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) Talking in a loud voice: While this may indicate some level of distress or confusion, it does not necessarily signal a specific neurological deficit. Clients may raise their voice for various reasons unrelated to neurological issues.
B) Grimacing with movement: This could suggest discomfort or pain but is not an explicit indicator of neurological impairment. Grimacing can occur for many reasons, including musculoskeletal issues or emotional responses, and does not specifically necessitate a focused neurological assessment.
C) Asymmetry of the client's smile: This finding is significant and raises concerns about potential neurological issues, such as a stroke or Bell's palsy. Facial asymmetry may indicate weakness or dysfunction in the cranial nerves responsible for facial movement, warranting a more thorough neurological examination to assess for underlying causes.
D) Inability to follow directions: While this may point to confusion or cognitive impairment, it is a more general indicator and could result from various factors, including anxiety or lack of understanding. It does not specifically highlight a localized neurological deficit as clearly as facial asymmetry does.
Correct Answer is D
Explanation
A) "Would you like to discuss this with the doctor?": This response may imply that the nurse is not equipped to handle the emotional aspect of the conversation, potentially minimizing the client's feelings and discouraging further sharing.
B) "How long were you married?": While this question seeks to gather more information, it does not directly address the client's emotional experience or feelings related to their wife's death, which is the primary concern in this context.
C) "What type of cancer did your wife have?": This question may shift the focus to medical details rather than the client's emotional state, which is crucial in a therapeutic conversation about grief and loss.
D) "How does that make you feel?": This response is the most therapeutic as it invites the client to express their emotions and thoughts about their loss. It acknowledges their pain and encourages them to explore their feelings, which is essential for processing grief.