The mother of a child with cerebral palsy (CP) asks the nurse if her child's impaired movements will worsen as the child grows.
Which response provides the best explanation?
CP is one of the most common permanent physical disabilities in children.
Brain damage with CP is not progressive but does have a variable course.
Severe motor dysfunction determines the extent of successful habilitation.
Continued development of the brain lesion determines the child's outcome.
The Correct Answer is B
Choice A rationale:
CP being one of the most common permanent physical disabilities in children is a general statement but does not directly address the mother's question about the progression of her child's impaired movements. It does not provide an explanation for the potential course of CP.
Choice B rationale:
Brain damage with CP is not progressive but does have a variable course. This response provides the best explanation to the mother's question. CP is a static neurological condition, which means that the initial brain injury that led to CP does not worsen over time. However, the functional abilities and impairments of a child with CP can vary widely and may change as the child grows and develops. Some children may improve with therapy and interventions, while others may have relatively stable impairments.
Choice C rationale:
Severe motor dysfunction determines the extent of successful habilitation is not entirely accurate. While the severity of motor dysfunction does play a role in the challenges a child with CP may face, it does not solely determine the extent of successful habilitation. Many factors, including early intervention, therapy, and individualized care, can influence a child's progress and potential for improvement.
Choice D rationale:
Continued development of the brain lesion determines the child's outcome is not an accurate statement. CP is primarily caused by non-pro
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Correct Answer is B
Explanation
Choice A rationale:
Reducing the client's interaction with others during the day is not the most appropriate approach in this situation. It may lead to increased social isolation and worsen the client's agitation and delusions. It does not address the client's emotional distress.
Choice B rationale:
Using distraction and therapeutic communication skills is the most suitable approach for a client with dementia who is experiencing agitation and delusional thoughts. Distraction techniques can help redirect the client's focus away from distressing thoughts, and therapeutic communication skills, such as active listening and validation, can help the client feel understood and supported.
Choice C rationale:
Awakening the client earlier for daily morning care may further disrupt the client's sleep patterns and worsen agitation. It does not address the underlying issue of delusional thoughts and the client's emotional distress.
Choice D rationale:
Clarifying reality with the client about delusional thoughts can be counterproductive in dementia care. The client's cognitive impairment may make it challenging for them to understand or accept the clarification, leading to increased frustration and agitation. It is essential to use a more empathetic and therapeutic approach.
Correct Answer is A
Explanation
Choice A rationale:
The nurse should instruct the client to sleep with an extra pillow under their head. This position, known as the semi-Fowler's position, elevates the upper body and head, which can help reduce shortness of breath and difficulty breathing while lying down at night. Propranolol, a non-selective beta-blocker, can cause bronchoconstriction in some individuals, especially those with a history of respiratory issues. Elevating the head can assist in improving lung expansion and reducing the sensation of breathlessness.
Choice B rationale:
Sleeping on their left side would not be the best option in this case. While sleeping on the left side is often recommended for individuals with certain cardiac conditions to improve blood flow and reduce pressure on the heart, it may not be as effective for alleviating the respiratory symptoms caused by propranolol. Elevating the head is a more appropriate intervention in this scenario.
Choice C rationale:
Sleeping on their right side is not the ideal choice either. While it can have benefits for individuals with certain cardiac conditions, it does not address the specific respiratory symptoms reported by the client. Elevating the head is a more targeted intervention to alleviate breathlessness associated with propranolol.
Choice D rationale:
Sleeping on their back may worsen the client's symptoms. Lying flat on the back can lead to increased pressure on the diaphragm, making it more challenging to breathe for individuals experiencing shortness of breath. Therefore, it is not the recommended position for this client.
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