A client with osteoarthritis of the knees and hips returns for a ...

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A client with osteoarthritis of the knees and hips returns for a 3-month follow-up with the provider. The nurse calculates that the client's BMI is now 22. The reports starting a water aerobics and step aerobics program three times per week.
 
  The client is also using hot packs for edema for 20 minutes and cold packs for pain for 40 minutes daily. After evaluating the client's actions, the nurse plans which follow-up interventions?
  Select all that apply.
  A) Reinforce the correct use of hot packs.
  B) Educate on low-impact exercise modes.
  C) Explain the risk of injury using cold packs.
  D) Counsel on continued weight loss.
  E) Congratulate on starting water aerobics.

Question 2

The nurse is caring for an older adult client who is taking calcium for the treatment of osteoporosis. Which statements will the nurse include when educating the client about this medication?
 
  Select all that apply.
  A) The most common adverse effect is hypercalcemia caused by taking too much of the supplement.
  B) Oral calcium supplements are best taken on an empty stomach.
  C) Adults 50 years of age and over should obtain at least 500-750 mg per day of elemental calcium.
  D) If you have a condition called ventricular fibrillation, this medication might help.
  E) Report symptoms of weakness, increased urination, and thirst.

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Answer to Question 1

Answer: B, C, E

Congratulate the client on starting water exercise. Also congratulate on weight loss. A BMI of 22 is ideal. Do not encourage continued weight loss. Educate the client that using cold packs for over 30 minutes may cause skin injury. Reinforce that hot packs are used to decrease pain and ice packs are used for edema (swelling). Educate on the negative effect that high-impact step aerobics may have on the joints.

Answer to Question 2

Answer: A, E

Calcium gluconate and other calcium compounds are used to treat and prevent osteoporosis. Oral calcium supplements are best taken with meals or within 1 hour following meals. It is recommended that adults 50 years of age and over obtain at least 1,000-1,200 mg per day of elemental calcium. The most common adverse effect is hypercalcemia caused by taking too much of the supplement. Symptoms include lethargy, drowsiness, weakness, headache, anorexia, nausea and vomiting, increased urination, and thirst. Calcium supplementation is contraindicated in clients with ventricular fibrillation.

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TYSM

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