NR 224 Week 3 Core Assignment; Hygiene and Tissue Integrity

NR 224 Week 3 Core Assignment; Hygiene and Tissue IntegrityFunctional Ability A client has a deficit in the functional ability of the right arm and hand. Which activities of daily living (ADLs) will the client need assistance with while hospitalized? Washing the left arm Buttoning a shirt The nurse considers which factors when assessing the functional ability of a client? Mobility Cognition Senses The nurse is completing a functional assessment on a client. The client asks what the purpose of the assessment is. How should the nurse respond? “It is used to identify ways to maintain independence.” Sensory perception: The ability to respond meaningfully to pressure-related discomfort. Moisture: The degree to which skin is exposed to moisture. Activity: The client’s level of physical activity. Mobility: The client’s ability to change and control body position. Nutrition: The ability of the client to take in enough food and liquids. Friction and Shear: The effects of moving while all or part of the body is in contact with surfaces that rub against the skin. Individuals with a total score of 16 or less are considered at risk. 15–16 = low risk 13–14 = moderate risk 12 or less = high risk A nurse is planning a presentation about functional ability in older adults. Which statements should be included in the presentation? Functional ability changes with illness. Assistive devices help clients maintain independence. A client with a physical and cognitive impairment was just admitted to the unit from the Emergency Department. Which statement is true about the functional ability of this client? The client’s functional abilities need to be assessed. Which client’s functional ability will be most impacted by their health? A client with drug-induced psychosis While caring for a client who wears glasses to correct severely impaired vision, the unlicensed assistive personnel (UAP) notices the client is not wearing their glasses. Which action should the UAP take first? Introduce themselves when entering the client’s room. The nurse is assessing a client with a left-sided weakness and wants to gain insight into the client’s instrumental activities of daily living (IADL) functional ability. What question would be most appropriate? "Are you able to shop independently for yourself?” Which factors are included in the Braden Scale rating? Nutrition Activity Sensory perception The Braden Scale includes the following factors: Sensory perception: The ability to respond meaningfully to pressure-related discomfort. Moisture: The degree to which skin is exposed to moisture. Activity: The client's level of physical activity. Mobility: The client's ability to change and control body position. Nutrition: The ability of the client to take in enough food and liquids. Friction and Shear: The effects of moving while all or part of the body is in contact with surfaces that rub against the skin. Activities of daily living (ADL) are basic tasks such as bathing, dressing, toileting, transferring, continence, and feeding. Instrumental activities of daily living (IADL) are the ability to use a telephone, shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility for one’s own medications, and