TBRQ Ch: 39 - Activity and Exercise Flashcards
A nurse is instructing a patient who has decreased leg strength on the left side how to use a cane. Which action indicates proper cane use by the patient?
- The patient keeps the cane on the left side of the body.
- The patient slightly leans to one side while walking.
- The patient keeps two points of support on the floor at all times.
- After the patient places the cane forward, he or she then moves the right leg forward to the cane.
Answer: 3.
Two points of support on floor maintains a safe balance.
The body alignment of the patient in the tripod position includes the following: (Select all that apply.)
- An erect head and neck
- Straight vertebrae
- Extended hips and knees
- Axillae resting on the crutch pads
- Bent knees and hips
Answer: 1, 2, 3.
This position improves the patient’s balance by providing a wider base of support.
A patient is experiencing some problems with joint stability. The doctor has prescribed crutches for the patient to use while still being allowed to bear weight on both legs. Which of the following gaits should the patient be taught to use?
- Four-point
- Three-point
- Two-point
- Swing-through
Answer: 1.
Three points of support maintains a safe balance.
Which of the following most motivates a patient to participate in an exercise program?
- Providing a patient with a pamphlet on exercise
- Providing information to the patient when he or she is ready to change behavior
- Explaining the importance of exercise at the time of diagnosis of a chronic disease
- Providing the patient with a booklet with examples of exercises
- Providing the patient with a prescribed exercise program
Answer:
- Patients are more open to developing an exercise program when they are at a stage of readiness to change their behavior.
Which of the following is a principle of proper body mechanics when lifting or carrying objects? (Select all that apply.)
- Keep the knees in a locked position.
- Bend at the waist to maintain a center of gravity.
- Maintain a wide base of support.
- Hold objects away from the body for improved leverage.
- Encourage patient to help as much as possible.
Answer: 3, 5.
Patient assistance promotes independence and strength while minimizing workload. A broad base of support increases stability.
The nurse recognizes that the older adult’s progressive loss of total bone mass and tendency to take smaller steps with feet kept closer together will most likely:
- Increase the patient’s risk for falls and injuries.
- Result in less stress on the patient’s joints.
- Decrease the amount of work required for patient movement.
- Allow for mobility in spite of the aging effects on the patient’s joints.
Answer: 1.
Physical inactivity, hormonal changes, and increased osteoclastic activity contribute to progressive loss of total bone mass in older adults. This increases the patient’s risk of falls and injuries.
A nurse plans to provide education to the parents of school-age children, which includes the increased prevalence of __________________ as a result of children being less physically active outside of school.
Answer:
Childhood obesity. It is increasingly evident that children are less active, resulting in an increase in childhood obesity and type 2 diabetes. Strategies for physical activity incorporated early into a child’s daily routine may provide a foundation for lifetime commitment to exercise and physical fitness.
A nursing assistive personnel asks for help to transfer a patient who is 125 lbs (56.8 kg) from the bed to a wheelchair. The patient is unable to help. What is the nurse’s best response?
- “As long as we use proper body mechanics, no one will get hurt.”
- “The patient only weighs 125 lbs. You don’t need my assistance.”
- “Call the lift team for additional assistance.”
- “The two of us can lift the patient easily.”
Answer: 3.
Body mechanics alone are not sufficient to prevent musculoskeletal injuries when positioning or transferring patients. Teaching the use of patient-handling equipment or a lift team in combination with proper body mechanics is more effective.
Which of the following statements made by an older adult reflects the best understanding of the need to exercise regardless of age?
- “You are never too old to begin an exercise program.”
- “My granddaughter and I walk together around the high school track 3 times a week.”
- “I purchased a subscription to a runner’s magazine for my grandson for Christmas.”
- “When I was a child, I exercised more than I see kids doing today.”
Answer: 2.
Patient understanding is confirmed when the patient is able to explain information or demonstrate it back. Inability to explain or demonstrate indicates the need for repeat instruction or trying a new approach. Teach Back is a way to confirm that a nurse has explained to a patient what he or she needs to know in a manner that the patient understands.
Which is the correct gait when a patient is ascending stairs on crutches?
- A modified two-point gait. (The affected leg is advanced between the crutches to the stairs.)
- A modified three-point gait. (The unaffected leg is advanced between the crutches to the stairs.)
- A swing-through gait
- A modified four-point gait. (Both legs advance between the crutches to the stairs.)
Answer: 2.
When ascending stairs on crutches, the patient usually uses a modified three-point gait.
Before transferring a patient from the bed to a stretcher, which assessment data do the nurse need to gather? (Select all that apply.)
- Patient’s weight
- Patient’s level of cooperation
- Patient’s ability to assist
- Presence of medical equipment
- Nutritional intake
Answer: 1, 2, 3, 4.
By assessing the patient thoroughly you make the correct decision concerning your ability to manage him or her safely, the need for additional personnel, the patient’s ability or inability to help you with the transfer, and the proper equipment to use for the transfer.
A patient with a right knee replacement is prescribed no weight bearing on the right leg. You reinforce crutch walking knowing that which of the following crutch gaits is most appropriate for this patient?
- Two-point gait
- Three-point gait
- Four-point gait
- Swing-through gait
Answer: 2.
Three-point alternating, or three-point gait requires the patient to bear all of the weight on one foot. In a three-point gait, the patient bears weight on both crutches and then on the uninvolved leg, repeating the sequence.
Which of the following indicates that additional assistance is needed to transfer the patient from the bed to the stretcher?
- The patient is 5 feet 6 inches and weighs 120 lbs.
- The patient speaks and understands English.
- The patient is returning to unit from recovery room after a procedure requiring conscious sedation.
- The patient received analgesia for pain 30 minutes ago.
Answer: 3.
Although the patient was discharged from the procedure recovery room, the patient did have some conscious sedation. This sedation may affect the patient’s ability to safely follow directions and participate in the transfer; therefore additional help would be needed to safely transfer the patient from the bed to the stretcher.
The nurse encourages a patient with type 2 diabetes to engage in a regular exercise program primarily to improve the patient’s:
- Gastric motility, thereby facilitating glucose digestion.
- Respiratory effort, thereby decreasing activity intolerance.
- Overall cardiac output, thereby resuming resting heart rate.
- Use of glucose and fatty acids, thereby decreasing blood glucose level.
Answer: 4.
Recent data in the United States show the prevalence of diabetes among adults aged 65 years and older to average around 28%. Obesity and a sedentary lifestyle are consistent contributing factors across all ethnic groups diagnosed with type 2 diabetes.
Musculoskeletal disorders are the most prevalent and debilitating occupational health hazards for nurses. To reduce the risk for these injuries, the American Nurses Association advocates which of the following?
- Mandate that physical therapists do all patient transfers
- Require adequate staffing levels in health care organizations
- Require the use of assistive equipment and devices
- Require an adequate number of staff to be involved in all patient transfers
Answer: 3.
Musculoskeletal disorders are the most prevalent and debilitating occupational health hazards for nurses. Preventive interventions are needed to avoid the hazards and economic burdens associated with patient-handling tasks. The American Nurses Association (ANA, 2010) position statement calls for the use of assistive equipment and devices to promote a safe health care environment for nurses and their patients.
