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Exhibits

Which item(s) should the nurse teach the client? Select all that apply.

Soaking baths for pain management

Circular wrapping of the residual limb

Prevention of skin breakdown

Therapeutic coping

Keeping a positive outlook

Use of equipment

Fine motor skills

Alternating positions

Answer and Explanation

Correct Answer : B,C,D,F,H

A. Soaking baths for pain management: Soaking the residual limb is generally discouraged post-amputation due to the risk of infection and skin maceration. The surgical site should be kept clean and dry, using moist gauze for cleaning as ordered, rather than immersing the limb in water.

B. Circular wrapping of the residual limb: Teaching the client how to perform circular wrapping of the residual limb promotes proper shaping for prosthetic fitting and helps prevent edema. This wrapping also provides support and reduces skin irritation during the healing phase.

C. Prevention of skin breakdown: Clients with reduced mobility and altered sensation—especially those with a history of vascular disease—are at high risk for pressure injuries. Teaching repositioning, inspection of pressure points, and skin hygiene is essential to preserve skin integrity.

D. Therapeutic coping: Amputation can have a profound psychological impact. Teaching and encouraging therapeutic coping strategies, such as guided imagery, journaling, or referral to counselling, helps the client emotionally adjust to body image changes and functional loss.

E. Keeping a positive outlook: While maintaining optimism is helpful, it is not a specific teaching point. It is more of an attitude that may be nurtured through supportive interventions rather than directly taught as part of discharge or rehabilitation education.

F. Use of equipment: Clients need education on safely using assistive devices such as walkers, wheelchairs, or prosthetic aids. Instruction on equipment helps promote independence and safety during mobility and self-care tasks.

G. Fine motor skills: These are not typically affected by a lower extremity amputation and do not require targeted teaching unless another condition is present. Focus should remain on gross motor functions and adaptation to mobility aids.

H. Alternating positions: Teaching the client to alternate positions, including use of the prone position as ordered, helps prevent hip contractures, improves circulation, and reduces pressure on any one area. Positioning strategies are crucial for both comfort and long-term functional outcomes.

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Correct Answer is B

Explanation

A. A 25-year-old dark-skinned client whose mother had skin cancer: Although a family history may increase genetic susceptibility, darker skin provides more natural protection against ultraviolet (UV) radiation. The risk from heredity alone is lower compared to cumulative environmental exposure in high-risk skin types.

B. A 65-year-old fair-skinned client who is a construction worker: This client has multiple risk factors for skin cancer—advanced age, fair complexion, and prolonged cumulative sun exposure due to outdoor work. UV radiation is the primary environmental cause of skin cancer, and occupational exposure significantly elevates lifetime risk, especially in individuals with low melanin protection.

C. A 70-year-old fair-skinned client who works as a secretary: Although age and fair skin are risk factors, working indoors most of the time greatly limits UV exposure. Without significant cumulative sun exposure, this client's risk remains lower than someone exposed to direct sunlight daily.

D. A 16-year-old dark-skinned client who tans in tanning beds once a week: Tanning bed use increases skin cancer risk, particularly melanoma, but this client’s young age, darker skin and less frequent exposure reduce immediate susceptibility compared to an older, fair-skinned individual with chronic sun exposure. However, the behavior is still concerning and warrants health education.

A. Encourage client to drink water. B. Assist client to an upright position. C. Apply a high-flow venturi mask. D. Administer a prescribed sedative.

Correct Answer is B

Explanation

A. Encourage client to drink water: While hydration is important for thinning secretions in COPD, encouraging fluid intake in a client experiencing acute respiratory distress may not be appropriate initially. The client’s dry mouth could be a result of mouth breathing due to hypoxia, but airway and breathing must be prioritized before addressing hydration.

B. Assist client to an upright position: Positioning the client upright (high Fowler’s) maximizes lung expansion and improves diaphragmatic movement, which facilitates better oxygenation. It is the most immediate and appropriate intervention to alleviate shortness of breath and anxiety caused by hypoxia. This intervention also helps reduce the work of breathing in COPD patients.

C. Apply a high-flow venturi mask: Although a Venturi mask delivers precise oxygen concentrations, high-flow oxygen can suppress the hypoxic drive in COPD clients. Oxygen should be titrated carefully in these clients, usually starting with low-flow oxygen and adjusted per blood gas results and should be guided by assessment, including pulse oximetry and arterial blood gas results.

D. Administer a prescribed sedative: Sedatives can suppress respiratory drive, particularly in older adults and those with chronic respiratory conditions like COPD. Although anxiety is present, addressing the underlying cause, hypoxia, should take priority. Sedatives should be used cautiously and only after stabilizing respiratory function.

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Exhibits Which item(s) should the nurse teach the client? Select all that apply.

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Explanation

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Exhibits

Which item(s) should the nurse teach the client? Select all that apply.