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Musculoskeletal System and CareMedical-Surgical Nursing-7th edition

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Question Answer
An immobilized patient gets a respiratory system assessment every ______.
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2 hours.
What components of a cardiovascular assessment are extremely important for an immobilized patient? (5)
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Blood pressure to detect orthostatic hypotension (increased risk for falls), apical and peripheral pulses (thrombus formation), edema (circulation impairment, thrombus formation), calf and thigh measurements daily (DVT formation), and monitoring for signs and symptoms of venous stasis (thrombus formation risk).
An immobilized client has cold hands, feet, nose and earlobes but their central body regions are warm. This means?
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The heart is unable to tolerate the increased work load leading to cardiac failure. This is a common complication in the elderly.
You hear a 3rd heart sound at the apex of the heart in an immobilized elderly woman. You suspect that she has developed?
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Congestive heart failure.
When assessing an immobilized patient for edema, what areas are you assessing?
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The sacrum, legs and feet
An immobilized patient should be assessed for the formation of a DVT every _______.
Show Answer
8 hours.
How should you assess a patient for the development of a DVT?
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Measure the calf circumference 10 centimeters down from the mid-patella, once daily. Measure the thigh. Check for redness, warmth and tenderness.
Who is most at risk for disuse osteoporosis?
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Clients on bed rest, post-menopausal women, patients on steroids, and patients with elevated serum and urine calcium.
What are the complications of dehydration when coupled with immobility?
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It increases the risk of skin breakdown, thrombus formation, respiratory infections, UTIs and constipation.
What is the major difference between a nursing diagnosis of Impaired physical mobility and Disuse Syndrome?
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Impaired mobility denotes some limitation but not a complete immobilization. Disuse syndrome denotes immobility and increased risk of multisystem problems.
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An elderly woman who has been immobilized for several days becomes uncharacteristically confused. She has no fever and has no signs of a thrombus formation. Based on this, you suspect?
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She has developed a UTI. Elderly patients typically present with confusion (and no fever).
What are lifestyle risk factors for the development of osteoporosis? (4)
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Smoking, caffeine consumption, alcohol consumption and menopause.
An immobilized, acute care patient should be on a diet high in?.
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Calories, protein, vitamins B and C
An immobile patient should consume ________ mL of fluid a day to decrease the viscosity of pulmonary secretions.
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2000 mL/2 liters
What interventions can prevent DVTs?
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Leg, foot and ankle exercises, TED Hose, fluids, position changes, getting the patient out of bed as soon as possible, medications, SCDs, or heparin.
What positions should be avoided for someone at risk for DVTs?
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Crossing the legs, prolonged sitting, restrictive clothing that compresses the legs or waist, or pillows under the knees.
ROM exercises to prevent DVTs should be performed every ______.
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1 to 2 hours. Knee flexion should be done every hour while the patient is awake.
Patients at risk for skin breakdown should shift their weight every _________.
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15 minutes
How long can a patient who is at risk for skin breakdown be permitted to sit in a bedside chair?
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One hour
A _________ prevents external rotation of the hips when a client is supine.
Show Answer
Trochanter roll
How is metabolism impacted in an immobilized patient that has active wound healing?
Show Answer
They have an increased basal metabolism rate because of increased cellular oxygen requirements.
  
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