Question 1

The nurse is caring for a patient who has had a recent stroke and is paralyzed on his left side.He has no respiratory or cardiac issues,but he cannot walk.He becomes extremely frustrated when he cannot button his shirt and cannot feed himself because he was left-handed.He has shown no signs of dysphagia,but he has been eating very little and has lost 2 lbs.He asks the nurse,"How can I go home like this? I'm not getting better.I can't ask my wife to take care of me like a baby." Of the following list of health care team members,which member would the nurse need to consult?

Accepted Answer

Physical therapists are a resource for planning ROM or strengthening exercises,and occupational therapists are a resource for planning ADLs that patients need to modify or re-learn.Referral to a mental health advanced practice nurse,a licensed social worker,or a physiologist to assist with coping or other psychosocial issues is also wise.Because the patient exhibits good cardiac and respiratory function,respiratory therapy and cardiac rehabilitation probably are not needed at this time.

Question 2

While performing passive ROM exercises,the nurse stands at the side of the bed closest to the joint being exercised and

Accepted Answer

The nurse carries out movements slowly and smoothly,just to the point of resistance.ROM should not cause pain.Never force a joint beyond its capacity.Each movement needs to be repeated five times during the session.

Question 3

The nurse is admitting a patient who has been diagnosed as having had a stroke.The physician writes orders for "ROM as needed." The nurse understands that

Accepted Answer

Further assessment of the patient is needed.Some patients are able to move some joints actively,whereas the nurse passively moves others.With a weak patient,the nurse may have to support an extremity while the patient performs the movement.In general,exercises need to be as active as health and mobility allow.

Question 4

The nurse is caring for a patient who has had a stroke causing total paralysis of the right side.To help maintain joint function and to prevent contractures,passive ROM will be initiated.When should therapy begin?

Accepted Answer

Passive ROM exercises should begin as soon as the patient's ability to move the extremity or joint is lost.The nurse should not wait for the acute phase to end.It may be some time before the patient enters the rehab unit,and contractures could form by then.ROM is certainly needed in this patient.

Question 5

The patient has been diagnosed with a spinal cord injury and needs to be repositioned using the logrolling technique to keep the spinal column in straight alignment.Which of the following is the proper technique for logrolling?

Accepted Answer

At least three to four people are needed to perform this skill safely.Have the patient cross arms on chest to prevent injury to the arms.Move the patient as one unit in a smooth,continuous motion on the count of three.Gently lean the patient as a unit back toward pillows for support.

Question 6

The patient is admitted to a skilled care unit for rehabilitation 10 days after the surgical procedure of fixation of a fractured left hip and has a nursing diagnosis of Impaired physical mobility related to musculoskeletal impairment from surgery and pain with movement.The patient is able to use a walker but needs assistance ambulating and transferring from the bed to the chair.Which of the following nursing interventions is most appropriate for this patient?

Accepted Answer

Assess the patient as she walks and measure how far she walks to quantify progress.The nurse should allow the patient to do as much for herself as possible.Therefore,she should observe the patient transferring from the bed to the chair using her walker,and should provide assistance as needed.The patient should be encouraged to use adequate pain medication to decrease the effects of pain and to increase mobility.The patient should be instructed on safe transfer and ambulation techniques in an environment with few distractions.

Question 7

Correct body alignment reduces strain on musculoskeletal structures and contributes to balance.Balance control is attained by

Accepted Answer

Without balance control,the center of gravity is displaced,thus creating risk for falls and injuries.Balance is enhanced by keeping the body's center of gravity low (not high)with a wide base of support and by maintaining correct body posture.Prolonged immobility leads to impaired balance.

Question 8

The nurse is caring for a patient with the diagnosis of Impaired physical mobility.The nurse needs to be alert for which of the following potential complications?

Accepted Answer

Immobility leads to complications such as pulmonary emboli or pneumonia.Other possible diagnoses include impaired skin integrity.Insomnia and social isolation are more common complications than somnolence or increased socialization.

Quiz 92: Mobility and Immobility