A nurse has been assigned four patients of which one of the patients is completely immobile. Which complication should the nurse expect as a result of immobility? (Select all that apply.)
Pressure ulcers
Contractures of the extremities
development of deep vein thrombosis
Crackles in the lungs
Polyuria
Diarrhea
Correct Answer : A,B,C,D
A. Immobile patients are at high risk for developing pressure ulcers due to prolonged pressure on the skin, leading to tissue breakdown.
B. Contractures of the extremities can occur as a result of muscle atrophy and lack of movement in immobilized patients.
C. Immobility increases the risk of venous stasis, leading to the development of deep vein thrombosis (DVT).
D. Crackles in the lungs may result from immobility due to fluid accumulation or atelectasis, particularly in patients who are not moving or changing position frequently.
E. Polyuria is not commonly associated with immobility.
F. Diarrhea is not commonly associated with immobility.
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Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
A. Discharge from the eyes is generally a symptom of infection or irritation and not a specific age-related condition.
B. Presbyopia is the age-related loss of near vision, common in older adults.
C. Cataracts, which involve clouding of the lens, are commonly seen with aging.
D. Xanthelasma is a condition in which yellowish deposits of fat form under the skin, usually around the eyes, and it is often seen in older adults.
E. Macular degeneration, which affects central vision, is a common condition in older adults.
Correct Answer is B
Explanation
A. A well-defined mass is typically benign, while malignant tumors are often irregular and less defined.
B. Nipple retraction or dimpling can be a sign of a malignant tumor because cancer can cause changes in the breast's structure.
C. Stretch marks are not related to malignancy and are often a result of changes in skin elasticity.
D. Tenderness of the breast is more commonly associated with benign conditions, such as fibrocystic changes, rather than malignancy.
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