The nurse is providing care to a client who is experiencing back pain. Which of the following in the client's history is a known risk factor for disc herniation?
Short stature
Anorexia
39 years of age
Female gender
The Correct Answer is C
A) Short stature: While body height can play a role in overall musculoskeletal health, short stature is not specifically identified as a risk factor for disc herniation. Other physical characteristics have a more direct impact on spinal issues.
B) Anorexia: Although nutritional status is important for general health, anorexia is not a recognized risk factor for disc herniation. The condition is more related to physical stressors and age rather than dietary habits alone.
C) 39 years of age: Age is a significant risk factor for disc herniation. Most cases occur in adults aged 30 to 50, as degenerative changes in the spine increase vulnerability to herniation. At 39, the client falls within this high-risk age range.
D) Female gender: While certain musculoskeletal conditions may vary by gender, disc herniation does not have a strong gender predisposition. Both men and women are equally affected, making this option less relevant as a specific risk factor.
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Correct Answer is C
Explanation
A) Re-assess in 15 minutes: While regular assessments are important in a neurological evaluation, if the Glasgow Coma Scale (GCS) score is 15, indicating the patient is fully alert and oriented, there may not be an immediate need to re-assess so soon unless the patient's condition changes.
B) Ask the patient to open eyes on command: If the GCS score is already determined to be 15, this indicates that the patient is responsive and capable of opening their eyes spontaneously. Asking the patient to open their eyes is unnecessary in this context since the score already reflects full responsiveness.
C) Document the findings: Documenting the GCS score of 15 is crucial as it establishes a baseline for the patient’s neurological status. This documentation is essential for ongoing assessments and monitoring, providing a record of the patient’s condition at this moment.
D) Notify the physician: Notifying the physician is not required for a GCS score of 15, as this score indicates a normal level of consciousness. Communication with the physician would be warranted only if there were changes in the patient's condition or a lower GCS score observed.
Correct Answer is B
Explanation
A) The patient's integumentary system is within normal limits for his age: While thinning skin and decreased turgor can be common in older adults, the specific combination of findings, including the patient feeling cold, suggests that further investigation is warranted rather than assuming they are normal.
B) The patient may have a metabolic condition causing him to feel cold: Thin skin and non-elastic turgor can be indicative of aging, but the sensation of always feeling cold may point to an underlying metabolic condition, such as hypothyroidism or poor circulation, which can affect thermoregulation.
C) The patient has abnormal thinning of skin: While skin thinning is common in older adults, it is not necessarily "abnormal" in the context of aging. However, in conjunction with other symptoms like non-elastic turgor and cold sensitivity, it may warrant further evaluation.
D) The patient should have elastic turgor: In older adults, it is common to see decreased elasticity and turgor of the skin. Therefore, expecting the patient to have elastic turgor may not be appropriate, as it reflects the natural aging process rather than a healthy standard.