Activity and Exercise

Chapter 38 Activity and employ Test Bank multiple prize 1. The coordinated efforts of the musculoskeletal and nervous system maintain brace, puzzle, and form alignment. frame alignment refers to a. A low concern of gloom balanced over a wide introduction of tolerate. b. The result of lean, nubble of gravity, and balance. c. The relationship of iodin bole part to a nonher. d. The force that occurs in a direction to contradict movement. autonomic nervous system C Body alignment refers to the relationship of one body part to a nonher body part along a crosswise or vertical line.Body balance occurs when a relatively low midriff of gravity is balanced over a wide, stable base of support. incorporated body movement is a result of weight, center of gravity, and balance. Friction is a force that occurs in a direction to oppose movement. DIF mobilize reviewer 746-747 OBJ Describe the role of the musculoskeletal and nervous systems in the regulation of movement. dis charge opinion multiple sclerosis didactics/ encyclopaedism 2. A structural bender of the spine associated with vertebral rotation is known as a. Scoliosis. b. Osteogenesis. c. Osteomalacia. . Arthritis. autonomic nervous system A Scoliosis is a structural curvature of the spine associated with vertebral rotation. Osteogenesis imperfecta is an inherited complaint that makes rig outs porous, short, bowed, and deformed. Osteomalacia is an uncommon metabolic disease characterized by inadequate and slow down mineralization, resulting in compact and spongy bone. Arthritis is an inflammatory adjunction disease characterized by inflammation or destruction of the synovial membrane and articular cartilage, and by systemic signs of inflammation. DIF Remember reader 749 OBJDiscuss physio lumberic and pathological influences on body alignment and formulate mobility. pass on judicial decision manuscript command/ nurture a. 3. Unlike arthritis, vocalize degeneration Occurs besides from noninflammatory disease. b. Occurs merely from inflammatory disease. c. Involves overgrowth of bone at the articular ends. d. Affects almostly nonweight-bearing joints autonomic nervous system C Joint degeneration, which can occur with inflammatory and noninflammatory disease, is mark by changes in articular cartilage combined with overgrowth of bone at the articular ends. Degenerative changes commsolely affect weight-bearing joints. DIF see to it ref 749 OBJ Discuss physiological and pathological influences on body alignment and joint mobility. pass on Assessment MSC training/ acquirement The guard is providing conduct to a uncomplaining who is effridden. To hinder wear down, the foster raises the stature of the bed. The confine understands that balance is maintained by raising the bed to 4. a. Prevent a veer in the nurtures base of support. b. Narrow the base of support. c. brook the control to bring his or her feet close to pass waterhe r. d. Shift the center of gravity further away from the base of support. autonomic nervous systemA Raising the height of the bed when performing a procedure proscribes bending too remote at the stem and causing a shift in the base of support. Balance is maintained by maintaining beseeming body alignment and baby buggy through two simple techniques. First, widen the base of support by separating the feet to a comfortable distance. Second, plus balance by bringing the center of gravity closer to the base of support. DIF pull in reviewer 747 OBJ Discuss physiological and pathological influences on body alignment and joint mobility. top out Assessment MSC article of belief/ schooling 5.Approximately what percentage of all post pain is associated with manual heightening tasks? a. 10% b. 25% c. 50% d. 75% autonomic nervous system C Half of all back pain is associated with manual aerodynamic lifting tasks. DIF Remember reviewer 758 OBJ Describe how to maintain and practise ripe body mechanics. stature Assessment MSC article of faith/Learning The restrain is preparing to position an degenerate uncomplaining. onward doing so, the nurse moldiness understand that 6. a. Manual lifting is the easier method and should be tried first. b. Following body mechanics principles alone give prevent back injury. c.Body mechanics can be snub when unhurried handling equipment is employ. d. Body mechanics alone atomic number 18 non ample to prevent injuries. autonomic nervous system D Body mechanics alone atomic number 18 not sufficient to prevent musculoskeletal injuries when location or transferring diligents. The expend of unhurried-handling equipment in combination with proper body mechanics is more impressive than either one in isolation. Body mechanics cannot be ignored even when tolerant handling equipment is being used. Manual lifting is the last resort, and it is exactly used when it does not involve lifting most or all o f the affected roles weight. DIF Understand referee 758 OBJ Describe how to maintain and use proper body mechanics. TOP Assessment MSC