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
Explanation
A. Chvostek's sign, a facial muscle spasm upon tapping, is a clinical indicator of hypocalcemia, often caused by accidental removal or damage to the parathyroid glands during thyroid surgery.
B. Hypercalcemia does not typically cause a positive Chvostek’s sign.
C. Hypokalemia affects muscle and cardiac function but does not result in a positive Chvostek’s sign.
D. Hyponatremia does not produce Chvostek's sign, which is specific to hypocalcemia.
Correct Answer is D
Explanation
A. Exophthalmos is typically associated with hyperthyroidism (specifically Graves' disease) rather than hypothyroidism.
B. Diaphoresis (excessive sweating) is also more common in hyperthyroid states, not hypothyroidism.
C. Palpitations are indicative of an increased metabolic rate, which is common in hyperthyroidism; therefore, they would not be expected in a client with hypothyroidism.
D. Lethargy is a classic symptom of hypothyroidism due to decreased metabolism, leading to fatigue and reduced energy levels, making it the expected finding.