Activity and Excercise
Preparing for Clinical Practice
Mrs. Smith has experienced some success in losing weight. She states, “I feel like I should have lost more weight by now.” However, she expresses concern about how to incorporate exercise into her daily routine to maintain weight and assist with future weight loss.
1. Mrs. Smith states, “It is hard for me to determine exactly how much exercise I get doing my usual activities.” She also expresses feelings of overwhelming stress and excessive demands on her time. Which interventions do you suggest to Mrs. Smith to help assess her current level of exercise?
2. Recognizing the challenges Mrs. Smith has voiced in balancing the excessive demands on her time and incorporating an exercise program. Develop some strategies to help initiate and maintain daily exercise.
3. Develop a feedback method for Mrs. Smith, emphasizing her success in exercise and maintaining a healthy weight.
Hygiene
1. During Mrs. White’s stay in the hospital, a student nurse prepares to provide perineal care. Mrs. White has a urinary catheter in place. The patient asks the student nurse why chlorhexidine gluconate (CHG) wipes are being used instead of soap and water. What is the response the student nurse should give Mrs. White?
2. Because the student nurse plans to use chlorhexidine gluconate (CHG) to bathe Mrs. White, list two assessments the student should conduct that are pertinent to using the antiseptic.
3. Given Mrs. White’s current condition and medical history, which of the following hygiene activities pose the greatest risk for the patient? Why?
1. Shampoo
2. Eye care
3. Mouth care
4. Foot care
Fluid, Electrolyte, and Acid-Base Balance
Mrs. Hilda Beck, age 72, fell at home because she became light-headed after vomiting and diarrhea that lasted over 24 hours. Even though she was nauseated, she drank some water because she knew she needed fluid. She was admitted for oral and intravenous (IV) fluid therapy.
1. What was problematic about Mrs. Beck’s oral fluid replacement at home when she had vomiting and diarrhea?
2. Mrs. Beck’s intravenous (IV) fluid order is 1000 mL 0.9% sodium chloride to run over 5 hours. Calculate the mL/hr that you should program into her infusion pump.
3. Mrs. Beck says, “When I get diarrhea, I should drink sodium-containing fluid when I’m thirsty.” She needs what additional teaching?
Sleep
Julie returns to the neighborhood health clinic for a follow-up visit. She tells you that, since she started her sleep-hygiene plan, she feels more rested. She tells you that she is concerned because her husband says that she has started snoring loudly when she’s sleeping.
1. On the basis of Julie’s husband’s report of her snoring, which additional assessment data should you gather from her?
2. Julie tells you that her 76-year-old mother is having trouble sleeping after being in the hospital. Julie asks you about a prescription for a sleeping pill for her mother. What is your best response?
3. Julie and David tell you that they are concerned about their 14-year-old daughter. She just started high school and is having sleep problems. List at least three interventions for Julie and David to use to improve their teenage daughter’s sleep patterns.
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