A patient has a new order for a thoraco-lumbo-sacral orthosis (TLSO) to help support and stabilize her spine. What are the nursing priorities when caring for this patient? (Select all that apply)
Ensuring proper fit of the brace
How patient sleeps with the brace on
Monitor patient breathing
Patient education and family about the brace’s purpose and care
Skin integrity
Correct Answer : A,C,D,E
Choice A reason: Ensuring proper fit of the TLSO is critical to stabilize the spine effectively, preventing further injury. An ill-fitting brace can cause misalignment, pressure sores, or reduced efficacy, as it fails to immobilize the thoracolumbar region, making this a key nursing priority.
Choice B reason: How the patient sleeps with the brace is not a primary nursing priority. While comfort during sleep matters, the TLSO is typically worn as prescribed, and sleep position is secondary to ensuring fit, breathing, education, and skin care, making this choice incorrect.
Choice C reason: Monitoring breathing is essential, as a TLSO can restrict chest expansion, potentially reducing tidal volume and causing respiratory distress. Nurses must assess respiratory rate and oxygen saturation to ensure the brace does not compromise ventilation, making this a critical priority.
Choice D reason: Educating the patient and family about the TLSO’s purpose and care ensures compliance and proper use. Understanding how to wear, clean, and adjust the brace prevents complications like skin breakdown or ineffective stabilization, making this a key nursing responsibility.
Choice E reason: Skin integrity is a priority, as prolonged brace use can cause pressure ulcers or irritation. Nurses must inspect skin under the TLSO regularly, ensuring proper padding and hygiene to prevent breakdown, especially in immobile patients, making this a critical care aspect.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: Discussing family assistance for postoperative care is important for discharge planning but not the priority preoperatively. Understanding the client’s knowledge ensures informed consent and addresses immediate educational needs, making this choice secondary.
Choice B reason: Determining the client’s knowledge about the surgery is the priority, as it ensures informed consent, a legal and ethical requirement. It identifies misconceptions, reduces anxiety, and promotes compliance, directly impacting surgical preparation, making this the correct choice.
Choice C reason: Reviewing the home environment is relevant for discharge planning, not preoperative care. It does not address immediate surgical preparation needs like understanding the procedure, making this choice less urgent than assessing knowledge.
Choice D reason: Identifying coping mechanisms supports emotional preparation but is not the priority. Ensuring the client understands the surgery is critical for consent and cooperation, making this choice secondary to assessing their knowledge.
Correct Answer is A
Explanation
Choice A reason: Solar radiation is the primary driver of Earth's climate system, delivering approximately 1361 W/m² of electromagnetic energy, including visible light, infrared, and ultraviolet. About 70% of this energy is absorbed by Earth's surface and atmosphere, heating them and powering atmospheric circulation, ocean currents, evaporation, and the hydrologic cycle. This solar input creates temperature gradients that drive weather patterns and sustain global climate dynamics, making it the dominant energy source for the climate system.
Choice B reason: Geothermal energy originates from Earth's internal heat, primarily from radioactive decay of isotopes like uranium and thorium, and residual heat from planetary formation. It contributes approximately 0.087 W/m², a negligible amount compared to solar radiation. This energy drives localized geological processes, such as volcanic activity and hydrothermal vents, but has minimal impact on global atmospheric or oceanic circulation, rendering it insignificant for the climate system.
Choice C reason: Tidal energy results from gravitational interactions between Earth, the Moon, and the Sun, driving ocean tides and coastal currents. While it influences localized ocean mixing and coastal ecosystems, its contribution to the global climate system is minimal. Tidal energy lacks the scale and distribution to drive atmospheric circulation or large-scale weather patterns, unlike solar radiation's pervasive and dominant influence on climate dynamics.
Choice D reason: Nuclear energy, whether from human-controlled fission or natural radioactive decay, does not significantly contribute to Earth's climate system. Natural decay adds slightly to geothermal heat, but its impact is limited to subsurface geological processes. It lacks the widespread energy transfer required to drive atmospheric dynamics, ocean currents, or global climate patterns, making it irrelevant as a primary driver of the climate system.
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