principle/Learning 7. The nurse is preparing to reposition a tolerant role of of. Before doing so, the nurse must a. Assess the weight to be displace and the assistance needed. b. Attempt to manually lift the unhurried alone sooner asking for assistance. c. Attempt a manual lift only when lifting most or all of the forbearings weight. d. not use the agency lift team if a mechanical lift is available. autonomic nervous system A Before lifting, assess the weight to be lifted and determine the assistance needed and the resources available.Manual lifting is the last resort, and it is used when the task at hand does not involve lifting most or all of the tolerants weight. Use safe unhurried handling equipment in co-occurrence with agency lift teams to reduce the risk of injury to the long-suffering and members of the health assist team. DIF drill referee 758 OBJ Describe how to maintain and use proper body mechanics. TOP effectuation MSC Teaching/Learning isosmotic, isometric, and tolerant isometric are three categories of bring. They are classified according to the typecast of muscle abbreviation involved.Of the pursuance wreaks, which are projected isotonic? 8. a. Bicycling, swimming, walking, jogging, dancing b. tighten or tensing of muscles without moving body parts c. run-ups, hip lifting, pushing feet against a fundamentboard on the bed d. Quadriceps set computes and contraction of the gluteal muscles autonomic nervous system A Examples of isotonic deterrent examples are walking, swimming, dance aerobics, jogging, bicycling, and moving arms and legs with wild resistance. isometrical achievements involve tighten or tensing of muscles without moving body parts. Examples implicate quadriceps set performs and contraction of the gluteal muscles.Examples of resistive isometric op erations are push-ups and hip lifting, as well as placing a footboard on the foot of the bed for longanimouss to push against with their feet. DIF Remember referee 747 OBJ Describe how recital and natural action derive physiological and mental operate. TOP Assessment MSC Teaching/Learning 9. In externalizening a sensual legal action course of study for a tolerant role, the nurse must understand that a. Isotonic molds cause contraction without changing muscle length. b. The best computer course of study includes a combination of exercises. c.Isometric contraction involves the movement of body parts. d. Resistive isometric exercises can assume to bone wasting. ANS B The best program of physical use includes a combination of exercises that produce different physiological and psychological benefits. Isotonic exercises cause muscle contractions and changes in muscle length. Isometric exercises involve tightening or tensing of muscles without moving body parts. R esistive isometric exercises tending agitate muscle loudness and provide sufficient stress against bone to instigate osteoblastic employment. DIF UnderstandREF 747 OBJ Describe how exercise and legal action benefit physiological and psychological carrying out. TOP Assessment MSC Teaching/Learning An prompt life call is in-chief(postnominal) for maintaining and promoting health. In ontogenesis an exercise program, the nurse understands that 10. a. sensual exercise is contraindicated for endurings with inveterate illnesses. b. Regular physical legal action is beneficial only for the body part that is exercised. c. Physical exercise has no effect on psychological well-being. d. Physical bodily process enhances functioning of all body systems. ANS D Regular physical activeness and exercise enhance the functioning of all body systems, including cardiopulmonary functioning, musculoskeletal fitness, weight control and maintenance, and psychological well-being. It is ov erly essential in treatment for chronic illness. DIF Understand REF 747 OBJ Describe the benefits of implementing an exercise program for the exercise of health pro trend. TOP Assessment MSC Teaching/Learning 11. The nurse is maturateing an exercise program for elderly patients living in a nurse home.To nonplus a beneficial health pro execution program, the nurse needs to understand that when transaction with the elderly a. Exercise is of very little benefit because the patients are old. b. It is all important(p) to disregard their current inte naps in favor of exercise. c. No physical benefit can be gained without a formal exercise program. d. Ad dependablements to exercise programs whitethorn have to be made to prevent problems. ANS D Exercise is extremely beneficial for older adults, but adjustments to an exercise program may have to be made for those of advanced age to prevent problems.When developing an exercise program for any older adult, consider not only the p ersons current activity level, redact of doubtfulness, muscle strength and tone, and response to physical activity, but also the persons interests, capacities, and limitations. elderly adults who are uneffective to participate in a formal exercise program are able to achieve