Nursing Care of Mobility

Prepare: The Nursing Care of Mobility

Nursing Intervention – Recognizing Cues

• The nurse is caring for a client who was recently injured the right leg while playing basketball. Which symptoms could be most consistent with a bone injury? Select all that apply.

Recognizing Cues – Altered Mobility

• The nurse is caring for a client with a nerve impingement in the lower back area around L4 and L5. Which symptoms are consistent with nerve injury? Select all that apply.

Nursing Intervention – Altered Mobility and Lifestyle

• The nurse is preparing a discharge plan for a client being discharged after a left tibial fracture. In suggesting lifestyle changes which can decrease the healing time, which of the following does the nurse review with the client?

Self-Check: Analyze Cues – Altered Mobility

• Review the information and picture to the right. Select the pertinent information below based on your assessment.

Laura is being discharged home today. She maintains full range of motion of both of her hands and is able to walk without pain. She was unable to get dressed this morning without assistance. Just before discharge she has walked around the unit five times (the physical therapy goal was twice). In offering further education on her new prescriptions, she says that she does not plan on taking the pain medicine and therefore refuses instructions. Vital signs: T=98.6, blood pressure 120/68, pulse 95, oxygen saturation 96% on room airPatient ambulated to the exam room with some assistance. Pedal pulses palpated at +2. Capillary refill less than 3 seconds below the point of the injury. Patient smokes 1 pack daily. Exercises four times a week. Works from home. No family history of illnesses. Past medical history of appendicitis, vitamin D deficiency, and right ulnar fracture.Patient ambulated to the exam room with some assistance. Pedal pulses palpated at +2. Capillary refill less than 3 seconds below the point of the injury.

Self-Check: Nursing Assessment of Risk – Altered Mobility

• The nurse is caring for a client with a femur fracture. Currently the client is on bedrest with the effected leg elevated. Which prescription from the health care provider requires urgent action to prevent complications?

Self-Check: Nursing Actions – Hematologic Alterations

Nursing Actions – Altered Mobility

• Review the nursing actions below. Select the nursing diagnosis that best fits these actions.

Self-Check: Outcome – Nursing Evaluation

• The nurse is caring for a patient who was involved in a motor vehicle accident. The client is alert and requesting pain medication for a pain level of 8 on a 1 to 10 scale. The client does not have elevated blood pressure or pulse and does not appear to be in distress. Non-pharmacological treatment has not worked. The client is due to receive the pain medication at this time as needed. Which of the following is most appropriate?

Self-Check: Analyze Cues – Altered Mobility

• The nurse is teaching a class and looks for some examples of different things that can affect treatment of altered mobility. Review the examples below and identify the barrier to each situation from the drop-down choices.

Reflect: The Nursing Care of Mobility

Recognizing Cues – Nursing Assessment

• Review the case below and select all assessment items that are risk factors or require priority follow-up.

Analyzing Cues – Nursing Assessment

• In analyzing the client record, which assessment items are consistent with a fractured hip?

Nursing Diagnoses – Planning Interventions

• Ernestine has a fractured hip. In developing the care plan, the nurse identifies some interventions that will help Ernestine.

Planning Care – Fracture

• Review the nurse’s progress note below, and answer the following questions.

Nurse’s Progress Note

Ernestine reports pain in her hip. Vitals: BP-152/88, P-102, R-24. Oxygen saturation 96%. She describes it as a soreness with intermittent throbbing. The nurse asks her to identify her pain as a 6 on a numeric pain scale. She received ketorolac 60mg IM at 10:00.

• Based on the information available, select the appropriate nursing actions from the prescriptions below. Select all that apply.
• What is the expected outcome to measure with your interventions?

Recognizing and Analyzing Assessment Cues – Amputation

• Review the nursing progress note below and select the priority nursing assessment cues.

Prioritizing Care

• For the nursing diagnoses listed below, match the appropriate “as evidenced by” reason.

Nursing Actions – Amputation

• The nurse is reviewing Martha’s post-operative prescriptions. Drag the correct nursing diagnosis to match the given prescription.

Nursing Outcomes – Amputation

• Review the nursing discharge note and check if the goal is being met at this time or check whether further follow-up is required before the transfer.

