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Which organization publishes the National Patient Safety Goals?

Choice A reason: This is not the priority assessment because peripheral edema is not a lifethreatening complication of immobility. Peripheral edema is the swelling of the lower extremities due to fluid accumulation. It can be caused by various factors, such as venous insufficiency, heart failure, kidney disease, or medication side effects. The nurse should monitor the client's fluid status and provide elevation and compression therapy as needed.

Choice B reason: This is the priority assessment because lung sounds can indicate the presence of respiratory complications, such as pneumonia or atelectasis, which are common and serious consequences of immobility. Pneumonia is an infection of the lungs that causes inflammation, mucus production, and impaired gas exchange. Atelectasis is the collapse of alveoli, which are the tiny air sacs in the lungs that facilitate oxygen and carbon dioxide exchange. The nurse should auscultate the client's lung sounds regularly and report any abnormal findings, such as crackles, wheezes, or diminished breath sounds. The nurse should also encourage the client to cough, deep breathe, and use incentive spirometry to prevent or treat respiratory problems.

Choice C reason: This is not the priority assessment because bowel sounds can reflect the status of the gastrointestinal system, which is not directly affected by immobility. Bowel sounds are the noises produced by the movement of food and gas through the intestines. They can vary in frequency and intensity depending on the client's diet, activity, and medications. The nurse should auscultate the client's bowel sounds and assess for any signs of constipation, diarrhea, or obstruction. The nurse should also promote the client's bowel function by providing adequate hydration, fiber, and laxatives as ordered.

Choice D reason: This is not the priority assessment because skin turgor can indicate the level of hydration, which is not a primary concern of immobility. Skin turgor is the elasticity of the skin that allows it to return to its normal shape after being pinched or pulled. It can be affected by factors such as age, weight loss, dehydration, or edema. The nurse should assess the client's skin turgor and provide adequate fluids and electrolytes as needed. The nurse should also pay attention to the client's skin integrity and prevent or treat any pressure ulcers or wounds that may result from immobility.

Choice A reason: Fowler's position is a semisitting position with the head of the bed elevated at 45 to 60 degrees. This position allows for maximum expansion of the chest and improves ventilation and oxygenation. It also reduces the work of breathing and prevents the abdominal organs from compressing the diaphragm.

Choice B reason: Sim's position is a sidelying position with the lower arm behind the back and the upper knee flexed. This position is used for patients who are unconscious, have difficulty swallowing, or are receiving an enema. It does not facilitate breathing or oxygenation for patients with COPD.

Choice C reason: Prone position is a lying position with the face down and the arms at the sides or bent at the elbows. This position is used for patients with acute respiratory distress syndrome (ARDS) or severe lung injury to improve oxygenation and reduce lung inflammation. It is not recommended for patients with COPD as it may increase the risk of aspiration, pressure ulcers, and nerve damage.

Choice D reason: Lateral position is a sidelying position with the upper leg slightly flexed and supported by a pillow. This position is used for patients who are resting or sleeping to prevent pressure ulcers and promote comfort. It does not improve breathing or oxygenation for patients with COPD.