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A nurse is discussing discharge instructions to a client with a lumbar herniated disk and is prescribed a conservative treatment. The nurse provides instructions based on this treatment plan and suggests which of the following.

A.

Reducing body weight.

B.

Avoiding painful positions.

C.

Attending physical and chiropractic therapy as prescribed.

D.

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) as prescribed.

E.

Taking corticosteroids as prescribed.

Question Solution

Correct Answer : A,B,C,D

A. Reducing body weight can relieve pressure on the lumbar spine, which can help decrease pain and improve function.  

 

B. Avoiding painful positions helps prevent exacerbation of symptoms and protects the affected area.  

 

C. Physical therapy is an important part of conservative treatment to strengthen supporting muscles, improve flexibility, and promote recovery. Chiropractic therapy may be recommended but should be guided by a physician's recommendation.  

 

D. NSAIDs are commonly prescribed to manage inflammation and relieve pain associated with lumbar herniated disks.  

 

E. Corticosteroids may be prescribed in some cases but are generally not part of initial conservative management unless inflammation is severe and not managed by NSAIDs.


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Correct Answer is D

Explanation

A. Encouraging deep breathing exercises may help with respiratory function but does not address the immediate risks associated with increased ICP.

B. Elevating the head of the bed can help reduce ICP; however, the priority intervention is to closely monitor ICP to identify any changes in the client's condition.

C. Administering a sedative may be appropriate, but it is not as critical as monitoring ICP in a client with Cushing's Triad, where altered consciousness and respiratory changes may be present.

D. Monitoring ICP is crucial in this situation, as Cushing's Triad indicates a potential increase in ICP, and timely interventions can prevent further complications.

Correct Answer is ["A","C","D"]

Explanation

A. Calcium binders are used to help decrease the amount of calcium absorbed from the gastrointestinal tract, thus lowering calcium levels in the blood.

B. Vitamin D supplements would actually increase calcium levels by enhancing intestinal absorption, so this option is not appropriate in hypercalcemia.

C. Administering fluids helps to dilute serum calcium levels and promote renal excretion of calcium, making it a priority treatment.

D. Furosemide (Lasix) can help promote diuresis, thereby increasing the excretion of calcium through the urine, which is beneficial in managing hypercalcemia.

E. Oral phosphates may be used in some cases to manage hypercalcemia, but they are not a first-line treatment and their administration should be carefully considered in conjunction with other treatments.

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