Author Question: An elderly nursing home resident fell 2 weeks ago and has been on bed rest. The patient has become ... (Read 89 times)

humphriesbr@me.com · **on:** Jul 22, 2018

An elderly nursing home resident fell 2 weeks ago and has been on bed rest. The patient has become increasingly fatigued during activities of daily living (ADLs). The family is concerned about the patient's declining condition.

The best explanation that the nurse can give the family is that the patient's fatigue is caused by which of the following? a. Decreased muscle endurance caused by immobility
b. Advanced age
c. Increased metabolism
d. Urinary stasis

Question 2

Patients on prolonged bed rest are at risk for a deep vein thrombosis. Which information indicates the nurse needs more teaching about the factors in Virchow's triad?

a. One of the factors is loss of integrity of the vessel wall.
b. One of the factors is abnormalities of blood flow.
c. One of the factors is alterations in blood constituents.
d. One of the factors is atrophy of the muscles.

kusterl · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

A
The body loses muscle strength when muscles are inactive. The rate of muscle decline varies with the degree of immobility, but it is rapid while mobility and weight bearing are restricted. These effects are devastating to patients who are marginally functional with their ADLs. This fatigue is a result of the bed rest, not from advanced age or urinary stasis. Reduced metabolism, not increased, leads to a loss of muscle and body mass, causing fatigue with prolonged activity. Urinary stasis does not affect activity level, but can lead to urinary tract infections.

Answer to Question 2

D
Three factors contribute to venous thrombus formation: (1) loss of integrity of the vessel wall (e.g., injury), (2) abnormalities of blood flow (e.g., slow blood flow in calf veins associated with bed rest), and (3) alterations in blood constituents (e.g., a change in clotting factors or increased platelet activity). These three factors are referred to as Virchow's triad. Disuse, atrophy, and shortening of muscle fibers and surrounding joint tissues cause joint contracture, not deep vein thrombosis.