One of the nursing priorities for a patient who suffered an ischemic stroke focuses on the prompt initiation of rehabilitation including the establishment of an exercise program
To prevent contractures and further deterioration of the neuromuscular system, the nurse:
A) Teaches the patient to exercise the affected extremity after sitting balance is maintained
B) Teaches the patient to immediately stop all exercises if tightness occurs in any area in order to prevent damage to the joints
C) Exercises the affected extremity passively through a full range of motion at least 4 to 5 times a day
D) Initiates quadriceps and gluteal setting exercises after the patient can tolerate sitting out of bed for at least 1 hour to reduce cardiac workload
Ans: C
Feedback: The affected extremities are exercised passively and put through a full range of motion 4 to 5 times a day to maintain joint mobility, regain motor control, prevent contractures and further deterioration of the neuromuscular system, and enhance circulation. If tightness occurs in any area, range-of-motion exercises should be performed more frequently. Quadriceps and gluteal setting exercises are started early to improve muscle strength needed for walking and should be performed at least 5 times a day for 10 minutes at a time. Establishing an exercise program is imperative and should be implemented as soon as possible regardless of the patient's sitting balance and out-of-bed tolerance. The patient is always observed for signs and symptoms that may indicate excessive cardiac workload during exercise.
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