Answer to Question 1
D
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A In the immobilized patient, decreased circulating fluid volume, pooling of blood in the lower extremities, and decreased autonomic response occur. These factors result in decreased venous return, followed by a decrease in cardiac output, which is reflected by a decline in blood pressure.
B Recumbency increases cardiac workload and results in an increased pulse rate.
C Fluid intake can diminish with immobility, and this, combined with other causes, such as fever, increases the risk of dehydration. Urinary output may decline on or about the fifth or sixth day after immobilization, and the urine is often highly concentrated.
D Immobility disrupts the normal functioning of the gastrointestinal system, resulting in decreased appetite and slowed peristalsis.
Answer to Question 2
A
If the client has unilateral weakness, the nurse should place food in the stronger side of the mouth.
The client should be positioned in an upright, seated position to prevent aspiration.
Clients with unilateral weakness often have difficulty using a straw.
Thickened liquids are often tolerated better and will help prevent aspiration, as clients with im-paired swallowing often choke more with thin liquids.
A nurse shows empathy to a client.
A nurse prepares a client for anesthesia and surgery.
The nurse applies a pulse oximeter sensor on the client’s finger.
Patient teaching: nose and sinus assessment
Chest X-ray of a patient with emphysema.
Toxoplasma gondii in the heart of an HIV patient.