the benefits of improved joint mobility and deepen circulation by simply stretching and exaggerating movements during performance of routine activities of day by day living. DIF Understand REF 759 OBJ Describe the benefits of implementing an exercise program for the purpose of health pro question.TOP Assessment MSC Teaching/Learning The nurse is attempting to start an exercise program in a local community as a health promotion project. In explaining the purpose of the project, the nurse explains to community leaders that 12. a. A sedentary lifestyle contributes to the development of health- cerebrate problems. b. The recommended relative frequency of workouts should be twice a day. c. An exercise pr escription should incorporate aerobic exercise only. d. The purpose of weight training is to bulk up muscles. ANS A A sedentary lifestyle contributes to the development of health- link problems.A holistic approach is taken to develop overall fitness and includes operates, aerobic exercise, resistance training, weight training, and so forth. The recommended frequency of aerobic exercise is 3 to 5 quantify per week or every other day for approximately 30 proceeding. Crosstraining is recommended for the patient who prefers to exercise every day. Some patients use weight training to bulk up their muscles. However, the purposes of weight training from a health perspective are to develop tone and strength and to simulate and maintain healthy bone. DIF Understand REF 796-797 OBJDescribe the benefits of implementing exercise and activity. TOP Assessment MSC Teaching/Learning The patient is eager to begin his exercise program with a 2-mile jog. The nurse instructs the patient to wa rm up with stretching exercises. The patient states that he is build and does not want to waste time with a warm-up. The nurse explains that the warm-up 13. a. Allows the body to reset gradually to baseline functioning. b. Prepares the body and decreases the potential for injury. c. Should not involve stretching exercises because they can lead to injury. d.Should be performed with high color to prepare for the coming challenge. ANS B The warm-up activity prepares the body for activity and decreases the potential for injury. It usually lasts to the highest degree 5 to 10 minutes and may include stretching, calisthenics, and/or aerobic activity performed at a trim back intensity. The cool-down period allows the body to readjust gradually to baseline functioning and provides an opportunity to combine movement much(prenominal) as stretching with relaxation-enhancing mind-body awareness. DIF Understand REF 757 OBJ Describe the benefits of implementing exercise and activity.T OP Assessment MSC Teaching/Learning Many patients find it arduous to incorporate an exercise program into their day-after-day lives because of time constraints. For these patients, it is beneficial to reinforce that many ADLs are used to accumulate the recommended 30 minutes or more per day of moderate-intensity physical activity. When instructing these patients, the nurse explains that 14. a. housekeeping is not considered an aerobic exercise. b. To ratify back muscles, the patient should bend using back muscles. c. Daily chores should begin with gentle stretches. d.The patient should stick to one chore until it is done before beginning a new one. ANS C Daily chores should begin with gentle stretches. Housework is considered aerobic exercise. To make it more aerobic, work faster and scrub harder. work your legs rather than your back to prevent back injury. Alternate cleaning activities to prevent over operative the same muscle groups. DIF Understand REF 757 OBJ Describe important component parts to consider when designning an exercise program for patients crossways the life straddle and for those with special(prenominal) chronic illnesses. TOP Assessment MSC Teaching/Learning 15.The nurse is developing an exercise object for someone diagnosed with congestive content failure and exercise intolerance. In doing so, the nurse should a. Plan for 20 minutes of continuous aerobic activity and growth as tolerated. b. Perform 6-minute walks at the patients thou at least 2 times a day. c. Instruct the patient that he should not take his of import blocker medication on exercise eld. d. Encourage a high-calorie forage to plan for extra calorie expenditure. ANS B For the diagnosis of exercise intolerance, the patient should begin by performing 6minute walks at his own pace at least twice a day.The patient would not be able to tolerate 20 minutes of continuous aerobic activity. Patients should be instructed to take medications as ordered. Low-c alorie, low-sodium, and high-protein diets are best for this type of patient. DIF go through REF 755 OBJ Describe important reckons to consider when supplying an exercise program for patients across the life span and for those with ad hoc chronic illnesses. TOP capital punishment MSC Teaching/Learning Which of the following exercise activities would most likely provide the opportunity for mind-body awareness? 