A patient who is confined to a wheelchair is encouraged to engage ...

[AEWBW]

A patient who is confined to a wheelchair is encouraged to engage in resistive isometric exercises to increase muscle strength and decrease the development of pressure ulcers.
 
  Which of the following is the most appropriate example of such an exercise for this patient? a. Hip lifting
  b. Moving arms and legs
  c. Gluteal contraction
  d. Quads setting

Question 2

Which of the following clients is at greatest risk for serious complications when using the Valsalva manoeuvre to expel feces?
 
  a. A 25-year-old pregnant client
  b. A 66-year-old male client with hypertrophied prostate disease
  c. A 44-year-old male client with glaucoma
  d. A 53-year-old female client with stomach cancer

[Liddy]

Answer to Question 1

A

Feedback
A An example of a resistive isometric exercise is hip lifting. In hip lifting, the patient, who is in a sitting position, pushes with the hands against a surface such as the seat of a chair and raises the hips.
B Moving arms and legs is an example of isotonic contraction and involves muscle strengthening, not pressure reduction.
C Gluteal contraction is an example of muscle strengthening, not pressure reduction.
D Quads setting is an example of isometric contraction and involves muscle strengthening, not pressure reduction.

Answer to Question 2

C
Clients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greatest risk of serious complications (such as cardiac irregularities and elevated blood pressure) with this manoeuvre, and need to avoid straining to pass the stool.
Although use of the Valsalva manoeuvre may contribute to hemorrhoids in pregnancy, this is not as serious as increasing the intraocular pressure of a client with glaucoma.
The Valsalva manoeuvre is not contraindicated in a client with hypertrophied prostate disease.
The Valsalva manoeuvre is not contraindicated in a client with stomach cancer.