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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching?
(Select All that Apply.)

Refrain from climbing ladders.

Do not go swimming without a partner.

Refrain from driving unless seizure-free for 3 months.

Avoid using power tools.

Place client on the floor when having a seizure.

Place client on their back when they are recovering from a seizure.

Answer and Explanation

Correct Answer : A,B,C,D,E,F

Choice A Reason:

Refraining from climbing ladders is appropriate. Climbing ladders involves a risk of falling, which can be particularly hazardous for individuals with epilepsy. Seizures can occur unexpectedly and may cause loss of muscle control or consciousness, increasing the risk of falls from heights such as ladders. Falling from a ladder during a seizure can result in serious injuries, including head trauma, fractures, or other injuries from impact. Advising the client to refrain from climbing ladders helps mitigate the risk of falls and associated injuries during a seizure episode, promoting their safety and well-being.

Choice B Reason:

Do not go swimming without a partner is inappropriate. Swimming alone can be dangerous for individuals with epilepsy as they may be at risk of drowning if they experience a seizure while in the water. Having a swimming partner can provide assistance and ensure safety in case of a seizure.

Choice C Reason:

Refraining from driving unless seizure-free for 3 months is appropriate. Driving restrictions are often recommended for individuals with epilepsy to minimize the risk of accidents caused by seizures. Many jurisdictions require individuals with epilepsy to be seizure-free for a certain period, typically around 3 to 6 months, before resuming driving.

Choice D Reason:

Avoiding using power tools is appropriate. Operating power tools or machinery can be hazardous if a seizure occurs, potentially leading to serious injuries. Therefore, individuals with epilepsy should avoid using power tools to reduce the risk of accidents during a seizure.

Choice E Reason:

Placing client on the floor when having a seizure is appropriate. Placing the client on the floor during a seizure helps prevent injury from falls. It is safer to have the individual lie down on a flat surface to reduce the risk of head injury or other trauma during the seizure.

Choice F Reason:

Placing client on their back when they are recovering from a seizure appropriate. Placing the client on their back after a seizure helps maintain an open airway and facilitates recovery. This position allows for proper breathing and circulation while monitoring the individual's condition.

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Correct Answer is D

Explanation

Choice A Reason:

Hypoxemia due to dead space is not appropriate. Dead space refers to areas of the lung where ventilation occurs but no perfusion takes place. In ARDS, hypoxemia typically occurs due to ventilation-perfusion (V/Q) mismatch and shunting rather than dead space.

Choice B Reason:

Impaired carbon dioxide elimination due to shunting is not appropriate. Shunting occurs when blood bypasses ventilated alveoli, leading to inadequate gas exchange. In ARDS, shunting contributes to hypoxemia, but it doesn't directly impair carbon dioxide elimination.

Choice C Reason:

Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch is incorrect. V/Q mismatch occurs when ventilation and perfusion are mismatched in different areas of the lung. This leads to areas of low ventilation (dead space) and areas of low perfusion (shunting). V/Q mismatch contributes to hypoxemia in ARDS but does not typically lead to decreased pulmonary arterial pressure.

Choice D Reason:

Decreased pulmonary compliance due to stiffness is correct. This is a characteristic feature of ARDS. The inflammation and damage to the alveoli cause them to become stiff, reducing pulmonary compliance and impairing lung expansion during ventilation.

A. Encourage the client to walk regularly. B. Provide the client with fresh fruits and vegetables. C. Restrict fluids to 800 mL/day. D. Minimize exposure to outside activities. E. Teach the client how to use a walker.

Correct Answer is ["A","B","E"]

Explanation

Choice A Reason:

Encouraging the client to walk regularly is appropriate. Regular exercise, including walking, can help improve mobility, balance, and overall physical function in individuals with Parkinson's disease. It can also help alleviate symptoms such as stiffness and tremors.

Choice B Reason:

Providing the client with fresh fruits and vegetables is appropriate. A healthy diet rich in fresh fruits and vegetables provides essential nutrients, antioxidants, and fiber, which can support overall health and well-being. While diet alone does not directly treat Parkinson's disease, maintaining a nutritious diet is important for overall health.

Choice C Reason:

Restricting fluids to 800 mL/day is inappropriate. Fluid restriction is not typically indicated for individuals with Parkinson's disease unless they have a specific medical condition such as heart failure or kidney disease, which may require fluid restriction as part of their management plan. Restricting fluids excessively can lead to dehydration, which can worsen symptoms such as fatigue, confusion, and constipation, common in Parkinson's disease. Adequate hydration is important for overall health and well-being, including maintaining proper kidney function and preventing urinary tract infections, which individuals with Parkinson's disease may be susceptible to due to urinary retention issues.

Choice D Reason:

Minimizing exposure to outside activities is inappropriate. While it's important for individuals with Parkinson's disease to take precautions to avoid falls and injuries, completely restricting exposure to outside activities is not necessary or advisable. Physical activity, social engagement, and exposure to sunlight are beneficial for both physical and mental health. Encouraging individuals with Parkinson's disease to remain engaged in activities they enjoy, with appropriate safety measures in place, can help maintain their quality of life and overall well-being.

Choice E Reason:

Teaching the client how to use a walker is inappropriate. Assistive devices such as walkers can help individuals with Parkinson's disease maintain mobility and independence, especially if they experience gait disturbances or balance problems. Teaching the client how to use a walker safely and effectively can enhance their quality of life and reduce the risk of falls.

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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching? (Select All that Apply.)

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A nurse is providing discharge instructions to a client who has epilepsy. Which of the following instructions should be included in the nurse's teaching?
(Select All that Apply.)