Soru

Zorluk: OrtaBasic Care and Comfort

A home health nurse is developing a plan of care for an older adult client with severe rheumatoid arthritis who experiences chronic joint pain and morning stiffness. Which of the following interventions should the nurse include in the plan of care to promote basic care and comfort? Select all that apply.

  1. Advise the client to take a warm shower or apply moist heat packs immediately upon waking.Cevap
  2. B
    Place a firm pillow directly under the client's knees while resting in bed to reduce lower back strain.
  3. Encourage the client to carry bags or objects using the forearms rather than grasping them with the fingers.Cevap
  4. D
    Instruct the unlicensed assistive personnel (UAP) to evaluate the client's joints for increased warmth and erythema during morning hygiene.
  5. E
    Reassure the client that sudden, severe episodes of confusion are a normal, expected consequence of aging and chronic pain.
  6. Recommend the use of a high-backed chair with firm armrests to provide support and facilitate safe standing.Cevap

Cevap

The correct interventions are advising a warm shower upon waking, using the forearms to carry objects, and utilizing a high-backed chair with firm armrests.
Effective basic care and comfort for a client with rheumatoid arthritis includes measures that reduce pain, preserve joint function, and promote safe mobility. Heat therapy, such as a warm shower, relaxes muscles and relieves morning stiffness. Joint protection principles emphasize using larger, stronger joints (like the forearms) instead of smaller, easily deformed joints (like the fingers) to perform tasks. Additionally, utilizing chairs with high backs and firm armrests provides essential postural support and allows the client to push off safely when standing, minimizing stress on the hips and knees.

Adım Adım Çözüm

1
Analyze the client's clinical presentation and care needs.
The client is an older adult with severe rheumatoid arthritis suffering from chronic joint pain and morning stiffness.
Understanding the specific pathology and symptoms directs the selection of appropriate non-pharmacological comfort measures.
2
Evaluate the proposed joint protection and comfort interventions.
Applying heat, using larger joints for carrying, and utilizing supportive seating (high-backed chair with armrests) are correctly identified as safe and effective strategies.
These measures actively reduce stiffness, prevent joint deformity, and minimize mechanical stress.
3
Identify contraindicated actions and improper nursing practices among the options.
Placing a pillow under the knees, delegating assessments to UAPs, and dismissing acute confusion as normal aging are identified as incorrect and unsafe practices.
Pillows under knees cause contractures, UAPs cannot perform clinical assessments, and sudden confusion indicates a serious acute pathology.

Anahtar Kavram

Non-pharmacological comfort and joint protection in rheumatoid arthritis
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