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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 C

Explanation

A. Diplopia is a concerning symptom but does not indicate immediate deterioration in neurological status like a change in GCS does.

B. Ataxia is also significant but is less acute than a drop in GCS score.

C. A change in the Glasgow Coma Scale score from 13 to 11 indicates a worsening level of consciousness and necessitates immediate reporting, as it may suggest increased intracranial pressure or other complications.

D. A decrease in heart rate from 76 to 69 bpm is not significant enough in the context of TBI to warrant immediate reporting, as it remains within a normal range.

Correct Answer is A

Explanation

A. Miotic medications work by constricting the pupil, which opens the trabecular meshwork and facilitates the drainage of aqueous humor, thus lowering intraocular pressure in clients with glaucoma.

B. Miotics do not dilate the pupil; they constrict it. Dilation would actually increase intraocular pressure, which is not therapeutic in glaucoma.

C. While these medications do affect eye muscles, they do not specifically prevent blurred vision; their primary effect is on eye pressure.

D. Miotics do not block nerve responses; they work by direct action on the eye muscles to promote fluid drainage and reduce pressure.

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