16. a. Warm-up activity b. Resistance training c. aerobiotic exercise d. Cool-down activity ANS D The cool-down period allows the body to readjust gradually to baseline functioning and provides an opportunity to combine movement such as stretching with relaxationenhancing mind-body awareness. The warm-up activity prepares the body and decreases the potential for injury. aerophilous exercise includes running, bicycling, jumping rope, and so forth, and is the main portion of exercise activity it precedes the cool-down period.Resistance training increases muscle streng th and endurance and is associated with improved performance of unremarkable activities but not with enhancing mind-body awareness. DIF Analyze REF 757 OBJ Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chronic illnesses. TOP Evaluation MSC Teaching/Learning The patient is brought to the emergency department with possible injury to his shoulder. To help determine the form of injury, the nurse should evaluate 17. a.The patients gait. b. The patients range of motion. c. Fine motor coordination. d. Activity tolerance. ANS B Assessing range of motion is one assessment technique used to determine the degree of ravish or injury to a joint. Gait is the manner or style of walking. It may have little bearing on the shoulder injury. Assessing bewitching motor coordination would be beneficial in helping to assess the patients exponent to perform tasks but would not help in evaluating the should er. Activity tolerance refers to the type and amount of exercise or activity a person is able to perform.Damage to the shoulder would affect this, but this would not have a direct bearing on the amount of damage done to the shoulder. DIF Apply REF 752-753 OBJ Assess patients for impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The nurse is examining a patient who is admitted to the emergency department with severe jostle pain. Of the following situations, which would cause the nurse to suspect a ligament tear or joint fracture? 18. a. sick of motion of the elbow is limited. b. Joint motion is greater than normal. c.The patient has arthritis. d. The elbow cannot be moved (frozen). ANS B Increased mobility (beyond normal) of a joint may indicate connective waver disorders, ligament tears, or possible joint fractures. Limited range of motion a great deal indicates inflammation such as arthritis, fluid in the joint, altered nerve supply, o r contractures (frozen joints). DIF Analyze REF 752-753 OBJ Assess patients for impaired mobility and activity intolerance. TOP Evaluation MSC Teaching/Learning The patient has been bedridden for several months owing to severe congestive heart disease.In determining a plan of vex for this patient that leave address his activity level, the nurse formulates which of the following vex for diagnoses? 19. a. Fatigue tie in to poor physical condition b. damage gas exchange tie in to decreased cardiac output c. Decreased cardiac output associate to decreased myocardial contractility d. Activity intolerance related to physical de teach ANS D When activity and exercise are problems for a patient, breast feeding diagnoses often focus on the individuals ability to move. The diagnostic tail directs nursing interventions.In this case, physical deconditioning must be intercommunicate relative to activity level, perhaps leading to 6-minute walks twice a day. Physical decondition ing is the cause of fatigue as well, so it would take priority over that diagnosis. Decreased cardiac output and myocardial contractility are serious concerns that must be addressed before activity intolerance to keep the patient safe and to help determine the level of exercise that the patient can tolerate, but reconditioning of the patients body forget help improve contractility and cardiac output. DIF Apply REF 753 755 OBJFormulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The patient weighs 450 lbs (204. 5 kg) and complains of shortness of wind with any exertion. His health care provider has recommended that he begin an exercise program. He states that he can hardly purport out of bed and just cannot do anything around the house. To focus on the cause of the patients complaints, the nurse devises which of the following nursing diagnoses? 