NR 224 Exam 3 rewrite_(Updated, 2020): CHAMBERLAIN COLLEGE OF NURSING (VERIFIED ANSWERS, DOWNLOAD TO SCORE A)

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Exam Study Guide Activity and Exercise 1. Health promotion and maintenance Encourage pt to engage in regular exercise program. Use holistic approach to make and implement plan to enhance the pt’s... overall physical fitness. Discuss recommendations & collaborate w/ pt to design program. Teach pt to calculate heart rate. Include warm-up(5-10min) & cool-down(5-10min) in program. 2. Restorative and Continuing Care Implementing activity & exercise strategies to assist pt w/ ADL’s after acute care is no longer needed. Also restore & promote optimal functioning pts w/ specific chronic illness (coronary heart disease -CHD, hypertension, COPD, diabetes) 3. Assistive devices for walking; proper technique Walkers – hold walker, take one step, move walker forward, and take another step. Lift device up & forward. Canes – use on stronger side. Place cane forward 15-25cm (6-10in) (keeping weight on both legs), Weaker one forward to meet cane (weight on cane & strong), then strong leg moves passed cane (weight on cane & weaker). Crutch: 4point – weight on both legs. Safest gait. Move RIGHT CRUTCH forward (6in), move LEFT FOOT forward to level of right crutch, move LEFT CRUTCH forward, move RIGHT FOOT forward. 3point – weight on UNAFFECTED leg. Move both crutches and weak leg forward, move stronger leg. 2point – partial bearing on BOTH legs. Faster than 4point. Requires more balance. Move the LEFT crutch & RIGHT foot FORWARD together, move the RIGHT crutch & LEFT foot forward together. Swing to gait – using for use w/ paralysis on both legs. Prolonged use results in atrophy of used muscle. Move both crutches together, lift weight by the arms & swing to the crutch (at the level) Swing though gait – move both crutches together, lift body weight by the arms & swing forward pass the crutches (beyond level) 4. Proper measurement for assistive devices Crutches – crutch length (in supine position, measure from axilla down), the angle of elbow flexion 30 degrees (goniometer), and the distance between the crutch pad & the axilla (3 to 4 fingers wide) Cane – length is equal to the distance between the greater trochanter (hip/legs start) and the floor. 5. Safety using assistive devices Crutch – show pt how to routinely inspect crutch tops, securely attach rubber tips, replace worn tips (to increase surface friction to prevent slipping). Explain tips need to remain dry (water decreases friction), teach how to dry w/ paper or cloth if they become wet. Show pt how to inspect the structure. Cracks in wooden crutches decrease ability to hold weight & bents in aluminum crutches alter body alignment. Walker/cane – instruct how to use safely to avoid risk of falling 6. Nursing Implications for assistive devices Collaboration w/ other health care professionals such as physical therapist, promote activity & exercise by teaching the proper use of canes; walkers; or crutches, Depending on the assistive device most appropriate for the pt’s condition. Oxygenation 1. Factors Affecting Oxygenation Physiological, development, lifestyle & environment Physiological – respiratory disorders(hyperventilation, hypoventilation, & hypoxia); cardio disorder(disturbed conduction, impaired valvular function, myocardia hypoxia, cardiomyopathy, peripheral tissue hypoxia). Alterations of blood-carrying oxygen, not inhaling enough oxygen, increased metabolism, alterations by musculoskeletal abnormality or neuromuscular affect chest wall movement. *** Please note that this is meant to serve as an augmentation tool. Students ARE subject to be tested on any material related to readings, simulations, labs, assignments and activities within the course. *** [Show More]

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