Nursing discharge note:

• Martha is being transferred to a rehabilitation unit today. She can pivot transfer from a bed to a wheelchair with assistance. She denies any pain currently. Her dressing is clean, dry, and intact without drainage. Occupational therapy has completed their plan of care. Vital signs: T=101.1, blood pressure 120/68, pulse 95, oxygen saturation 96% on room air.

Prepare: Magnetic Properties

Magnets

• All magnets have a north and south pole and these two poles attract each other. When a magnet is passed back and forth through a copper circle:

MRI Scans

• MRI scans are very useful in that they:

Self-Check: Magnetic Metals

• Which of the metals below is NOT one of the most common magnetic metals?

Self-Check: Magnetic Material

• The tiny magnets inside a substance which align when the substance is near a magnet are called:

Self-Check: Electric Current

• A changing electric current generates:

Self-Check: Magnet Therapy

• Magnet therapy for pain treatment is a bit controversial in that:

Self-Check: MRIs

• An MRI makes use of strong:

Reflect: Magnetic Properties

Poles

• Which type of material always has two opposite poles which attract each other?

Current

• When a current is passed back and forth through a piece of metal, what is produced?

MRI Scans

• MRI scans are unique compared to Xrays and CT scans in that MRIs:

Magnetic Metals

• Which of the lists below contains the main magnetic metals:

Magnetic Material

• When a magnetic material is brought near a magnet, what happens?

Copper

• When a magnet is set next to a copper circle, what happens?

Magnet Therapy

• What effect could magnet therapy have in the body?

MRIs

• The magnets in an MRI:

Osteoarthritis

Prepare: Osteoarthritis

Recognizing Cues – Pathophysiology of Osteoarthritis

• Which statement describes the primary cause of osteoarthritis?

Recognizing Cues – Osteoarthritis Risk Factors

• Which factors increase the risk of osteoarthritis arthritis (OA)? Select all that apply.

Nursing intervention – OA and Lifestyle

• The nurse is preparing a discharge plan for a client post total right knee replacement. Which information that would promote healing should the nurse review with the client? Select all that apply.

Self-Check: Analyze Cues – Arthritis

• Select the correct choice in the sentences below to accurately describe Osteoarthritis.

Self-Check: Analyze Cues – Arthritis

• Review the table below and select the cues that would be expected for each type of arthritis. For each cue below, more than one choice can be correct.

Self-Check: Nursing Actions – Osteoarthritis

• Match the nursing diagnosis with the proper action.

Self-Check: Planning for Intervention – Osteoarthritis Arthritis

• Review the medication name below and match it to the appropriate class and considerations for administration.

Self-Check: Analyze Cues – Osteoarthritis

Analyze Cues – Arthritis

• Select the correct choice in the sentences below to accurately describe Osteoarthritis.

Analyze Cues – Osteoarthritis

• The nurse is teaching a class and looks for some examples of different things that can affect treatment of osteoarthritis. Review the examples below and identify the barrier to each situation from the drop-down choices

Reflect: Osteoarthritis

Recognizing Cues – Nursing Assessment

• Review the case below and select all assessment items that are expected for this client based on the admission diagnosis of degenerative joint disease

Analyzing Cues – Nursing Assessment

• In analyzing the patient record, which assessment items are consistent with degenerative joint disease caused by osteoarthritis? Select all that apply.

Nursing Diagnoses – Planning Interventions

• Linda will need a total right knee replacement. In developing the care plan, the nurse identifies some interventions that will help Linda before surgery. Select from the following inventions and match them with the nursing diagnosis.

Planning Care – Osteoarthritis

Nurses Progress Note:

• At 1400, Linda is voicing pain in right knee. Vitals: BP-152/88, P-102, R-22. Oxygen saturation 96%. She describes it as a soreness with intermittent throbbing. The nurse asks her to identify her pain on a numeric pain scale, which she describes as 5/10. Which prescribed medication would have the least likelihood of adverse effects?

Recognizing and Analyzing Assessment Cues – Osteoarthritis

• Review the nursing progress note below and select the priority nursing assessment cues.

Prioritizing Care – Osteoarthritis

• For the assessment findings below, match the appropriate nursing diagnosis.

