Problem 1 - Clinical Nursing Skills and Techniques

Question

The nurse notes that a patient's left elbow is resistant to extension and flexion while performing range-of-motion exercises. What is the appropriate nursing action at this time? 1 Move the joint through the full range of motion. 2 Perform range of motion to the left elbow only until resistance is met. 3 Omit all the range-of-motion exercises until the health care provider is notified. 4 Tell the health care provider that the patient is uncooperative with exercising.

Step-by-Step Solution

Answer

Perform range of motion only until resistance is met (Option 2).

Step 1: Identify the Problem

The patient’s left elbow is resistant to extension and flexion, causing issues during range-of-motion exercises.

Step 2: Analyze Options

You have four possible actions to consider: 1) Force the joint through the full range of motion, 2) Perform exercises until resistance is met, 3) Omit exercises entirely until discussing with the health care provider, or 4) Report patient non-cooperation to the provider.

Step 3: Evaluate Safety and Best Practices

Forcing the joint beyond resistance could cause harm, so options 1 is unsafe. Skipping all exercises can lead to decreased mobility, so option 3 may not be best without further assessment.

Step 4: Choose Appropriate Action

The best approach is option 2: Perform the range of motion until resistance is met. This respects the patient's current physical limitation safely.

Key Concepts

Range of Motion Exercises

Range of motion exercises are crucial in maintaining and improving joint flexibility.
Their main goal is to help patients regain or maintain mobility after an injury or due to a medical condition. When practicing range of motion exercises, it's important to monitor for resistance or discomfort.
Resistance indicates a limit to the movement, beyond which pushing further could lead to joint damage or pain.

• Start gently: Begin with smooth, controlled movements within the patient's comfort level.
• Watch for signs: Keep an eye out for facial expressions or verbal cues that indicate discomfort or pain.
• Stop at resistance: Always stop when you feel the joint resisting the movement to prevent injury.

Understanding these exercises helps provide effective care and improve the patient's overall mobility without causing additional harm.

Patient Safety

Patient safety is a primary concern for nurses during all procedures and interactions, including range of motion exercises.
Ensuring a patient's safety means understanding their current condition and limitations to prevent harm. During exercises:

• Avoid forcing movements: Forcing a joint beyond its natural resistance can cause damage, such as tears or fractures.
• Provide support: Physically support the limb being exercised for stability and control.
• Communicate effectively: Talk to the patient about how they feel during the exercises and adjust accordingly.

By prioritizing patient safety, nurses can ensure that therapeutic exercises are beneficial and do not inadvertently lead to adverse outcomes.

Nursing Assessment

Nursing assessment is a critical component in deciding the appropriate intervention for any patient-related issue.
It involves gathering information about the patient's physical condition, understanding their limitations, and making informed decisions about their care plan. Key elements of nursing assessment include:

• Observational skills: Watching how a patient moves can give valuable insight into their mobility issues.
• Communication: Conversing with the patient about any discomfort or past medical history.
• Clinical judgment: Making educated decisions based on the patient’s current status and historical data.
  Avoid assumptions that could lead to incorrect care choices.

With thorough nursing assessment, nurses can tailor exercise routines to fit the needs and limitations of each patient, ensuring optimal care and progress.