A nurse is teaching a client who has a new second-degree ankle sprain. Which of the following instructions should the nurse include in the teaching? Select all that apply.

Apply intermittent ice to the affected ankle for the first 48 hours.

Wrap the affected ankle with an elasticized compression bandage.

Apply full weight-bearing on the affected ankle.

Elevate the affected ankle above the level of the heart.

Apply a heating pad intermittently to the affected ankle after 48 hours.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Apply intermittent ice to the affected ankle for the first 48 hours

Applying ice intermittently to the affected ankle for the first 48 hours helps reduce swelling and inflammation. Ice should be applied for 15-20 minutes every 2-3 hours during the initial phase of injury management. This practice is part of the RICE (Rest, Ice, Compression, Elevation) protocol commonly used for sprains and strains.

Choice B reason: Wrap the affected ankle with an elasticized compression bandage

Wrapping the affected ankle with an elasticized compression bandage helps to minimize swelling and provide support to the injured area. Compression bandages should be snug but not too tight to avoid restricting blood flow. This is another component of the RICE protocol.

Choice C reason: Apply full weight-bearing on the affected ankle

Applying full weight-bearing on the affected ankle is not recommended immediately after a second-degree sprain. The ankle needs time to heal, and weight-bearing should be gradually reintroduced as pain and swelling decrease. Initially, the client should avoid putting weight on the injured ankle to prevent further damage.

Choice D reason: Elevate the affected ankle above the level of the heart

Elevating the affected ankle above the level of the heart helps reduce swelling by promoting venous return and decreasing fluid accumulation in the injured area. This is an essential part of the RICE protocol and should be done as much as possible during the first 48 hours.

Choice E reason: Apply a heating pad intermittently to the affected ankle after 48 hours

Applying a heating pad intermittently to the affected ankle after 48 hours can help increase blood flow and promote healing. Heat therapy should be used after the initial acute phase (first 48 hours) when swelling has subsided. Heat can help relax muscles and reduce stiffness in the injured area.

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Correct Answer is C

Explanation

Choice A reason: Your baby will receive the first diphtheria, tetanus, pertussis vaccine at the 2-week well-baby visit is incorrect. The first dose of the diphtheria, tetanus, and pertussis (DTaP) vaccine is typically given at 2 months of age, not at 2 weeks.

Choice B reason: Your baby should receive the measles, mumps, rubella vaccine at 6 months is incorrect. The first dose of the measles, mumps, and rubella (MMR) vaccine is usually given at 12 to 15 months of age.

Choice C reason: Your baby will only receive the hepatitis B vaccine prior to discharge is correct. The hepatitis B vaccine is typically given within 24 hours of birth, and it is the only vaccine administered before the newborn is discharged from the hospital.

Choice D reason: Your baby should receive the pneumococcal conjugate vaccine on his first birthday is incorrect. The pneumococcal conjugate vaccine (PCV13) is given in a series of doses starting at 2 months of age, with additional doses at 4 months, 6 months, and a booster dose at 12 to 15 months.

A. “Please do not raise your voice at the children. I am the one who left the dishes in the sink.” B. “If you keep saying that, I will tell everyone what you did last night.” C. “Can you tell me the reason you get upset each time I go to the mall?” D. “She is always bossing me around. Should she do that?”

Correct Answer is A

Explanation

Choice A reason:

The statement “Please do not raise your voice at the children. I am the one who left the dishes in the sink.” is an example of effective communication. It demonstrates taking responsibility for one’s actions and addressing the issue calmly and directly. This approach helps to de-escalate potential conflict and promotes a respectful and constructive dialogue among family members. Effective communication in family therapy involves clear, honest, and respectful exchanges that foster understanding and resolution of issues.

Choice B reason:

The statement “If you keep saying that, I will tell everyone what you did last night.” is an example of ineffective communication. It is threatening and manipulative, which can escalate conflict and create a hostile environment. Such statements undermine trust and respect among family members, making it difficult to resolve issues constructively. Effective communication should avoid threats and focus on expressing feelings and concerns in a non-confrontational manner.

Choice C reason:

The statement “Can you tell me the reason you get upset each time I go to the mall?” is a step towards effective communication as it seeks to understand the other person’s feelings. However, it could be improved by using “I” statements to express personal feelings and concerns. For example, “I feel concerned when you get upset each time I go to the mall. Can we talk about it?” This approach reduces defensiveness and encourages open dialogue.

Choice D reason:

The statement “She is always bossing me around. Should she do that?” is an example of ineffective communication. It is accusatory and does not address the issue constructively. Effective communication should focus on specific behaviors and how they affect the individual, rather than making general accusations. For example, “I feel frustrated when I am told what to do. Can we discuss how we can share responsibilities more fairly?” This approach promotes understanding and cooperation.

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