Nur 236 chapters 31 and 32 muscle skeletal exam with complete solution
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Nurs236
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Nurs236
The nurse is discussing actions that can be taken to best prevent osteoporosis with a patient. Which information should the nurse include?
Exercise throughout life.
A lifetime of even mild daily exercise will delay or prevent osteoporosis.
What does goniometry measure?
Range-of-motion (...
Nur 236 chapters 31 and 32 muscle
skeletal exam with complete solution
The nurse is discussing actions that can be taken to best prevent osteoporosis
with a patient. Which information should the nurse include? - ANSWER- Exercise
throughout life.
A lifetime of even mild daily exercise will delay or prevent osteoporosis.
What does goniometry measure? - ANSWER- Range-of-motion (ROM)
Goniometry measures joint mobility, described as the number of degrees that the
joint can move from the 0-degree mark.
Positioning and range-of-motion (ROM) exercises most help the immobilized
patient to prevent which complication? - ANSWER- Contractures
Although positioning may help decrease pain and increase circulation,
anatomical alignment and ROM exercises are most helpful in preventing
contractures in the immobilized patient. Pressure ulcers are prevented by
frequent position changes.
The nurse adds interventions for range-of-motion (ROM) and isometric exercises
for the new patient with a stroke. The nurse's reasoning stems from her
awareness that contracture formation may begin with how many days of
immobilization? - ANSWER- 3 days
Contracture-related muscle changes occur as early as 3 days of immobilization.
If muscles are not regularly stretched and contracted, how will the muscles be
effected? - ANSWER- Muscles will become shorter and less elastic
,The formation of contractures (shortening of skeletal muscle tissue causing
deformity), loss of muscle tone, and fixation of joints can be prevented in most
cases by consistent nursing intervention. The major components of the
intervention are gradual mobilization, an exercise program, proper positioning,
and instruction of the patient and family. Within a matter of a few days, the
structures of immobilized muscles and joints begin to undergo changes. If no
effort is made to prevent these changes, the patient will become permanently
disabled.
The nurse uses a visual aid to show the pathologic muscle tone changes that
result in foot drop. Which changes should the nurse include? - ANSWER- The
stretching of flexor muscles
The most frequent contractures occurring in patients immobilized for long
periods are "foot drop," knee and hip flexion contractures, "wrist drop," and
contractures of the fingers and arms. Calf muscles contract and flexor muscles
are stretched, allowing the unbraced foot to drop toward the surface of the bed.
How often should range-of-motion (ROM) exercises be performed? - ANSWER-
Three to four times a day
ROM exercises, both passive and active, are planned and carried out as soon as
feasible after immobilization occurs as a result of disease, injury, or surgery. The
exercises are done to maintain functional connective tissue within the joint and
thereby ensure that every joint retains its function and mobility. ROM exercises
should be done three to four times a day.
The physician has prescribed isometric exercises for a patient. For which patient
should the nurse question this order? - ANSWER- A patient experiencing an
acute exacerbation of congestive heart failure
Isometric exercises are based on the energy of opposing muscles working
against each other. Isometric exercise may be contraindicated in patients with
hypertension, increased intracranial pressure, or congestive heart failure, as
there is a significant increase in blood pressure and heart rate during isometric
exercise
, When the patient returns to the unit from having had an arthrogram, which
intervention should the nurse perform first? - ANSWER- Apply ice packs to the
knee
Ice packs applied to the knee will reduce swelling. The patient will ambulate at
some point but not before the application of ice. There is not going to be a
significant loss of mobility for the patient, so ROM exercises will not likely be
included in the plan of care. There is no indication that an elastic bandage is
needed.
The nurse encourages the patient to use the four-point crutch gait technique.
Which statement indicates that the patient accurately understands the nurse's
teaching? - ANSWER- This way of walking is the most stable gait."
The four-point crutch gait is the most stable, requires that there may be partial
weight bearing on both legs, and does not mimic normal walking pattern.
The nurse is assessing the patient's cane for appropriate length. Which
observation affirms that an appropriate cane has been selected? - ANSWER- The
handgrip is at hip level.
The handgrip should be at hip level to allow for proper flexion of the arm to bear
weight. The cane tip should be placed 6 inches from the good foot. The elbow
angle should be 30 degrees
The nurse is instructing the patient on quadriceps and gluteal muscle exercises.
Which instructions should the nurse include? - ANSWER- In a supine position,
straighten the leg and tense leg muscles while raising heel.
The quad setting exercise is to straighten the leg and tense the leg muscles while
raising the heel
What is the name for the anatomical structure that joins the bones of a joint
together? - ANSWER- A ligament
Ligaments hold the bones of a joint together. Tendons are connective tissues that
provide joint movement. Cartilage is a type of connective tissue in which fibers
and cells are embedded in a semisolid gel material.
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