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Kaplan NCLEX Review > Basic Care And Comfort > Flashcards

Basic Care And Comfort Flashcards

1
Q

Proper crutch measurement and position

A
  • 2 fingers below axilla
  • crutches 8-10 inches out to side
  • flex elbows 20-30 degrees
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2
Q

Type of exercise in which the client alternates contraction and relaxation of a muscle to maintain strength of muscle when joint is immobilized

A

Isometric exercise

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3
Q

Which position avoids hip flexion?

A

Supine

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4
Q

Which position is supine with the knees flexed?

A

Dorsal recumbent

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5
Q

Which position promotes extension of the hip joint?

A

Prone

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6
Q

Which position promotes drainage of oral secretions?

A

Side lateral

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7
Q

Which position promotes visualization of the rectal area?

A

Knee-chest

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8
Q

Which position decreases abdominal tension?

A

Sim’s

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9
Q

Position that increases venous return and promote lung expansion

A

Fowler’s

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10
Q

High Fowler’s

A

60-90 degrees

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11
Q

Fowler’s

A

45-60 degrees

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12
Q

Semi-Fowler’s

A

30-45 degrees

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13
Q

Low Fowler’s

A

15-30 degrees

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14
Q

Position used for shock

A

Modified trendelenburg (feet elevated 20 degrees, head slightly elevated)

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15
Q

Position used for a vaginal exam

A

Lithotomy

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16
Q

Myasthenia gravis results from a deficiency in

A

Acetylcholine
NOTE: key manifestation is ptosis

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17
Q

Parkison’s disease results from a deficiency in

A

Dopamine

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18
Q

When is joint and muscle stiffness at its worst in a client with rheumatoid arthritis?

A

In the morning and after periods of inactivity

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19
Q

Heberden’s and Bouchard’s nodules are manifestations of which disease process?

A

Osteoarthritis

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20
Q

Inflammation of the fluid filled sac between the muscles, tendons, and bones affecting larger joints such as the knees, elbows, and shoulders

A

Bursitis

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21
Q

Heat/cold therapy for bursitis

A

Apply heat for movement and cold to reduce inflammation

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22
Q

Assessment of developmental dysplasia of the hip (DDH)

A
  • uneven gluteal folds and thigh creases
  • limited abduction of hip
  • ortalin’s sign (seen in infants < 4 years old; clicking sound when hip is moved to abduction)
  • limb on affected side is shorter than limb on unaffected side
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23
Q

DDH interventions for the newborn to 6 months

A

Pavlik harness for 3-6 months

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24
Q

DDH interventions for infant 6-18 months

A

Bilateral Bryant’s traction, hip spica cast for immobilization

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25
Q

DDH interventions for the older child

A

Open reduction, hip spica cast

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26
Q

Scoliosis assessment

A
  • uneven hips or scapula
  • kyphosis lump on back
  • instruct client to bend at waist to visualize deformity
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27
Q

Assessment of spinal bifida occulta

A

Dimpling at the site

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28
Q

Nursing interventions for meningocele/myelomeningocele

A
  • Cover lesion with moist sterile dressing
  • Position infant on abdomen or semi-prone
  • Monitor for S/S of meningitis and increased ICP
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29
Q

How frequently should a client who is to undergo a delayed prosthesis fitting be positioned prone?

A

30 minutes three times/day to prevent hip contracture

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30
Q

Injury to the soft tissue characterized by ecchymosis and hematoma formation

A

Contusion

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31
Q

Interventions for contusion

A

Application of cold for 24 hrs followed by moist heat, elastic bandage

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32
Q

Complication of fracture to long bone, such as the femur

A

Fat embolism
NOTE: S/S similar to PE + petechiae

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33
Q

Most common and early symptom of compartment syndrome

A

Severe pain unrelieved by analgesics

34
Q

The nurse cares for the school-age child diagnosed with a fracture of the tibia located in the epiphyseal plate. What is a major complication associated with this type of fracture

A

Bone growth of the fractured leg may be affected

35
Q

Assessment of a hip fracture

A

Shortened leg that is adducted and externally rotated

36
Q

Parathyroid hormone helps to maintain the balance of _________ and _________ in the body

A

Calcium; phosphorus

37
Q

Hypoparathyroidism will present with symptoms of _________

A

Hypocalcemia
NOTE: hyperparathyroidism will present with signs of Hypercalcemia

38
Q

Clients with hyperparathyroidism are at risk for

A

Renal calculi
NOTE: increase fluid intake and follow acid-ash diet for prevent of stones

39
Q

A goiter is enlargement of the thyroid gland most often caused by lack of _________ in the diet

A

Iodine

40
Q

Foods that promote growth of a goiter

A

Cabbage, turnips, spinach, and seafood

41
Q

The client’s diet during lactation should be increased by ___ calories/day

A

500

42
Q

Why would the nurse’s administration of tube feedings (enteral nutrition) be more appropriate than total parenteral nutrition (TPN) for the client diagnosed with a stroke?

