A practical nurse (PN) in a rehabilitation unit is planning care for an older adult client with severe rheumatoid arthritis who experiences significant morning joint stiffness in the hands. The goal is to promote the client's independence with activities of daily living (ADLs). Which of the following actions should the PN include in the plan of care? Select all that apply.
- Provide adaptive clothing with hook-and-loop closures instead of traditional buttons.Answer
- BDocument any sudden, acute confusion during morning care as an expected age-related cognitive decline.
- CDelegate the initial evaluation of the client's ability to safely use a walker to the unlicensed assistive personnel (UAP).
- Supply foam-built-up handles on eating utensils and toothbrushes to reduce strain on the finger joints.Answer
- EServe the facility's standard breakfast tray without verifying if it meets the client's cultural dietary restrictions.
- Schedule self-care activities later in the morning to allow time for morning stiffness to decrease and pain medications to take effect.Answer
Answer
The correct actions include providing adaptive clothing with hook-and-loop closures, supplying foam-built-up handles for utensils, and scheduling self-care activities later in the morning.
Clients with severe rheumatoid arthritis experience pronounced joint stiffness, particularly in the morning, which impairs fine motor skills and grip strength. Supplying adaptive clothing with hook-and-loop closures and built-up handles on utensils compensates for these deficits, allowing the client to dress and eat without exacerbating joint pain. Furthermore, scheduling ADLs later in the morning ensures that prescribed pain and anti-inflammatory medications have reached peak effect, maximizing the client's physical capability to participate in their own care.
Step-by-Step Solution
Key Concept
Promoting Self-Care and Independence in Clients with Chronic Joint Stiffness