A nurse is reinforcing teaching with a school-age child who has hemophilia about participating in school

sports. Which of the following sports should the nurse recommend for the child? (Select all that apply.)

Choice A reason: Giving the patient extra time to perform activities is an appropriate action by the nurse because it respects the patient's autonomy and dignity, and reduces frustration and anxiety. Bradykinesia is a condition of slow movement that affects people with Parkinson's disease due to decreased dopamine levels in the brain.

Choice B reason: Teaching the client to walk more quickly when ambulating is not an appropriate action by the nurse because it can increase the risk of falls and injuries, and worsen the patient's symptoms. Bradykinesia can impair the patient's balance, coordination, and gait, making it difficult to initiate and maintain movement.

Choice C reason: Placing the client on a low-protein, low-calorie diet is not an appropriate action by the nurse because it can lead to malnutrition, weight loss, and muscle wasting, which can further compromise the patient's health and function. Bradykinesia does not affect the patient's metabolism or nutritional needs.

Choice D reason: Completing passive range-of-motion exercises daily is not an appropriate action by the nurse because it does not address the underlying cause of bradykinesia, which is reduced dopamine production in the brain. Passive range-of-motion exercises are movements performed by another person without the patient's active participation, which can decrease the patient's motivation and self-efficacy.

a) Collect fingerstick glucose levels.Correct

Collecting fingerstick glucose levels is the most important intervention for the PN to implement for a client who is receiving TPN. TPN is a method of feeding that bypasses the gastrointestinal tract and provides all the nutritional needs of the body through a vein. TPN contains a high concentration of glucose, which can cause hyperglycemia or fluctuations in blood sugar levels. Therefore, it is essential to monitor the client's glucose levels frequently and adjust the infusion rate or insulin administration accordingly.

b) Implement bleeding precautions.

Implementing bleeding precautions is not the most important intervention for the PN to implement for a client who is receiving TPN. Bleeding precautions are measures to prevent or minimize bleeding in clients who have a high risk of hemorrhage due to conditions such as thrombocytopenia, coagulopathy, or anticoagulant therapy. TPN does not directly increase the risk of bleeding, although it may affect the liver function and clotting factors in some cases². Therefore, bleeding precautions are not a priority for a client who is receiving TPN.

c) Obtain daily weights.

Obtaining daily weights is not the most important intervention for the PN to implement for a client who is receiving TPN. Obtaining daily weights is a way to monitor the client's fluid balance, nutritional status, and response to therapy. TPN can cause fluid overload, dehydration, or electrolyte imbalances in some cases²⁵. Therefore, obtaining daily weights is important, but not as important as monitoring glucose levels.

d) Check urine for albumin.

Checking urine for albumin is not the most important intervention for the PN to implement for a client who is receiving TPN. Checking urine for albumin is a way to detect proteinuria, which is an indicator of kidney damage or disease. TPN does not directly cause kidney problems, although it may affect the renal function and urine output in some cases². Therefore, checking urine for albumin is not a priority for a client who is receiving TPN.