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Chapter 9: Problem 118

A patient with multiple myeloma is admitted to the hospital with a pathologic fracture of the tibia and is ordered to be on bed rest. Which of the following nursing actions would be appropriate? 1\. raising the head of the bed to a 10-degree angle 2\. tuming the patient on her side once a shift 3\. having the patient fast before a scheduled \(x-r a y\) 4\. accurate reconding of fluid intake and output

Short Answer

Expert verified
Record fluid intake and output accurately for the patient.

Step by step solution

01

Understand the Condition

Multiple myeloma is a type of cancer that can cause bones to become fragile and break easily, leading to pathologic fractures. Patients with such fractures need careful handling to prevent additional injury.
02

Review Nursing Actions

Analyze each of the nursing actions presented in the question: 1. Raising the head of the bed to a 10-degree angle 鈥� This is generally for comfort and to prevent aspiration but doesn't align strongly with fracture care. 2. Turning the patient on her side once a shift 鈥� While movement is important, the fracture site needs to be stabilized, and such infrequent turning could lead to extended pressure on certain areas, increasing the risk of pressure sores. 3. Fasting before an X-ray 鈥� Typically not required for such diagnostic imaging. 4. Accurate recording of fluid intake and output 鈥� Monitoring fluid balance is crucial for patients, especially those on bed rest or undergoing certain treatments.
03

Determine the Appropriate Nursing Action

Choose the most appropriate nursing action based on the scenario. Given the patient's condition and the requirement for careful handling and monitoring, option 4, accurate recording of fluid intake and output, is most appropriate. This monitoring helps manage the patient's overall health and detect any additional complications.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Nursing Care for Multiple Myeloma
Multiple myeloma is a cancer that specifically affects plasma cells in the bone marrow. It can lead to substantial weakness and breaks in bones due to the impact on healthy bone cells. Due to these characteristic bone issues, pathologic fractures, such as those occurring with minimal trauma, are common. Nurses play a crucial role in managing these conditions effectively.

Key aspects of nursing care for multiple myeloma include:
  • Close monitoring: Regular check-ups to assess the progression of the disease and monitor any complications including kidney function, calcium levels, and signs of infection.
  • Symptom management: This involves offering pain relief through medications and assisting with any necessary therapies.
  • Patient education: Teaching patients about their condition, helping them understand treatment regimens, and advising them on lifestyle changes that can help manage symptoms.
  • Coordination of care: Working with a multidisciplinary team to ensure comprehensive care that covers all aspects of the patient's health.
Timely and effective nursing care can significantly improve the quality of life for patients with multiple myeloma.
Pathologic Fracture Management
Pathologic fractures occur when bones weakened by disease break with little to no trauma. This is common in patients with conditions such as multiple myeloma. Managing these fractures requires careful attention to avoid further injury or complications.

Essential nursing actions include:
  • Stabilization: Ensuring the affected bone is kept in a stable position to facilitate healing. This may involve splints, braces, or bed rest protocols.
  • Pain management: Administering appropriate analgesics and monitoring their effectiveness to ensure patient comfort.
  • Preventing complications: Keeping a close eye for signs of infections, blood clots, or worsening conditions.
  • Collaboration with healthcare professionals: Engaging with physicians, physiotherapists, and occupational therapists to create a comprehensive treatment plan.
By focusing on these areas, nurses can help improve recovery and maintain patient wellbeing after a pathologic fracture.
Nursing Best Practices
Nursing best practices are critical in ensuring that patients receive the highest level of care. These practices involve utilizing current clinical guidelines, technology, and evidence-based methods to optimize patient outcomes.

Some fundamental nursing best practices include:
  • Continuous learning: Engaging in regular training and education to stay updated with the latest methods and treatments.
  • Evidence-based practice (EBP): Applying research findings and clinical expertise to the care provided to patients.
  • Patient-centered care: Focusing on the individual needs of patients, respecting their preferences and values in all aspects of care.
  • Effective communication: Building rapport with patients and clearly conveying information about their condition and care.
Adhering to best practices can considerably enhance the safety, effectiveness, and patient satisfaction in nursing care.
Patient Handling Techniques
Proper patient handling is essential in preventing injuries to both patients and healthcare workers. This is especially important for patients with mobility issues such as those with multiple myeloma or fractures.

Key techniques for safe patient handling include:
  • Using assistive devices: Utilizing lifts, transfer belts, or slide sheets to safely move patients.
  • Maintaining good body mechanics: Nurses should use their knees instead of their backs to lift, keeping movements smooth and avoiding sudden jerks.
  • Teamwork: Coordinating with other staff members for assistance when moving patients, ensuring a safe and aligned approach.
  • Training and education: Engaging in regular training sessions on patient handling and proper ergonomic practices.
By implementing these techniques, healthcare professionals can ensure safe and efficient patient movement, reducing the risk of injury and enhancing patient care quality.

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Most popular questions from this chapter

In planning for a patient's discharge from the hospital, the nurse needs information on all of the following except: 1\. type of insurance. 2\. availability of caregivers for the patient. 3\. transportation available. 4\. banking services used.

A new manager does not seem to trust that assignments will be completed as delegated without much supervision and direction. This style of management is called: 1\. laissez-faire. 2\. autocratic. 3\. democratic. 4\. diplomatic.

Sarah Morgan, age 77, is admitted to the medicalsurgical unit because of uncontrolled diabetes. When assessing this elderly client, the nurse should place extra emphasis on which component of the health history? 1\. developmental considerations 2\. childhood illnesses 3\. biographic data 4\. role and relationship patterns

our ER patient is a 10 year old with contusions that may have been inflicted by a caregiver. As a nurse advocate to facilitate the patient's care, you would do all of the following except: 1\. identify and document the patient's condition. 2\. tell the mother. 3\. follow your facility protocol for mandatory reporting of suspicion of child abuse. 4\. discuss your findings with the physician in charge.

Which one of the following assessment findings indicates a lifestyle risk factor? 1\. obesity 2\. overcrowded housing 3\. sunbathing 4\. industrial-based occupation
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