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What is a priority nursing intervention for a client with lupus who is receiving steroids for a flareup?
The nurse washes their hands before entering the room.
Assist with the enhancement of social wellbeing by providing activities.
Assessing the client’s support system.
Ensure privacy by keeping the door always closed.
The Correct Answer is A
Choice A reason: This is the priority nursing intervention because it helps to prevent infection, which is a major complication and risk factor for mortality in clients with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Steroids are used to reduce inflammation and suppress the immune system, but they also increase the susceptibility to infection. The nurse should wash their hands before and after contact with the client and follow standard precautions to reduce the transmission of microorganisms.
Choice B reason: This is not the priority nursing intervention, but it is a good intervention to promote the psychosocial health of the client. Lupus can affect the client's selfesteem, mood, and social relationships, especially during a flareup, which is a period of increased symptoms and activity of the disease. The nurse should assist with the enhancement of social wellbeing by providing activities that are appropriate for the client's physical and mental condition, such as reading, listening to music, or talking with friends and family.
Choice C reason: This is not the priority nursing intervention, but it is a good intervention to evaluate the client's coping and support resources. Lupus can be a chronic and unpredictable disease that can cause stress, anxiety, and depression in the client. The nurse should assess the client's support system, such as family, friends, or community groups, that can provide emotional, practical, and financial assistance to the client. The nurse should also refer the client to counseling, support groups, or other services as needed.
Choice D reason: This is not the priority nursing intervention, but it is a good intervention to respect the client's dignity and autonomy. Lupus can affect the client's appearance, mobility, and independence, which can make them feel vulnerable and embarrassed. The nurse should ensure privacy by keeping the door always closed, unless the client requests otherwise, and by knocking and asking for permission before entering the room. The nurse should also cover the client with a blanket or gown and expose only the necessary body parts during assessment or procedures.
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Correct Answer is B
Explanation
Choice A reason: Providing active range of motion (ROM) is not a treatment that the nurse can perform for a quadriplegic client. Active ROM means that the client moves their own joints without assistance. A quadriplegic client has paralysis of all four limbs and cannot move their joints voluntarily.
Choice B reason: Providing passive range of motion (ROM) is a treatment that the nurse can perform for a quadriplegic client. Passive ROM means that the nurse moves the client's joints through their full range of motion without resistance. This helps prevent joint contracture, which is the loss of joint movement and flexibility due to muscle shortening and stiffness. It also helps maintain joint mobility, which is the ability of the joint to move smoothly and freely.
Choice C reason: Turning the client every 2 hours is not a treatment that the nurse can perform to decrease the risk of joint contracture and promote joint mobility. Turning the client every 2 hours is a preventive measure to avoid pressure ulcers, which are skin injuries caused by prolonged pressure on the skin. It does not directly affect the joint function or movement.
Choice D reason: Administering glucosamine supplements is not a treatment that the nurse can perform to decrease the risk of joint contracture and promote joint mobility. Glucosamine supplements are dietary supplements that may help reduce the pain and inflammation of osteoarthritis, which is a degenerative joint disease that causes the breakdown of the cartilage and bone in the joints. It does not affect the muscle or nerve function or movement.
Correct Answer is C
Explanation
Choice A reason: This is an incorrect answer because Medicare is a federal health insurance program that covers certain groups of people, such as the elderly, the disabled, and the lowincome. Medicare does not publish the National Patient Safety Goals, but it does have its own quality and safety standards that health care providers must meet to receive reimbursement.
Choice B reason: This is an incorrect answer because the American Nurses Association (ANA) is a professional organization that represents the interests of registered nurses in the United States. The ANA does not publish the National Patient Safety Goals, but it does have its own code of ethics, standards of practice, and policies that guide nursing practice and promote quality and safety.
Choice C reason: This is the correct answer because the Joint Commission is an independent, nonprofit organization that accredits and certifies more than 22,000 health care organizations and programs in the United States. The Joint Commission publishes the National Patient Safety Goals, which are specific and measurable goals that address the most critical patient safety issues in health care. The Joint Commission updates the goals annually based on the latest evidence and expert input.
Choice D reason: This is an incorrect answer because the Institute of Medicine (IOM) is a division of the National Academies of Sciences, Engineering, and Medicine, which is a private, nonprofit organization that provides independent, objective, and authoritative advice to inform policy and practice. The IOM does not publish the National Patient Safety Goals, but it does conduct research and issue reports on various topics related to health and health care, including quality and safety.
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