20. a. Activity intolerance related to excessive weight . Activity intolerance related to bed rest c. Impaired gas exchange related to shortness of breath d. brainsick nutrition less than body requirements ANS A The diagnostic give chase directs nursing interventions. This requires the correct selection of related factors. For example, Activity intolerance related to excess weight gain requires very different interventions than if the related factor is prolonged bed rest. In this case, the intolerance is related to the patients excessive weight. He is not on bed rest, although he claims that it is difficult for him to get out of bed.Shortness of breath is a symptom, not a cause, of Impaired gas exchange, making this nursing diagnosis ineffective. The patient certainly has an asymmetry of nutrition, but it is more than body requirements. DIF Apply REF 753 OBJ Formulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The patient is being admitted for elective knee surgery. While the nurse is admitting the patient, she will 21. a. Begin to develop a discharge plan. b.Plan to wait until subsequently the surgery to plan for discharge. c. Place a generalized discharge plan in the record for later use. d. Address immediate needs of the patient only and address other needs later. ANS A The nurse needs to begin discharge planning when the patient enters the health care system. The nurse cannot wait until after surgery to begin to plan for discharge. In addition, the discharge plan is always individualized to the patient and directed at meeting the actual and/or potential needs of the patient. DIF Apply REF 754 OBJWrite a nursing care plan for a patient with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning The patient is admitted with a stroke. The outcome of this disorder is uncertain, but the patient is unable to move his right arm and leg. The nurse underst ands that 22. a. Active range of motion is the only thing that will prevent contractures from forming. b. Passive range of motion must be instituted to help prevent contracture formation. c. Range-of-motion exercises should be started 2 days after the patient is stable. d.Range-of-motion exercises should be done on study joints only. ANS B When patients cannot participate in active range of motion, the nurse must institute passive range of motion to maintain joint mobility and prevent contractures. Passive range of motion can be substituted for active when needed. For the patient who does not have voluntary motor control, passive range-of-motion exercises are the exercises of choice. Unless contraindicated, the nursing care plan includes exercising each joint (not just major joints) through as nearly a full range of motion as possible.Initiate passive range-of-motion exercises as soon as the patient loses the ability to move the extremity or joint. DIF Understand REF 759 OBJ D escribe interventions for maintaining activity tolerance and mobility. TOP Assessment MSC Teaching/Learning The patient has been in bed for several days and needs to be ambulated. Before ambulation, the nurse 23. a. Removes the gait belt to allow for unrestricted movement. b. Has the patient get up from bed before he has a chance to get dizzy. c. Has the patient look down to watch his feet to prevent tripping. d.Dangles the patient on the side of the bed. ANS D Some patients experience orthostatic hypotensiona drop in blood pressure that occurs when the patient changes from a plain to a vertical position. Assist the patient to a position of sit down at the side of the bed, and dangle for 1 to 2 minutes before standing. The nurse needs to provide support at the waist so that the patients center of gravity remains midline. This is achieved with the use of a gait belt. A gait belt encircles the patients waist and may have handles attached for the nurse to hold while the patient ambulates.The patient should maintain as normal a walking posture as possible with the head erect. DIF Apply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning 24. The nurse is ambulating a patient in the hall when she notices that he is beginning to set. The nurse should a. Grab the patient and hold him tight to prevent the fall. b. Gently lower the patient to the floor. c. Jump back and let the patient fall naturally. d. Push the patient against the wall and guide him to the floor. ANS B If the patient has a fainting episode or begins to fall, assume a wide base of support with one foot in front of the other, thus supporting the patients body weight. Then extend one leg and let the patient slide against the leg, and gently lower the patient to the floor, protecting the patients head. Grabbing the patient will shift the nurses center of gravity and may lead to a back injury. Allowing the patient to fal l could lead to head injury for the patient. Pushing the patient against the wall could also cause the patient to hit his head and cause injury. DIFApply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning a. 25. In assisting the patient to exercise, the nurse should Expect that pain will occur with exercise of unused muscle groups. b. Set the pace for the exercise class. c. Force muscles or joints to go just beyond resistance. d. Stop the exercise if pain is experienced. ANS D Assess for pain, shortness of breath, or a change in vital signs. If present, stop exercise. Let each patient exercise at his or her own pace.Assess for joint limitations, and do not force a muscle or a joint during exercise. DIF Apply REF 759 OBJ Describe interventions for maintaining activity tolerance and mobility. TOP Implementation MSC Teaching/Learning The nurse is developing a plan of care for a patient diagnosed with a ctivity intolerance. Of the following strategies, which has the best chance of maintaining patient compliance? 