A nurse is caring for a client who is recovering from an amputation of her right arm below the elbow. Which of the following information should the nurse report to the occupational therapist?

The client is allergic to penicillin.

The client's parent is in a skilled nursing facility.

The client has two small children at home.

The client lives in a two-story home.

Answer and Explanation

The Correct Answer is C

A. The client is allergic to penicillin: Medication allergies are critical for the nurse and prescriber to know, but they are not directly relevant to occupational therapy planning.

B. The client's parent is in a skilled nursing facility: While this may influence social support, it is not directly relevant to the client’s rehabilitation needs or adaptive strategies for activities of daily living.

C. Having two small children at home significantly impacts the client's functional needs and IADLs. Caring for infants or toddlers requires bilateral hand coordination for tasks like holding a child safely, fastening car seats, lifting, changing diapers, and preparing bottles. The occupational therapist needs this critical information to tailor the rehabilitation plan, introduce specific adaptive equipment, and practice child-care tasks using one hand or a temporary prosthesis before discharge.

D. The client lives in a two-story home: The home environment, including stairs, affects mobility, accessibility, and safety after amputation. Reporting this information is essential for planning adaptive equipment, home modifications, and safe discharge.

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Correct Answer is C

Explanation

A. Atrial fibrillation: This dysrhythmia is characterized by an irregularly irregular rhythm with absent or unidentifiable P waves, not a prolonged constant P-R interval.

B. Premature atrial complexes: PACs involve early P waves that may have a normal or slightly different P-R interval, but they do not cause a consistently prolonged P-R interval across all beats.

C. First-degree atrioventricular block: A constant P-R interval greater than 0.20 seconds indicates a first-degree AV block. The atrial impulses are delayed at the AV node, but all impulses are conducted to the ventricles, producing a regular rhythm with prolonged P-R intervals.

D. Complete heart block: In complete heart block (third-degree AV block), there is no relationship between P waves and QRS complexes. The P-R interval is variable, unlike the constant prolongation seen in first-degree AV block.

A. "You will need to change the IV dressing site once per week." B. "You will need to warm the solution in the microwave before administration." C. "You will need to weigh the client twice per week." D. "You will need to monitor the client's electrolytes daily."

Correct Answer is D

Explanation

Rationale:

A. "You will need to change the IV dressing site once per week.": Central line dressings for TPN are typically changed every 48–72 hours for gauze or every 5–7 days for transparent dressings, or sooner if the dressing becomes damp, loose, or soiled, to reduce infection risk.

B. "You will need to warm the solution in the microwave before administration.": TPN solutions should never be microwaved due to the risk of uneven heating and nutrient degradation. They should be administered at room temperature.

C. "You will need to weigh the client twice per week.": Clients receiving TPN require daily weights to monitor fluid balance, nutritional status, and detect fluid retention or dehydration promptly. Twice-weekly measurements are insufficient for close monitoring.

D. "You will need to monitor the client's electrolytes daily.": TPN can cause rapid changes in fluid and electrolyte balance, so daily electrolyte monitoring allows timely adjustments to prevent complications such as hypo- or hypernatremia, hypokalemia, and metabolic imbalances.

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A nurse is caring for a client who is recovering from an amputation of her right arm below the elbow. Which of the following information should the nurse report to the occupational therapist?

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