A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery.

Which of the following statements by the client indicates a need for further teaching?

“I will use a walker until I can walk without pain.”.

“I will avoid crossing my legs or bending my hip more than 90 degrees.”.

“I will sleep on my back with a pillow between my legs.”.

“I will apply ice to my hip if it becomes swollen or inflamed.”.

Answer and Explanation

The Correct Answer is A

The correct answer is A.

“I will use a walker until I can walk without pain.” This statement indicates a need for further teaching because the client should use a walker or other assistive device until they have regained their balance, flexibility and strength, not just until the pain subsides. Using a walker too long or too little can affect the healing process and the stability of the new hip joint.

Choice B is correct because the client should avoid crossing their legs or bending their hip more than 90 degrees to prevent dislocating the new hip joint.

Choice C is correct because the client should sleep on their back with a pillow between their legs to keep the hip in a neutral position and prevent excessive internal or external rotation.

Choice D is correct because the client should apply ice to their hip if it becomes swollen or inflamed to reduce pain and inflammation. The client should also elevate their leg and notify their healthcare provider if they notice any signs of infection, such as fever, chills, redness, warmth or drainage from the incision site.

Normal ranges for hip replacement surgery recovery vary depending on the individual and the type of surgery, but some general guidelines are:.

• The client should be able to walk with a cane or crutches within 2 to 4 weeks after surgery.

• The client should be able to resume most daily activities within 6 to 12 weeks after surgery.

• The client should avoid high-impact activities, such as running, jumping or contact sports, for at least 6 months after surgery.

• The client should have regular follow-up visits with their healthcare provider and physical therapist to monitor their progress and adjust their treatment plan as needed.

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Correct Answer is D

Explanation

The correct answer isD.

All of the above.All of these findings are risk factors for falls in older adults, according to the literature.

Some explanations for why each choice is a risk factor are:.

A. Orthostatic hypotension: This is a condition where blood pressure drops too much when getting up from lying down or sitting, causing dizziness, lightheadedness, or fainting.This can affect balance and increase the chance of falling.

B. Urinary frequency: This is a condition where one needs to urinate often, sometimes urgently.This can cause rushed movement to the bathroom, especially at night, which can lead to tripping, slipping, or losing balance.

C. Visual impairment: This is a condition where one has reduced or distorted vision, such as due to cataracts, glaucoma, macular degeneration, or diabetic retinopathy.This can affect depth perception, contrast sensitivity, and ability to detect obstacles or hazards in the environment.

Some normal ranges for these conditions are:.

• Orthostatic hypotension: A normal blood pressure change when standing up is less than 20 mmHg systolic (top number) or 10 mmHg diastolic (bottom number).

Orthostatic hypotension is defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.

• Urinary frequency: A normal urinary frequency is about 4 to 6 times per day, depending on fluid intake and other factors.

Urinary frequency is considered abnormal if it is more than 8 times per day or more than 2 times per night.

• Visual impairment: A normal visual acuity is 20/20 or better with or without correction.

Visual impairment is defined as a visual acuity of 20/40 or worse in the better-seeing eye with best correction possible.

A. The client is independent in all ADLs. B. The client needs assistance with two ADLs. C. The client is dependent on others for all ADLs. D. The client has difficulty with four ADLs.

Correct Answer is B

Explanation

The correct answer is B.

The client needs assistance with two ADLs.This is because the Katz Index of Independence in Activities of Daily Living (ADLs) is a tool that measures the client’s ability to perform six basic ADLs independently: bathing, dressing, toileting, transferring, continence, and feeding.The score ranges from 0 to 6, with 6 indicating complete independence, 4 indicating moderate impairment, and 2 or less indicating severe dependence.The score is based on the number of ADLs that the client can perform without supervision, direction, personal assistance, or total care.

Therefore, a score of 4 out of 6 means that the client needs assistance with two ADLs.

Choice A is wrong because it implies that the client is independent in all ADLs, which would require a score of 6 out of 6.

Choice C is wrong because it implies that the client is dependent on others for all ADLs, which would require a score of 0 out of 6.

Choice D is wrong because it implies that the client has difficulty with four ADLs, which would require a score of 2 out of 6.

The normal range for the Katz Index of Independence in Activities of Daily Living (ADLs) depends on the setting and population of the client.For example, one study found that the average score for residents in skilled nursing facilities was 3.1 out of 6.Another study found that the hierarchy of difficulty of the six ADLs from least to greatest was: eating, maintaining continence, transferring, toileting, dressing, and bathing.

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A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery. Which of the following statements by the client indicates a need for further teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing an older adult client who has a history of falls. Which of the following findings should the nurse identify as a risk factor for falls in older adults?

Correct Answer is D

Explanation

A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool. What does this score indicate?

Correct Answer is B

Explanation

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A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery.

Which of the following statements by the client indicates a need for further teaching?