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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Chicken, yams, pinto beans, and pecans: This meal is not ideal for a client with CKD because pinto beans and pecans are high in potassium and phosphorus, which can be problematic for clients with CKD. Yams are also high in potassium.

B. Steak and baked potato with butter and cheese topping: Steak is high in protein and phosphorus, which can overload the kidneys. Baked potato, especially with cheese, can be high in potassium, which should be monitored in CKD.

C. Canned ham and green beans: Canned ham is often high in sodium, which is not recommended for clients with CKD, as it can exacerbate fluid retention and high blood pressure. Green beans are a good choice, but the sodium content in the ham is a concern.

D. Pasta with fish and an orange: Pasta is low in potassium and phosphorus, and fish provides a good source of protein that is generally easier on the kidneys compared to red meat. This meal is lower in sodium, phosphorus, and potassium, making it a better choice for CKD.

Correct Answer is ["1350"]

Explanation

Rationale:

Fluid resuscitation rate using the Parkland formula:

Calculate the total fluid volume needed for the first 24 hours.

The Parkland formula: 4 mL × client weight (kg) × % TBSA burned.

Client weight = 90 kg

TBSA burned = 45%

Total fluid volume = 4 mL × 90 kg × 45 = 16,200 mL

Determine the amount of fluid to be given in the first 8 hours.

According to the Parkland formula, half of the total fluid volume is administered in the first 8 hours from the time of the burn injury.

Fluid for first 8 hours = 16,200 mL / 2

= 8,100 mL

Calculate the infusion rate for the first 8 hours.

The burn occurred at 1000. The nurse arrives at 1200. This means 2 hours have already passed since the burn occurred within the initial 8-hour period.

Remaining time in the first 8 hours = 8 hours - 2 hours

= 6 hours.

Infusion rate (mL/hour) = Fluid for remaining first 8 hours / Remaining time in first 8 hours

= 8,100 mL / 6 hours

= 1350 mL/hour.

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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?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Correct Answer is D

Explanation

Correct Answer is ["1350"]

Explanation

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