A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

"Support your body weight on the underarm crutch pads."

"Look down at your feet before moving the crutches."

"Place one crutch forward with the opposite foot and then place the second crutch forward followed by the second foot."

"Move both crutches forward while standing on the unaffected leg, then lift and swing your body past the crutches."

Answer and Explanation

The Correct Answer is D

A.   Crutches should not be used to support body weight under the arms, as this can cause nerve damage or discomfort. Instead, weight should be supported on the hands and arms, with the crutches positioned to support the client’s weight. Proper use involves placing the crutches slightly in front of the feet, with weight supported on the hands, not the underarms.
B.   While it's important to be aware of your surroundings, looking down at your feet can be counterproductive as it may affect balance and coordination. The client should maintain an upright posture and look ahead to ensure proper gait and balance while moving. This helps in coordinating the movement of crutches and feet more effectively.
C.   In a four-point gait, each crutch and foot move alternately, which is different from the three-point gait. The three-point gait involves moving both crutches and the affected leg forward simultaneously, followed by the unaffected leg.
D.   In the three-point gait, the client moves both crutches forward at the same time while keeping the affected leg off the ground or in a non-weight-bearing position. Then, the client swings the unaffected leg forward to step past the crutches. This method ensures that weight is only placed on the unaffected leg while moving.

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Correct Answer is C

Explanation

A. While Lactated Ringer's is often used for fluid resuscitation, it doesn't contain the necessary nutrients to replace TPN. It can lead to electrolyte imbalances and other complications if used for extended periods.
B. While Dextrose 10% provides calories, it lacks essential amino acids, electrolytes, and other nutrients found in TPN. Prolonged use can lead to imbalances and nutritional deficiencies.
C. Dextrose 5% in water is a commonly used IV fluid that can be administered temporarily while waiting for the next TPN container. It provides hydration and some calories, but it's important to monitor the client's glucose levels closely.
D. While 0.9% sodium chloride (normal saline) is used for fluid replacement, it can lead to hypernatremia (excess sodium) if used for extended periods, especially in clients receiving TPN.

A. Ibuprofen B. Omeprazole C. Senna D. Zolpidem

Correct Answer is C

Explanation

A. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation. While it does not directly affect bowel obstruction, NSAIDs can cause gastrointestinal irritation and potentially worsen symptoms in some patients. However, it is not the primary medication to withhold due to a small bowel obstruction.
B. Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid. It is generally safe to use in the context of a small bowel obstruction because it does not affect bowel motility directly. It might be used to manage symptoms related to acid reflux or gastritis, which could be secondary issues in a patient with SBO.
C. Senna is a stimulant laxative used to promote bowel movements. In the context of a small bowel obstruction, administering a laxative like Senna is contraindicated because it can worsen the obstruction by increasing bowel motility or causing further distention. The primary goal in treating an SBO is to relieve the obstruction, and using a laxative could complicate the situation.
D. Zolpidem is a sedative-hypnotic used for short-term management of insomnia. It does not directly impact bowel function or obstruction. While not ideal for all patients, it does not specifically exacerbate a small bowel obstruction.

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A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

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