A

The client’s gastrointestinal tract can still digest feedings

43
Q

Parenteral nutrition nursing interventions

A
  • change IV tubing every 24 hrs
  • keep solutions refrigerated, and warm to room temperature prior to administration
  • if new solution unavailable, used D10W temporarily to avoid rebound hypoglycemia
44
Q

Vitamin A is necessary for

A

Visual acuity

45
Q

Vitamin D is necessary for

A

Calcification of bones and absorption of calcium and phosphorus

46
Q

Vitamin E is an antioxidant. Without vitamin E, the client will experience

A

Hemolytic anemia

47
Q

Vitamin K is necessary for

A

Blood clotting
NOTE: vitamin K deficiency can result in bleeding and bruising

48
Q

Vitamin B1 (thiamine) is essential for

A

Carbohydrate metabolism

49
Q

Vitamin B2 (riboflavin) is needed for

A

Protein metabolism

50
Q

B6 (Pyridoxine) is needed for

A

Amino acid metabolism
NOTE: B6 deficiencies can result in anemia, seizures, and peripheral neuropathy

51
Q

Folic acid is necessary for

A

RBC formation
NOTE: deficiency may result in anemia

52
Q

Vitamin B12 (Cyanocobalamin) is necessary for

A

Nerve function and RBC formation
NOTE: B12 deficiency may result in pernicious anemia

53
Q

Niacin is need for

A

Normal growth

54
Q

Vitamin C (ascorbic acid) is needed for

A

Collagen synthesis
NOTE: Vitamin C deficiency can result in scurvy

55
Q

Primary sources of calcium

A

Milk products, green leafy vegetables, eggs

56
Q

Primary sources of phosphorus

A

Milk, eggs, nuts

57
Q

Primary sources of iodine

A

Seafood, iodine salt

58
Q

Primary sources of sodium

A

Table salt, canned vegetables, milk, cured meats, processed foods

59
Q

Primary sources of potassium

A

Grains, meats, vegetables

60
Q

Primary sources of iron

A

Liver, oysters, leafy vegetables, apricots

61
Q

At what age can a bland diet of rice cereal and strained fruit be introduced?

A

4-5 months

62
Q

At what age can strained vegetables and meat be introduced?

A

5-6 months

63
Q

At what age can chopped meat and finger foods be introduced?

A

7-9 months

64
Q

Toddlers begin to eat solid food when they have ___ to ___ teeth

A

6-8 (12-36 months)

65
Q

Recommended amount of vegetables per day

A

2.5-3 cups

66
Q

Recommended amount of fruits per day

A

1.5-2 cups

67
Q

Recommended amount of grains per day

A

6-7 oz. Equivalents

68
Q

Recommended amount of milk per day

A

3 cups

69
Q

Recommended amount of meat and beans per day

A

5-6 oz. Equivalents

70
Q

Recommended amount of oils per day

A

5-6 teaspoons

71
Q

What does the client following a vegan diet eat?

A

Fruits, vegetables, nuts, seeds

72
Q

What does the client following a lactovegetarian diet eat?

A

Vegan diet + milk, cheese, yogurt, and milk products

73
Q

What does the client following the ovovegetarian diet eat?

A

Vegan diet + eggs

74
Q

What does the client following the lactoovovegetarian diet eat?

A

Vegan diet + dairy products and eggs

75
Q

Caloric requirement for normal, healthy adult

A

1,500-3,000 kcal/day

76
Q

Fluid requirement for the average adult

A

1,800-2,500 mL/day

77
Q

Kidney diet

A

Low protein, potassium, and sodium

78
Q

Normal urine pH

A

4.5-8.0

79
Q

Normal urine specific gravity

A

1.010-1.030
NOTE: this is a measurement of urine concentration

80
Q

Toilet training is initiated after ___ months of age

A

18

81
Q

Examples of foods high in oxalates

A

Spinach, wheat germ, and peanuts

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