Which of the following would be the most appropriate goal for an elderly client with a nursing diagnosis of risk for injury after hip surgery?

Client will remain free from falls throughout their hospital stay.

Client will increase activity tolerance by discharge from the hospital.

Client will demonstrate effective breathing pattern when ambulating throughout hospital stay.

Client will increase mobility by the time of discharge from hospital.

Answer and Explanation

The Correct Answer is A

Choice A reason: Client will remain free from falls throughout their hospital stay is the most appropriate goal for an elderly client with a nursing diagnosis of risk for injury after hip surgery, because it is specific, measurable, attainable, realistic, and timely. This goal addresses the main risk factor for injury, which is falling, and the main outcome indicator, which is the absence of falls. This goal also reflects the client's condition, needs, and preferences, and is consistent with the standards of care and evidencebased practice.

Choice B reason: Client will increase activity tolerance by discharge from the hospital is not the most appropriate goal for an elderly client with a nursing diagnosis of risk for injury after hip surgery, because it is vague, subjective, unachievable, unrealistic, and untimely. This goal does not address the main risk factor for injury, which is falling, nor the main outcome indicator, which is the absence of falls. This goal also does not reflect the client's condition, needs, and preferences, and is not consistent with the standards of care and evidencebased practice.

Choice C reason: Client will demonstrate effective breathing pattern when ambulating throughout hospital stay is not the most appropriate goal for an elderly client with a nursing diagnosis of risk for injury after hip surgery, because it is irrelevant, unrelated, unnecessary, unrealistic, and untimely. This goal does not address the main risk factor for injury, which is falling, nor the main outcome indicator, which is the absence of falls. This goal also does not reflect the client's condition, needs, and preferences, and is not consistent with the standards of care and evidencebased practice.

Choice D reason: Client will increase mobility by the time of discharge from hospital is not the most appropriate goal for an elderly client with a nursing diagnosis of risk for injury after hip surgery, because it is vague, subjective, unachievable, unrealistic, and untimely. This goal does not address the main risk factor for injury, which is falling, nor the main outcome indicator, which is the absence of falls. This goal also does not reflect the client's condition, needs, and preferences, and is not consistent with the standards of care and evidencebased practice.

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Correct Answer is A

Explanation

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.

A. Provide the client with antipyretic therapy. B. Administer antibiotics to the client. C. Increase the client's protein intake. D. Teach relaxation breathing to reduce the client's pain.

Correct Answer is B

Explanation

Choice A reason: Providing the client with antipyretic therapy is not the nurse's priority. Antipyretic therapy is a treatment that lowers the body temperature and reduces fever. Fever is a common symptom of acute osteomyelitis, which is a bacterial infection of the bone and bone marrow. Antipyretic therapy may help to relieve the discomfort and inflammation caused by fever, but it does not address the underlying cause of the infection.

Choice B reason: Administering antibiotics to the client is the nurse's priority. Antibiotics are medications that kill or inhibit the growth of bacteria. Antibiotics are the main treatment for acute osteomyelitis, as they target the specific type of bacteria that is causing the infection. Antibiotics can prevent the spread of the infection to other bones or organs and reduce the risk of complications, such as chronic osteomyelitis, septic arthritis, or sepsis.

Choice C reason: Increasing the client's protein intake is not the nurse's priority. Protein intake is a nutritional factor that affects the wound healing and immune system. Protein is composed of amino acids, which are the building blocks of cells and tissues. Protein intake can enhance the repair and regeneration of the bone and the soft tissues that are damaged by the infection. Protein intake can also support the immune system's ability to fight off the infection. However, protein intake alone is not sufficient to treat acute osteomyelitis, as it does not eliminate the bacteria that are causing the infection.

Choice D reason: Teaching relaxation breathing to reduce the client's pain is not the nurse's priority. Relaxation breathing is a technique that involves deep and slow breathing that helps to relax the body and mind. Relaxation breathing can help to reduce the pain and stress that are associated with acute osteomyelitis. Pain is a common symptom of acute osteomyelitis, which is caused by the inflammation and pressure on the bone and the surrounding tissues. Relaxation breathing can help to ease the pain and improve the mood and quality of life of the client. However, relaxation breathing alone is not enough to treat acute osteomyelitis, as it does not address the source of the pain.

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