A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?

Perform active range of motion exercises.

Apply compression stockings.

Give antispasmodic medications.

Massage the extremities twice a week.

Answer and Explanation

The Correct Answer is C

A. Perform active range of motion exercises: Active ROM exercises are beneficial for maintaining joint mobility and circulation, but they may not sufficiently reduce spasticity in clients with upper motor neuron lesions.

B. Apply compression stockings: Compression stockings help prevent venous thromboembolism and manage edema, but they do not treat muscle spasticity. They offer circulatory support, not neuromuscular control, and therefore would not alleviate the client’s current concern.

C. Give antispasmodic medications: Antispasmodics such as baclofen or tizanidine directly target muscle spasticity by acting on the central nervous system. These medications reduce the frequency and intensity of spasms, improving comfort and mobility in clients with spinal cord injuries.

D. Massage the extremities twice a week: Massage may offer relaxation and temporary relief but is not a primary treatment for spasticity. It does not alter the neurophysiological causes of muscle spasms and is unlikely to produce sustained control over involuntary muscle activity.

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Correct Answer is A

Explanation

A. Glucose and calcium levels: During thyrotoxic crisis, the body’s metabolism is increased, which can lead to hyperglycemia. Additionally, calcium levels may fluctuate due to the impact of thyroid hormones on bone metabolism, making these values critical to monitor.

B. Electrolytes and hemoglobin: While monitoring electrolytes is important, they are not the most critical values in a thyrotoxic crisis. Hemoglobin levels are not directly impacted by thyroid storm and are less likely to provide essential insights for managing this condition.

C. Renal and liver function tests: While important for general health monitoring, renal and liver function tests are not the most critical in the immediate management of a thyrotoxic crisis. The focus should be on metabolic and electrolyte imbalances rather than organ function tests.

D. Blood and urine cultures: Blood and urine cultures are used to detect infections, they are not a priority during a thyrotoxic crisis unless there is a concern about infection. The primary focus should be on managing thyroid hormone levels and associated metabolic effects.

A. Encourage the parent to apply lotion with each diaper change. B. Instruct the parent to change the child's diaper more often. C. Ask the parent to decrease the infant's intake of fruits for 24 hours. D. Tell the parent to cleanse with soap and water at each diaper change.

Correct Answer is B

Explanation

A. Encourage the parent to apply lotion with each diaper change: Lotions are not usually recommended for diaper rash as they can trap moisture against the skin, worsening irritation. Barrier creams (like zinc oxide) are preferred.

B. Instruct the parent to change the child's diaper more often: Frequent diaper changes help keep the area dry and clean, reducing skin irritation and promoting healing, especially when there's no sign of infection or allergy.

C. Ask the parent to decrease the infant's intake of fruits for 24 hours: There’s no indication that diet is contributing to the rash, especially since there are no watery stools or other signs of gastrointestinal upset.

D. Tell the parent to cleanse with soap and water at each diaper change: Using soap can dry or irritate already sensitive skin. Plain water or gentle wipes without alcohol/fragrance are preferred for cleaning the area.

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A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which laboratory values are critical for the nurse to monitor for a client who is experiencing a thyrotoxic crisis?

Correct Answer is A

Explanation

The parent of a 7-month-old brings the infant to the clinic because the skin in the diaper area is excoriated and red, but there are no blisters or bleeding. The parent reports no evidence of watery stools. Which nursing intervention should the nurse implement?

Correct Answer is B

Explanation

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Exhibits The nurse reviews the prescriptions and plans initial steps for caring for the client. Click to indicate which interventions the nurse should perform to care for this client. Each row must have one response indicated.