A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

"Support your body weight on the underarm crutch pads."

"Look down at your feet before moving the crutches."

"Place one crutch forward with the opposite foot and then place the second crutch forward followed by the second foot."

"Move both crutches forward while standing on the unaffected leg, then lift and swing your body past the crutches."

Answer and Explanation

The Correct Answer is D

A.   Crutches should not be used to support body weight under the arms, as this can cause nerve damage or discomfort. Instead, weight should be supported on the hands and arms, with the crutches positioned to support the client’s weight. Proper use involves placing the crutches slightly in front of the feet, with weight supported on the hands, not the underarms.
B.   While it's important to be aware of your surroundings, looking down at your feet can be counterproductive as it may affect balance and coordination. The client should maintain an upright posture and look ahead to ensure proper gait and balance while moving. This helps in coordinating the movement of crutches and feet more effectively.
C.   In a four-point gait, each crutch and foot move alternately, which is different from the three-point gait. The three-point gait involves moving both crutches and the affected leg forward simultaneously, followed by the unaffected leg.
D.   In the three-point gait, the client moves both crutches forward at the same time while keeping the affected leg off the ground or in a non-weight-bearing position. Then, the client swings the unaffected leg forward to step past the crutches. This method ensures that weight is only placed on the unaffected leg while moving.

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Correct Answer is A

Explanation

A. Allowing a small amount of air inside the bag can prevent the formation of ice crystals that could lead to frostbite or skin damage. Air space allows the ice to conform better to the shape of the injury and can help distribute the cold more evenly. However, the bag should not be too full to ensure effective cooling.
B. Placing an ice bag directly on the skin can lead to skin damage or frostbite. To prevent this, a thin cloth or towel should be placed between the ice bag and the skin. This barrier helps protect the skin from the intense cold and reduces the risk of injury.
C. Applying an ice bag for 30 minutes at a time can be too long and may risk skin damage or frostbite. Typically, ice should be applied for 15-20 minutes at a time, followed by a break to allow the skin to warm up before reapplication.
D. After applying an ice bag for 15-20 minutes, it is usually recommended to remove it and allow the skin to return to normal temperature before reapplying. Waiting about 30 minutes before reapplying allows the skin to recover and helps avoid potential complications like frostbite or cold burns.

A. Urine output of175 mL in the past 8 hr B. First-voided urine in the morning has a strong odor C. Urine output of 2,200 mL in the past 24 hr D. Urine is cloudy after sitting in the urinal for 6 hr

Correct Answer is A

Explanation

A. A urine output of 175 mL over 8 hours is significantly below normal, which is generally considered less than 0.5 mL/kg/hr in adults (the normal range is about 0.5-1.5 mL/kg/hr). Reduced urine output can be indicative of acute kidney injury or worsening renal function, and it needs prompt evaluation and intervention.
B. This finding is generally not urgent but could be noted. Strong-smelling urine, especially in the morning, may be due to concentration of waste products overnight or dietary factors. While it might suggest dehydration or infection, it is less immediately concerning than changes in urine output. If accompanied by other symptoms such as pain, fever, or changes in urine color, it might warrant further investigation.
C. This finding is typically within normal limits and may not need immediate reporting. Normal urine output is about 800-2,000 mL per day. An output of 2,200 mL is slightly elevated but still within the normal range, depending on fluid intake.
D. This finding is generally not urgent but worth noting. Cloudy urine can result from the presence of cells, bacteria, or other substances. It may become cloudy after standing due to the formation of crystals or precipitation of substances.

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A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

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