The nurse is preparing a staff presentation about physiological responses of client immobility. Which physiological alterations should the nurse include in the presentation? (Select All That Apply)

constipation

urinary retention

disuse osteoporosis

hypostatic pneumonia

orthostatic hypotension

a decrease in cardiac output and stroke volume

Answer and Explanation

Correct Answer : A,B,C,D,E,F

A. constipation. Reduced physical activity and the supine position decrease gastrointestinal peristalsis and the effectiveness of abdominal muscles used during defecation. This leads to prolonged colonic transit time and increased water absorption from fecal matter, resulting in hardened stools. It is a classic gastrointestinal complication of restricted mobility.

B. urinary retention. Immobility leads to a loss of gravity-aided bladder emptying and decreased detrusor muscle tone. The resulting urinary stasis increases the risk for both bladder distention and ascending infections due to incomplete voiding. This physiological alteration is common when clients are confined to a horizontal position.

C. disuse osteoporosis. The lack of weight-bearing stress on the skeletal system shifts the balance between osteoblast and osteoclast activity. Accelerated bone resorption leads to the leaching of calcium into the bloodstream, weakening the structural integrity of the trabecular bone. This metabolic change increases the risk for skeletal fragility.

D. hypostatic pneumonia. Prolonged recumbency results in the pooling of bronchial secretions in the dependent lobes of the lungs. Decreased chest expansion and diminished cough reflex prevent the effective clearance of these fluids, creating a medium for bacterial growth. This respiratory alteration significantly increases the risk of infection in immobile patients.

E. orthostatic hypotension. Immobility causes a reduction in the sensitivity of baroreceptors and a decrease in the efficiency of the skeletal muscle pump. When moving to an upright position, the cardiovascular system fails to constrict peripheral vessels adequately, leading to a sudden drop in blood pressure. This neurovascular maladaptation is a hallmark of prolonged bed rest.

F. a decrease in cardiac output and stroke volume. Prolonged bed rest leads to a reduction in total circulating blood volume and a subsequent decrease in venous return. The heart muscle may undergo slight atrophy, resulting in less forceful contractions and reduced volume ejected per beat. This cardiovascular decline limits the client's tolerance for physical exertion.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. I will take my pulse before taking this pill: Monitoring the pulse is a standard requirement for medications like digoxin or beta-blockers, not oral opioids. While opioids can cause respiratory depression, they do not typically require routine heart rate checks by the client at home. This indicates a misunderstanding of the drug's primary side effects.

B. I will increase my intake of fiber in my diet: Opioids like oxycodone significantly decrease gastrointestinal motility by binding to mu-receptors in the enteric nervous system. This lead to a high incidence of opioid-induced constipation in post-operative patients. Increasing dietary fiber and fluid intake is a critical non-pharmacological strategy to mitigate this effect.

C. I will cut back on my intake of coffee and diet soda: While caffeine might interfere with sleep, it is not a direct contraindication for taking oxycodone and acetaminophen. There is no specific requirement to eliminate these beverages during a 1-week course of analgesics. This statement does not reflect core safety teaching for opioid use.

D. I should take this pill with dairy products to enhance its absorption: Dairy products do not enhance the absorption of oxycodone or acetaminophen and can sometimes delay it. Some medications have specific interactions with calcium, but these analgesics are not among them. Taking them with food is only recommended to reduce potential gastric upset.

Correct Answer is ["0.3"]

Explanation

Dose prescribed /Dose available× Volume=Amount to administer

40 mg /125mg×1ml=0.32

Round to nearest tenth

0.32≈0.30

Correct Answer: 0.3

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The nurse is preparing a staff presentation about physiological responses of client immobility. Which physiological alterations should the nurse include in the presentation? (Select All That Apply)

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Naxlex Comprehensive Predictor Exams

A client will be discharged with a 1-week supply of the combination medication of oxycodone and acetaminophen for pain management after abdominal surgery. Which statement by the client indicates to the nurse that teaching about self-administration of this analgesic was effective?

Correct Answer is B

Explanation

Correct Answer is ["0.3"]

Explanation

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