Question 1: When the nurse is caring for a patient whose HIV status is unknown, the exposure that is most likely to require postexposure prophylaxis is a needle stick with a needle and syringe used to draw blood. This is because blood is a known reservoir for HIV, and if the patient’s HIV status is unknown, there is a risk of transmission through the needle stick injury. Therefore, postexposure prophylaxis should be initiated in such cases to prevent HIV infection.
Question 2: When teaching range-of-motion exercises to a patient with an exacerbation of rheumatoid arthritis, the nurse will include the following information:
a. Affected joints should not be exercised when pain is present: This is important because exercising the affected joints during periods of pain can worsen the symptoms and potentially cause further damage. It is important for the patient to avoid exercising when experiencing pain and consult their healthcare provider for appropriate pain management strategies.
b. Application of cold packs before exercise may decrease joint pain: Cold packs can help decrease joint pain and inflammation by numbing the area and reducing blood flow to the affected joint. Applying a cold pack before exercise can help alleviate pain and make it easier for the patient to perform range-of-motion exercises.
c. Exercises should be performed passively by someone other than the patient: In some cases, the patient may not be able to perform range-of-motion exercises independently due to their condition or exacerbation of symptoms. In such cases, a caregiver or healthcare provider may assist in performing the exercises passively. Passive range-of-motion exercises involve moving the joints through their full range of motion without the patient’s active participation.
d. Walking may substitute for range-of-motion (ROM) exercises on some days: While range-of-motion exercises are important for maintaining joint mobility and preventing stiffness in rheumatoid arthritis, walking can also be a beneficial exercise. Walking helps improve cardiovascular health, maintain overall fitness, and can help keep the joints mobile. It can be an alternative to range-of-motion exercises on days when the patient is unable to perform them or may provide a variety in their exercise routine.
Question 3: The nurse needs to contact the healthcare provider before giving metformin if they obtain the following information about the patient:
The finding indicating a need to contact the healthcare provider before giving metformin is not mentioned in the question prompt. To provide a specific answer, information about the patient’s medical history, laboratory values, and specific contraindications or precautions related to metformin administration would be necessary. Metformin is a medication commonly used to manage type 2 diabetes and can have several potential side effects and interactions with other medications or medical conditions. Therefore, if there is any concern or uncertainty related to giving metformin to a particular patient, it is essential to contact the healthcare provider for further guidance and clarification.