The nurse designs care for the immobilized patient to help combat the major dangers of immobilization, which include: Select all that apply.
Loss of calcium from bone matrix
Stasis of respiratory secretions
Increased cardiac workload
Decreased circulation from pressure
Increased mental activity
Correct Answer : A,B,C,D
A. Loss of calcium from bone matrix
Immobility causes bone demineralization, increasing the risk for osteoporosis and fractures.
B. Stasis of respiratory secretions
Lack of movement decreases chest expansion, leading to retained secretions and risk of pneumonia or atelectasis.
C. Increased cardiac workload
Immobilization leads to venous stasis and reduced venous return, increasing cardiac workload and risk of thromboembolism.
D. Decreased circulation from pressure
Prolonged pressure leads to reduced perfusion, increasing risk for pressure ulcers.
E. Increased mental activity
Immobilization often results in decreased mental stimulation, potentially leading to depression or confusion, especially in older adults.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. False
The statement is false because all listed effects are known complications of prolonged immobilization.
Correct Answer is D
Explanation
A. Hyperextension
Hyperextension refers to bending backward beyond the normal range.
B. Lateral flexion
Lateral flexion involves bending the neck to the side, ear toward shoulder.
C. Rotation
Rotation refers to turning the head side-to-side (e.g., shaking head “no”).
D. Flexion
Touching the chin to the chest is flexion of the neck-bending forward.
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