Question 1

A client with a flaccid bladder is undergoing bladder training.The nurse begins the client's bladder training using which technique?

Accepted Answer

With a flaccid bladder,the voiding reflex arc is not intact and additional stimulation may be needed to initiate voiding-the Valsalva and Credé maneuvers.Intermittent catheterization may be used after the previous maneuvers are attempted.In reflex bladder,the voiding arc is intact and voiding can be initiated by any stimulus,such as stroking the medial aspect of the thigh.A consistent toileting routine is used to re-establish voiding continence with an uninhibited bladder.

Question 2

The nurse is implementing nutritional changes to reduce the risk for skin breakdown in a client with impaired physical mobility.Which dietary modifications will the nurse reinforce?

Accepted Answer

The goal of nutrition therapy is to provide sufficient nutrients to promote wound healing,prevent skin breakdown,and avoid gaining excessive weight.The two most important nutrients to stimulate cell division and prevent loss of muscle mass are carbohydrates and proteins.

Question 3

An older adult client tells the nurse,"I tire easily." Which activities best assist the client to conserve energy?

Accepted Answer

Major tasks should be performed in the morning,when energy levels are high.Lesser tasks should be done throughout the day after frequent rest periods.Gathering equipment before performing a chore decreases unneeded steps.Carrying more than one or two items at a time saves time and energy.It takes less energy to push items than to carry them.Breaking larger chores into smaller ones allows rest periods between activities and gives the client a sense of completion if unable to complete the whole task.Someone should be hired to do the chores only if the client cannot do them.The outcome should be achieving independence as close as possible to the pre-disability level.

Question 4

The nurse is caring for a client after a stroke.The client has a right facial droop,drools continuously,and chokes on her own saliva.What rehabilitation team member should the nurse consult to ensure client safety?

Accepted Answer

Speech-language pathologists (SLPs)evaluate and retrain clients with speech,language,or swallowing problems.Nutritionists may be needed to ensure that clients meet their nutritional needs.Rehabilitation case managers coordinate the efforts of health care team members.Cognitive therapists,usually neuropsychologists,work primarily with clients who have experienced head injury with cognitive impairment.

Question 5

The nurse collaborates with a physical therapist when providing care for a rehabilitation client.The role of the physical therapist is to help the client with which activities?

Accepted Answer

The role of the physical therapist is to assist in muscle strength development and ambulation.The occupational therapist deals with ADLs,dressing,and activities needed for job training.

Question 6

The nurse is caring for a client with left-sided weakness.Which gait-training techniques will the physical therapist and the nurse use when assisting the client to walk with a cane?

Accepted Answer

Placing the cane in the client's weaker hand does not provide sufficient stability.After the cane in the stronger hand is moved ahead,the cane and the stronger leg provide a stable base for movement of the weaker leg.

Question 7

The nurse is caring for a client with a disabling condition.Which abnormal findings would alert the nurse to an increased risk for skin breakdown?

Accepted Answer

A low serum albumin level indicates less than adequate nutrition,especially of proteins; this greatly increases the risk for skin breakdown and reduces the rate of wound healing.Protein is a critical nutrient for stimulating DNA synthesis,cell division,and tissue repair.Increased weight gain makes it more difficult to move and puts more pressure on pressure areas.Incontinence of bowel or bladder irritates the skin,making it more prone to breakdown.

Question 8

The nurse is caring for a client who is wheelchair bound.Which interventions will the nurse implement to prevent skin breakdown?

Accepted Answer

Clients who sit for prolonged periods in a wheelchair need to be repositioned at least every 1 to 2 hours.Wheelchair push-ups should be done for at least 10 seconds every hour.If the client is wearing tennis shoes to prevent foot drop,the shoes should be removed every 2 hours to check for pressure areas.The lower legs,where the wheelchair could rub against the legs,also needs to be assessed.Pillows under the heels could exert pressure on the heels.It is better to place the pillow under the ankle.The calves of a client with no or decreased lower extremity mobility should not be massaged because of the risk of embolization or thrombus.

Quiz 8: Rehabilitation Concepts for Chronic and Disabling Health Problems