The patient is admitted with a stroke. The outcome of this ...

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The patient is admitted with a stroke. The outcome of this disorder is uncertain, but the patient is unable to move his right arm and leg. The nurse understands that
 
  a. Active range of motion is the only thing that will prevent contractures from forming.
  b. Passive range of motion must be instituted to help prevent contracture formation.
  c. Range-of-motion exercises should be started 2 days after the patient is stable.
  d. Range-of-motion exercises should be done on major joints only.

Question 2

The nurse is caring for a patient who becomes nauseated and vomits without warning. The nurse has contaminated hands. The nurse's best next step is to
 
  a. Clean hands with wipes from the bedside table.
  b. Wash hands with an antimicrobial soap and water.
  c. Use an alcohol-based waterless hand gel.
  d. Instruct the patient to wash his face and hands.

[Pamela.irrgang@yahoo.com]

Answer to Question 1

B
When patients cannot participate in active range of motion, the nurse must institute passive range of motion to maintain joint mobility and prevent contractures. Passive range of motion can be substituted for active when needed. For the patient who does not have voluntary motor control, passive range-of-motion exercises are the exercises of choice. Unless contraindicated, the nursing care plan includes exercising each joint (not just major joints) through as nearly a full range of motion as possible. Initiate passive range-of-motion exercises as soon as the patient loses the ability to move the extremity or joint.

Answer to Question 2

B
The Centers for Disease Control recommends that when hands are visibly soiled, one should wash with a non-antimicrobial soap or with antimicrobial soap. Cleaning hands with wipes or using waterless hand gel does not meet this standard. If hands are not visibly soiled, use an alcohol-based waterless antiseptic agent for routinely decontaminating hands. The patient may very well need to wash his face and hands, but this is not the best next step.

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Excellent

[amcvicar]

Gracias!