patient with diabetes mellitus carrying hard candy while doing exercises
c. A patient with a heart attack doing isometric exercises
d. A patient with hypertension doing Tai Chi exercises
ANS: C
The nurse must see the myocardial infarction patient first to stop this type of exercise. It is important to understand the energy expenditure (increased respiratory rate and increased work on the heart) associated with isometric exercises because the exercises are sometimes contraindicated in certain patients’ illnesses (e.g., myocardial infarction or chronic obstructive pulmonary disease). All the rest are appropriate. Stretching exercises are beneficial for patients with chronic obstructive pulmonary disease. Also instruct patients to perform low- to moderate-intensity exercises, carry a concentrated form of carbohydrates (sugar packets or hard candy), and wear a medical alert bracelet. The effect of a Tai Chi exercise program has demonstrated a significant reduction in systolic and diastolic blood pressures.
A nurse is preparing to move a patient who is able to assist. Which principles will the nurse consider when planning for safe patient handling? (Select all that apply.)
a. Keep the body’s center of gravity high.
b. Face the direction of the movement.
c. Keep the base of support narrow.
d. Use the under-axilla technique.
e. Use proper body mechanics.
f. Use arms and legs.
ANS: B, E, F
When a patient is able to assist, remember the following principles: The wider the base of support, the greater the stability of the nurse; the lower the center of gravity, the greater the stability of the nurse; facing the direction of movement prevents abnormal twisting of the spine. The use of assistive equipment and continued use of proper body mechanics significantly reduces the risk of musculoskeletal injuries. Use arms and legs (not back) because the leg muscles are stronger, larger muscles capable of greater work without injury. The under-axilla technique is physically stressful for nurses and uncomfortable for patients.
A nurse writes the following outcomes for a patient who has chronic obstructive pulmonary disease to improve activity level: Diastolic blood pressure will remain below 70 mm Hg with systolic below 130 mm Hg. Resting heart rate will range between 65 and 75. The last goal is that the patient will exercise 3 times a week. Which evaluative findings indicate successful goal achievement? (Select all that apply.)
a. Resting heart rate 70
b. Blood pressure 126/64
c. Blood pressure 140/90
d. Reports doing stretching and flexibility exercises 2 times this week
e. Reports doing resistive training 1 time and aerobics 2 times this week
ANS: A, B, E
Compare actual outcomes with expected outcomes to determine the patient’s health status and progression. Heart rate of 70 is between 65 and 75. Blood pressure 126/64 meets the goal. Did resistive training 1 time and aerobics 2 times equals exercising 3 times a week. Did stretching and flexibility exercises 2 times is below the 3 times a week. Blood pressure 140/90 is too high and does not meet the goal.
