The nurse is admitting a patient who has been diagnosed as having had a stroke. The physician writes orders for "ROM as needed." The nurse understands that
a. The nurse will have to move all the patient's extremities.
b. The patient is unable to move his extremities.
c. Further assessment of the patient is needed.
d. The patient needs to restrict his mobility as much as possible.
ANS: C
Further assessment of the patient is needed. Some patients are able to move some joints actively, whereas the nurse passively moves others. With a weak patient, the nurse may have to support an extremity while the patient performs the movement. In general, exercises need to be as active as health and mobility allow.
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a. atelectasis c. infection b. hemorrhage d. pressure sores
A client wants to use the vaginal sponge as a method of contraception. Which of the following statements indicate that she will need further instruction? (Select all that apply.)
1. "I need to use a lubricant prior to insertion.". 2. "I need to add spermicidal cream prior to intercourse.". 3. "I need to moisten it with water prior to use.". 4. "I need to leave it in no longer than 6 hours.". 5. "I can insert the sponge no longer than 24 hours prior to having intercourse.".
Which of the following statements accurately describes a recommended guideline for implementation? Select all that apply
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