A client with a medical diagnosis of acute respiratory distress syndrome (ARDS) is being placed in the prone position. The nurse explains to family members that, "This will help improve ventilation by:

allowing undamaged areas in the lower part of the lungs to be ventilated."

relieving pressure on the diaphragm and allowing expansion."

decreasing pressure to the back of the rib cage."

snifting fluid into the back area of the lungs.'

Answer and Explanation

The Correct Answer is A

A. Allowing undamaged areas in the lower part of the lungs to be ventilated: The prone position is commonly used in patients with acute respiratory distress syndrome (ARDS) to improve oxygenation and ventilation. In ARDS, the lung tissue is often damaged, particularly in the dorsal (back) regions of the lungs, due to gravity and ventilation-perfusion mismatch. By placing the patient in the prone position, gravity helps redistribute the blood flow and improve ventilation to the posterior (lower) parts of the lungs, which are typically under-ventilated in the supine position. This positioning allows healthier or less-damaged areas of the lungs to receive better airflow, improving overall oxygenation.

B. Relieving pressure on the diaphragm and allowing expansion: While the prone position does shift pressure away from certain areas, its primary benefit is not related to relieving pressure on the diaphragm. The diaphragm, while somewhat affected by body position, is not the key structure being targeted for ventilation improvement. The main goal of prone positioning is to improve lung aeration in areas affected by ARDS, not directly to relieve diaphragm pressure.

C. Decreasing pressure to the back of the rib cage: The prone position does not specifically target reducing pressure to the back of the rib cage. Although it changes how pressure is distributed across the body, the main goal is to facilitate better ventilation and perfusion to the posterior lung regions, not necessarily to reduce pressure on the rib cage itself.

D. Sniffing fluid into the back area of the lungs: This option is unclear and not accurate. The prone position does not "sniff" fluid into the lungs; rather, it helps to redistribute fluid and improve the ventilation of the lung areas that are less affected by edema or inflammation in ARDS. The goal is to improve the ventilation/perfusion ratio and prevent further collapse of lung tissue.

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Correct Answer is A

Explanation

A. Muscle rigidity and bradykinesia: Parkinson's disease (PD) is characterized by a combination of motor symptoms due to the degeneration of dopamine-producing neurons in the brain. The hallmark motor symptoms include muscle rigidity (stiffness of muscles, making movement difficult) and bradykinesia (slowness of movement). These symptoms are typically present early in the disease and can lead to difficulties with daily activities such as walking, speaking, and performing fine motor tasks. These two signs are primary indicators of Parkinson's disease.

B. Facial pain and ptosis: Facial pain and ptosis (drooping eyelids) are not typical symptoms of Parkinson's disease. PD can affect facial expression (resulting in a masked face), but it does not usually cause facial pain. Ptosis is more commonly seen in conditions like Horner's syndrome, myasthenia gravis, or as a side effect of medications, but it is not a hallmark symptom of Parkinson's disease.

C. Diarrhea and nausea: While gastrointestinal symptoms such as constipation can be seen in Parkinson's disease due to autonomic dysfunction and decreased gut motility, diarrhea and nausea are not typical primary symptoms. In fact, constipation is a more common issue in PD. Nausea could result from the use of medications like levodopa, but it is not a defining feature of the disease itself.

D. Ecchymosis and petechiae: Ecchymosis (bruising) and petechiae (small red or purple spots on the skin) are not characteristic of Parkinson's disease. These findings are more often associated with platelet disorders, bleeding disorders, or vascular conditions. While Parkinson's disease can involve complications like falls (which could lead to bruising), these are not direct symptoms of the disease itself. The primary symptoms involve motor and autonomic dysfunction.

A. Resume smoking initially to help manage stress and anxiety. B. Consume a high-fat diet to promote weight gain and energy. C. Avoid physical activity and rest as much as possible. D. Continue taking all prescribed medications as directed. E. "Can you rate your pain on a 0-10 scale?"

Correct Answer is D

Explanation

A. Resume smoking initially to help manage stress and anxiety:
Smoking is a significant risk factor for cardiovascular disease and can worsen the prognosis after coronary artery bypass graft (CABG) surgery. Smoking increases the risk of coronary artery disease and impairs healing after surgery. Therefore, advising the client to resume smoking, even temporarily, is unsafe and completely contrary to health recommendations for post-CABG care. Smoking cessation should be emphasized as a key part of the recovery process.

B. Consume a high-fat diet to promote weight gain and energy:
A high-fat diet is not recommended for individuals with coronary artery disease, especially after CABG surgery. Consuming a diet high in saturated fats and cholesterol can lead to further plaque buildup in the coronary arteries, increasing the risk of atherosclerosis and cardiac events. After CABG, patients are typically encouraged to follow a heart-healthy diet that is low in saturated fat, high in fiber, and rich in fruits, vegetables, and lean proteins to support overall heart health and recovery.

C. Avoid physical activity and rest as much as possible:
While rest is essential immediately following surgery, complete avoidance of physical activity is not advisable long-term. In fact, early and gradual physical activity is a key component of rehabilitation after CABG surgery. A sedentary lifestyle can increase the risk of complications such as blood clots, muscle weakness, and weight gain, while physical activity helps improve circulation, heart function, and overall recovery. The nurse should encourage the client to gradually resume physical activity according to the guidance of their healthcare provider, often starting with light walking and progressing as tolerated.

D. Continue taking all prescribed medications as directed: Following coronary artery bypass graft (CABG) surgery, it is essential for the client to continue taking all prescribed medications, including antiplatelets, statins, beta-blockers, and any other medications ordered by the healthcare provider. These medications play a critical role in preventing blood clots, controlling blood pressure, reducing cholesterol levels, and preventing future cardiac events. Stopping or altering medications without consulting a healthcare provider could increase the risk of complications or recurrent cardiac events.

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A client with a medical diagnosis of acute respiratory distress syndrome (ARDS) is being placed in the prone position. The nurse explains to family members that, "This will help improve ventilation by:

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