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.
Reducing body weight.
Avoiding painful positions.
Attending physical and chiropractic therapy as prescribed.
Taking nonsteroidal anti-inflammatory drugs (NSAIDs) as prescribed.
Taking corticosteroids as prescribed.
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 ["A","B","D"]
Explanation
A. Hypertension can occur due to autonomic dysreflexia, especially in clients with cervical spinal cord injuries, as they may have exaggerated sympathetic responses.
B. A weakened gag reflex can result from cranial nerve involvement due to the cervical spinal cord injury, impacting the client's ability to protect their airway.
C. Absence of bowel sounds may indicate bowel immobility or dysfunction; however, it is not a direct complication of a cervical spinal cord injury.
D. Bradycardia is a common finding in cervical spinal cord injuries due to impaired sympathetic nervous system function, leading to decreased heart rate.
E. Tachycardia is less common in cervical injuries and is typically associated with lower injuries in the spinal cord.
Correct Answer is C
Explanation
A. While pain level assessment is important, it is not the priority immediately after a significant brain injury where neurological changes may occur.
B. Wound site assessment is also essential but does not take precedence over neurological assessment in this context.
C. A neurological assessment is the priority to identify any changes in the client's condition that may indicate complications such as increased intracranial pressure, which can occur after brain surgery.
D. Respiratory status assessment is important but is usually addressed through monitoring and interventions related to neurological function, as brain injuries can affect respiratory drive and function.