The nurse and the nursing assistive personnel (NAP) are caring ...

[student77]

The nurse and the nursing assistive personnel (NAP) are caring for a group of postoperative patients who need turning, coughing, deep breathing, incentive spirometer, and leg exercises. Which task will the nurse assign to the NAP?
 
  a. Teach postoperative exercises.
  b. Do nothing associated with postoperative exercises.
  c. Document in the medical record when exercises are completed.
  d. Inform the nurse if the patient is unwilling to perform exercises.

Question 2

Which nursing assessment will indicate the patient is performing diaphragmatic breathing correctly?
 
  a. Hands placed on the border of the rib cage with fingers extended will touch as the chest wall contracts.
  b. Hands placed on the chest wall with fingers extended will separate as the chest wall contracts.
  c. The patient will feel upward movement of the diaphragm during inspiration.
  d. The patient will feel downward movement of the diaphragm during expiration.

[rleezy04]

Answer to Question 1

ANS: D
The nurse can delegate to the NAP to encourage patients to practice postoperative exercises regularly after instruction and to inform the nurse if the patient is unwilling to perform these exercises. The skills of demonstrating and teaching postoperative exercises and documenting are not within the scope of practice for the nursing assistant. Doing nothing is not appropriate.

Answer to Question 2

ANS: A
Positioning the hands along the borders of the rib cage allows the patient to feel movement of the chest and abdomen as the diaphragm descends and the lungs expand. As the patient takes a deep breath and slowly exhales, the middle fingers will touch while the chest wall contracts. The fingers will separate as the chest wall expands. The patient will feel normal downward movement of the diaphragm during inspiration and normal upward movement during expiration.