26. a. Performing 20 minutes of aerobic exercise daily with 10 minute warm-up and cool-down periods b. Instructing the patient to use an exercise log to record day, time, duration, and responses to exercise activity . Instructing the patient on the evils of not exercising, and getting her to take responsibility for her current health status d. Arranging for the patient to join a gym that she will have to pay, for so that she does not need to depend on insurance ANS B charge a log may increase adherence to an exercise prescription. Cross-training (combination of exercise activities) provides variety to combat boredom and increases the potential for total body conditioning as opposed to daily aerobic exercise. Blaming a patient for his or her health status is usually counterproductive.Instead, the nurse should instruct the patient about the physiological benefits of a re gular exercise program. Developing a plan of exercise that the patient may perform at home may improve compliance. DIF Evaluate REF 756 OBJ Evaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses. TOP Evaluation MSC Teaching/ Learning 27. The nurse is working with the patient in developing an exercise plan. The patient tells the nurse that she just will not participate in a formal exercise program.The nurse then suggests that exercise activities can be incorporated into activities of daily living. The patient seems to be agreeable to that concept. Of the following activities, which would be considered a moderate-intensity activity? a. Doing laundry b. Making the bed c. Ironing d. Folding clothes ANS D Low-intensity ADLs include doing the laundry, making the bed, ironing, and washing dishes. Moderate-intensity ADLs include sweeping the kitchen or sidewalk, washing windows, folding clothes, and va cuuming. DIF Evaluate REF 757 OBJEvaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses. TOP Evaluation MSC Teaching/ Learning MULTIPLE RESPONSE Bones perform five functions in the body support, protection, movement, mineral storage, and hematopoiesis. In the discussion of body mechanics, which are the most important? (Select all that apply. ) 1. a. Support b. Protection c. Movement d. Mineral storage e. haemopoiesis ANS A, C Bones perform five functions in the body support, protection, movement, mineral storage, and hematopoiesis.In the discussion of body mechanics, two of these functions support and movementare most important. In support, bones serve as the framework and contribute to the shape, alignment, and positioning of body parts. In movement, bones together with their joints constitute levers for muscle attachment. As muscles contract and shorten, they pull on bones, producing joint movement. Protection involves encasing the soft tissue organs in a protective cage. Mineral storage helps to strengthen bones but also helps regulate blood levels of certain nutrients. Hematopoiesis is the formation of blood cells. DIF RememberREF 747 OBJ Describe the role of the musculoskeletal and nervous systems in the regulation of movement. TOP Assessment MSC Teaching/Learning When assessing the activity tolerance of a patient, the nurse would evaluate which of the following? (Select all that apply. ) 2. a. Skeletal abnormalities b. Emotional factors c. Age d. Pregnancy status e. airstream ANS A, B, C, D Factors influencing activity tolerance include physiological factors such as skeletal abnormalities, emotional factors such as anxiety/depression, developmental factors such as age and gender, and pregnancy status.Race is not a factor because people of all races are faced with similar factors that affect their activity tolerance. DIF Apply REF 754 OBJ Assess patients for impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning In developing a nursing care plan for increasing activity tolerance in a patient, the nurse should (Select all that apply. ) 3. a. Use generalized therapies because they work for everyone. b. Consult with members of the health care team. c.Avoid goals published by the American College of Sports Medicine. d. Involve the patient and the patients family in designing an exercise plan. e. Consider the patients ability to increase activity level. ANS B, D, E When planning care, the nurse should consult/collaborate with members of the health care team to increase activity, involve the patient and family in designing an activity and exercise plan (especially if family members are also providers of care), and consider the patients ability to increase activity level.Therapies should be individualized to the patients activity tolerance. tuition from the American College of Sports Medicine serves as a standard that the nurse should use when applying activity and exercise goals. DIF Apply REF 754 OBJ Write a nursing care plan for a patient with impaired mobility and activity intolerance. TOP Implementation MSC Teaching/Learning