Nursing Actions – Osteoarthritis

• The nurse is reviewing Mary’s post-operative orders. Match the order to the nursing diagnosis.

Nursing Outcomes – Knee Replacement Surgery

• Mary is being transferred to a rehabilitation unit today. She can pivot transfer from a bed to a wheelchair with assistance. She has been having pain of 5/10 even after pain medication two hours ago. Her dressing is dry and intact with no drainage. Occupational therapy has not been able to see the patient yet. Vital signs: T=98.6, blood pressure 120/68, pulse 95, oxygen saturation 96% on room air. Review the nursing discharge note and check if the goal is being met at this time or check whether further follow-up is required before the transfer.

Rheumatoid Arthritis

Prepare: Rheumatoid Arthritis

Recognizing Cues – Rheumatoid Arthritis

• Which pathophysiologic change is the primary cause of rheumatoid arthritis?

Recognizing Cues – Rheumatoid Arthritis

• Which factors increase the risk of rheumatoid arthritis (RA)? Select all that apply.

Recognizing Cues – Rheumatoid Arthritis

• Which factors may precede joint inflammation in rheumatoid arthritis? Select all that apply.

Self-Check: Analyze Cues –Arthritis

• Select the correct choice in the sentences below to accurately describe rheumatoid arthritis:

Self-Check: Signs and Symptoms

Recognizing Cues – Arthritis

• Review the choice of symptoms and signs below. Drag each symptom to the correct condition for that symptoms.

Self-Check: Planning for Intervention – Rheumatoid Arthritis

• Select the correct term that accurately completes these sentences.

Self-Check: Planning for Intervention – Rheumatoid Arthritis

• Review the medication name below and match it to the appropriate class and considerations for administration:

Self-Check: Planning for Intervention – Rheumatoid Arthritis

• Review the nursing interventions below and match to the appropriate nursing diagnosis:

Reflect: Rheumatoid Arthritis

Recognizing Cues – Rheumatoid Arthritis

• Review the case below and select all abnormal assessment items that are unique to rheumatoid arthritis and not to osteoarthritis

Recognizing Cues – Rheumatoid Arthritis

• In reviewing the provider orders for Laura, the nurse notes some diagnostic tests. Laura asks which tests were ordered for the inflammation in her hands. Select the tests below specific for inflammation and rheumatoid arthritis. Select all that apply.

Analyzing Cues – Rheumatoid Arthritis

• Review the cases below and select the ones that are consistent with rheumatoid arthritis.

Planning Care – Rheumatoid Arthritis

• Laura will be receiving her first dose of infliximab 400mg IV next week. The following orders were received. Select the orders that need completion before giving infliximab.

Generating Hypotheses – Nursing Analysis

• Laura is newly diagnosed with rheumatoid arthritis. She currently works fulltime as a server, and lives below the poverty line in her state. She is the sole wage earner. She has trouble going to work and staying at work as she tires easily, and has periods of moderate pain in her hands, wrists, neck, and ankles. She currently has a moderate amount of pain and it is difficult to close her hands completely. She doesn’t understand why she sometimes feels fine, and other times feels terrible.

Planning Care – Nursing Delegation

• The nurse is caring for a client with rheumatoid arthritis. Currently, an unlicensed assistive personnel (UAP) is also assigned to this patient. Which actions can the nurse delegate to the UAP to perform?

Nursing Actions – Rheumatoid Arthritis

• Review the following nursing diagnoses, and match the nursing action that is most appropriate for each. Click the nursing diagnosis in the left column and then click the matching action in the right column.

Nursing Outcomes – Rheumatoid Arthritis

• Review the nursing discharge note and check if the goal is being met at this time or check whether further follow-up is required before the transfer.

Nursing discharge note:

• Laura is being discharged home today. She maintains full range of motion of both of her hands and is able to walk without pain. She was unable to get dressed this morning without assistance. Just before discharge she has walked around the unit five times (the physical therapy goal was twice). In offering further education on her new prescriptions, she says that she does not plan on taking the pain medicine and therefore refuses instructions. Vital signs: T=98.6, blood pressure 120/68, pulse 95, oxygen saturation 96% on room air.