Basic Care and Comfort NCLEX Questions with Correct Answers| 2024/2025 Update Grade A+ Assisting a pt with a weak side ✔✔move towards stronger side Active Resistance ROM ✔✔performed by pt, ROM with resistance. Like exercise bands! Fowler's Positioning ✔✔Low: 15 -30 Fowlers: 45 -60 High: 60 -90 Semi: 30 -45 Trendleburg's ✔✔Used in shock pt's, the feet are elevated 20 and the head is flat, increases venous return and helps the heart pump more easily Going up stairs with crutches ✔✔Up with the good leg, down with the bad leg Walker use ✔✔step forward with bad leg, support self with arms followed by good leg Cane walking ✔✔hold on strong side, advance cane and weak leg, lean on cane when moving strong leg Herniated intervertebral disk care ✔✔preop: meds (nsaids), traction, TENS (electronic nerve stimulation) postop of laminectomy: log roll pt's, assess lower extremity CMS, errect posture, avoid long periods of errect posture, Developmental Dysplasia of the Hips ✔✔T Asymmetrical gluteal folds Limp Limited abduction of the hip femur is not attached to acetabulum tx: pelvic harness from 3 -6 mos, must be worn at all times! teach parents how to apply, 6 -18 mos use traction, surgery will need to be done, or hip spica cast - cast care (keep dry) scoliosis ✔✔abnormal curvature of spinal column assess: bend at 90, see uneven clothing, functional: can be corrected structural: cannot be corrected, often hereditary Rheumatoid arthritis ✔✔nodules in joints, systemic can worsen, remissions and exacerbations osteoarthritis ✔✔seen with aging, obesity, use, no family hx, not seasonal dx: arthroscopy looking into joints tx: depends on severity, rest and activity, give nsaids, anti inflammatories for RA, weight control Gout ✔✔joint pain and swelling, high amount of uric acid in blood, avoid purine foods (beer/organ meat), decrease purine build up osteoporosis ✔✔post menopausal women, reduction of bone mass, kyphosis, over 60 years old, women who drink/smoke, sedentary life prevention: tx: implement diet high in calcium, protein, estrogen therapy, wt bearing excersise, fosimax (recalcifies bone) Osteomyletis ✔✔infxn in bone, pain/swelling at site, caused by staph A, confirmed by x ray, tx: antibiotics, analgesic, high protein diet, spina bifida ✔✔meningiocyle: sack filled with fluid, protruding from back myelomeningocyle: contains spinal cord occulta: low risk - dimpling NTD, assc with low folic acid, s/s: high cry=increase ICP, observe for meningitis tx: cover leason with wet dressing, surgical repair 24 -48 hours of child Hydrocephalus ✔✔increase in CSF, increase head circumference tx: shunt into veritoneal, VP shunt changed with growth Cerebral Palsy ✔✔Poor control over voluntary muscles because of brain damage, can occur by anoxia. One time injury s/s: spasisity, involuntary movements, high calorie diet muscular dystrophy ✔✔progressive muscle weakness, waddle gait, teach safety, pt may need braces, balance between activity and rest Parkinson's ✔✔deficiency in dopamine, tremors, rigidity, pill rolling, slurred speach, tx: swinging while walking, finger exercising, Cogentin, Levidopa, Carbidopa, Symmetryl Myesthenia Gravis ✔✔lack of acetylcholine, autoimmune disorder diplopia, ptosis, impaired speach remissions/exacerbations, can be sudden, crisis: cannot maintain airway, medical emergency! give good eye care, and give restful enviornment give anticholinesterases, corticosteroids immunosuppresants dx: through tensilon test, if pt strength increases= MG, must have atropine as anecdote
