A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?
Perform active range of motion exercises.
Apply compression stockings.
Give antispasmodic medications.
Massage the extremities twice a week.
The Correct Answer is C
A. Perform active range of motion exercises: Active ROM exercises are beneficial for maintaining joint mobility and circulation, but they may not sufficiently reduce spasticity in clients with upper motor neuron lesions.
B. Apply compression stockings: Compression stockings help prevent venous thromboembolism and manage edema, but they do not treat muscle spasticity. They offer circulatory support, not neuromuscular control, and therefore would not alleviate the client’s current concern.
C. Give antispasmodic medications: Antispasmodics such as baclofen or tizanidine directly target muscle spasticity by acting on the central nervous system. These medications reduce the frequency and intensity of spasms, improving comfort and mobility in clients with spinal cord injuries.
D. Massage the extremities twice a week: Massage may offer relaxation and temporary relief but is not a primary treatment for spasticity. It does not alter the neurophysiological causes of muscle spasms and is unlikely to produce sustained control over involuntary muscle activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B,A,D,C
Explanation
1. B. Verify the insulin prescription: The first step is to verify the prescription to ensure the correct type and dose of insulin before administering it. This ensures one is following the appropriate instructions.
2. A. Obtain blood glucose level: The next step is to check the client's blood glucose level to determine the amount of insulin needed based on the sliding scale.
3. D. Cleanse the selected site: After obtaining the blood glucose level, the next step is to prepare the injection site by cleaning it properly to prevent infection.
4. C. Draw insulin into insulin syringe: Finally, drawing the appropriate amount of insulin into the syringe, based on the sliding scale and the blood glucose level, to administer the injection.
Correct Answer is C
Explanation
A. Only 30% of clients did not attend self-management education sessions: This outcome does not directly indicate the effectiveness of a tertiary prevention program, which focuses on managing disease complications and improving quality of life after diagnosis.
B. Average client scores improved on specific risk factor knowledge tests: Improved knowledge is important, but tertiary prevention aims more at managing and reducing the impact of complications in individuals who already have the disease.
C. Clients who developed disease complications promptly received rehabilitation: Tertiary prevention focuses on minimizing the impact of established disease and preventing further disability. Effective rehabilitation for clients with complications demonstrates successful tertiary prevention.
D. More than 50% of at-risk clients were diagnosed early in their disease process: Early diagnosis falls under secondary prevention, not tertiary. Secondary prevention aims to identify and treat disease early to prevent complications, not managing existing complications.
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