Exam 28: Immobility

A patient has damage to the cerebellum. Which disorder is most important for the nurse to assess?

A nurse is preparing to reposition a patient. Which task can the nurse delegate to the nursing assistive personnel?

A nurse is preparing a care plan for a patient who is immobile. Which psychosocial aspect will the nurse consider?

The patient has been in bed for several days and needs to be ambulated. Which action will the nurse take first?

The nurse is caring for a patient who has had a recent stroke and is paralyzed on the left side. The patient has no respiratory or cardiac issues but cannot walk. The patient cannot button a shirt and cannot feed self due to being left-handed and becomes frustrated very easily. The patient has been eating very little and has lost 2 lbs. The patient asks the nurse, "How can I go home like this? I'm not getting better." Which health care team members will the nurse need to consult? (Select all that apply.)

Which patient will cause the nurse to select a nursing diagnosis of Impaired physical mobility for a care plan?

The nurse is caring for a patient who is immobile and needs to be turned every 2 hours. The patient has poor lower extremity circulation, and the nurse is concerned about irritation of the patient's toes. Which device will the nurse use?

A nurse is caring for an immobile patient. Which metabolic alteration will the nurse monitor for in this patient?

Upon assessment a nurse discovers postural abnormalities on several patients. Match the abnormalities to the findings the nurse observed. -Torticollis

Upon assessment a nurse discovers postural abnormalities on several patients. Match the abnormalities to the findings the nurse observed. -Kyphosis

Which goal is $\bold{most}$ appropriate for a patient who has had a total hip replacement?

A nurse is assessing body alignment. What is the nurse monitoring?

A nurse is supervising the logrolling of a patient. To which patient is the nurse most likely providing care?

A nurse is evaluating care of an immobilized patient. Which action will the nurse take?

The nurse is assessing the patient for respiratory complications of immobility. Which action will the nurse take when assessing the respiratory system?

Upon assessment a nurse discovers postural abnormalities on several patients. Match the abnormalities to the findings the nurse observed. -Lordosis

The nurse is assessing body alignment for a patient who is immobilized. Which patient position will the nurse use?

The nurse is caring for a patient who needs to be placed in the prone position. Which action will the nurse take?

The nurse is caring for an older-adult patient with a diagnosis of urinary tract infection (UTI). Upon assessment the nurse finds the patient confused and agitated. How will the nurse interpret these assessment findings?

A nurse is assessing pressure points in a patient placed in the Sims' position. Which areas will the nurse observe?