Chapter 11 - Prioritization, Delegation, and Assignment 2023

The nurse is caring for a patient who had a dual-energy x-ray absorptiometry (DEXA) scan and is now prescribed calcium with vitamin D twice a day. The patient asks the nurse the purpose of this drug. What is the nurse's *best* response? *Select all that apply.* •"When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases." •"When your vitamin D level is high, your bones release calcium to keep your blood calcium level in the normal range." •"When your blood calcium is low, calcium is released from your bones increasing your risk for fractures." •"When blood calcium is normal, long bones are formed increasing a person's height." •"The extra calcium and vitamin D will help protect your bones from damage such as fractures." •"You can also get extra vitamin D by increasing your intake of beef and pork sources." - Correct Answer-•"When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases." •"When your blood calcium is low, calcium is released from your bones increasing your risk for fractures." •"The extra calcium and vitamin D will help protect your bones from damage such as fractures." •Vitamin D and its metabolites are produced in the body and transported in the blood to promote the absorption of calcium and phosphorus from the small intestine. A decrease in the body's vitamin D level can result in osteomalacia (softening of bone) in an adult. When serum calcium levels are lowered, parathyroid hormone (PTH, or parathormone) secretion increases and stimulates bone to promote osteoclastic activity and release calcium to the blood. PTH reduces the renal excretion of calcium and facilitates its absorption from the intestine. Sources of vitamin D include sunlight, fatty fish, and vitamin D-enriched foods. The nurse is preparing a discussion of musculoskeletal health maintenance for a group of older adults. Which key points would the nurse be sure to include? *Select all that apply.* •Be aware of and consume foods rich in calcium and vitamin D •Wear hats and long sleeves to avoid sun exposure at all times •Consider exercise with low impact to avoid risk for injury •If you smoke, consider a smoking cessation program •Excessive alcohol intake can interfere with vitamins and nutrients for bone growth •Weight-bearing activities decrease the risk for osteoporosis - Correct Answer-•Be aware of and consume foods rich in calcium and vitamin D •Consider exercise with low impact to avoid risk for injury •If you smoke, consider a smoking cessation program •Excessive alcohol intake can interfere with vitamins and nutrients for bone growth •Weight-bearing activities decrease the risk for osteoporosis •Many health problems of the musculoskeletal system can be prevented through health promotion strategies and avoidance of risky lifestyle behaviors. Weight-bearing activities such as walking can reduce risk factors for osteoporosis and maintain muscle strength. Young men are at the greatest risk for trauma related to motor vehicle crashes. Older adults are at the greatest risk for falls that result in fractures and soft tissue injury. Highimpact sports, such as excessive jogging or running, can cause musculoskeletal injury to soft tissues and bone. Tobacco use slows the healing of musculoskeletal injuries. Excessive alcohol intake can decrease vitamins and nutrients the person needs for bone and muscle tissue growth. The nurse is caring for a patient with osteoporosis who is at increased risk for falls. Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? •Identifying environmental factors that increase risk for falls •Monitoring gait, balance, and fatigue level with ambulation •Collaborating with the physical therapist to provide the patient with a walker •Assisting the patient with ambulation to the bathroom and in the halls - Correct Answer- •Assisting the patient with ambulation to the bathroom and in the halls •Assisting with activities of daily living, including assisting with ambulation to the bathroom, is within the scope of the UAP's practice. The other three interventions require additional educational preparation and are within the scope of practice of licensed nurses. The nurse is preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points should the nurse be sure to include? *Select all that apply.* •Wear a hip protector when ambulating •Remove throw rugs and other obstacles at home •Exercise to help build your strength •Expect a few bumps and bruises when you go home •Rest when you are tired •Avoid consuming three or more alcoholic drinks per day - Correct Answer-•Wear a hip protector when ambulating •Remove throw rugs and other obstacles at home •Exercise to help build your strength •Rest when you are tired CONTINUES...