Brunner-Suddarth Med-Surg 13th Ed. Ch. 41

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

"Metal pins will go through my skin to the bone."

A client has a plaster cast applied to the left leg. Which of the following comments by the client following the procedure should the nurse address first?

"My toes are stiff."

The client with a fractured femur is upset and agitated that skeletal traction will be necessary for 6 to 8 weeks. The client states, "How can I stay like this for weeks? I can't even move!" Based on these statements, the nurse would identify which of the following as the most appropriate nursing diagnosis?

Ineffective Coping related to prolonged immobility

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority?

Maintaining traction continuously to ensure its effectiveness

A client is about to have a cast applied to his left arm. The nurse would alert the client to which of the following as the cast is applied?

Sensation of warmth or heat with application

All of the following are guidelines for avoiding hip dislocation after replacement surgery. Select the answer that is not.

You may flex at the hip to put on clothing such as pants, stockings, socks, or shoes.

Which of the following statements is accurate regarding care of a plaster cast?

The cast can be dented while it is damp.

A patient had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated?

The left leg is internally rotated.

The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?

Weights hanging and touching the floor

The client displays manifestations of compartment syndrome. The nurse expects the client to be scheduled for:

A fasciotomy

A client has a Fiberglas cast on the right arm. Which action should the nurse include in the care plan?

Assessing movement and sensation in the fingers of the right hand

A patient in the emergency department is being treated for a wrist fracture. The patient asks why a splint is being applied instead of a cast. What is the best response by the nurse?

"A splint is applied when more swelling is expected at the site of injury."

Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. The best response by the nurse is:

"CPM increases range of motion of the joint."

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education?

"The client is receiving physical therapy twice per day, so he doesn't need a continuous passive motion device."

A patient diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse?

"The joint above the fracture and below the fracture must be immobilized."

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker?

24 hours

A patient with an arm cast complains of pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? (Select all that apply.)

Assess the fingers for color and temperature. Assess for a pressure sore Determine the exact site of the pain.

Which of the following would be an inconsistent initial pain relief measure for the patient with a cast?

Application of a new cast

Which of the following nursing actions would help prevent deep vein thrombosis in a patient who has had an orthopedic surgery?

Apply antiembolism stockings

A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?

Apply lotions and take warm baths or soaks.

Which of the following would be inconsistent as a component of self-care activities for the patient with a cast?

Cover the cast with plastic to insulate it

A patient is placed in traction for a femur fracture. The nurse would document what as the expected outcomes of traction? Select all that apply.

Realignment of a fracture Reduction of deformity Minimization of muscle spasms

A nurse is giving instructions to a client who's going home with a cast on his leg. Which teaching point is most critical?

Reporting signs of impaired circulation

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?

Total arthroplasty

A nurse is caring for a client who recently underwent a total hip replacement. The nurse should:

limit hip flexion of the client's hip when he sits.

A 12-year-old girl fractured her right leg several weeks ago while skiing and is returning to the orthopedist to have her cast removed. What is of primary importance in your nursing management during cast removal?

Assuring the client she won't be cut

A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction?

Buck's

A client who is undergoing skeletal traction complains of pressure on bony areas. Which action would be most appropriate to provide comfort for the client?

Changing the client's position within prescribed limits.

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?

Cutting a cast window

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which of the following complications?

Dislocation of the hip

A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for?

Left hip arthroplasty

The physician is preparing to bivalve the client's cast. Which supplies should the nurse assemble?

Elastic compression bandages

A client returned to the nursing unit following orthopedic surgery and is complaining of pain. Which of the following interventions will help relieve pain?

Elevate the affected extremity and use cold applications.

A client has just undergone a leg amputation. The nurse would closely monitor the client for which of the following during the immediate postoperative period?

Hematoma

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Farenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which of the following complications?

Hypovolemic shock

Which intervention should the nurse implement with the client who has undergone a hip replacement?

Instruct the client to avoid internal rotation of the leg.

Which of the following is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?

It promotes healing by increasing circulation and movement of the knee joint.

A client's fracture was reduced by surgically exposing the bone and realigning it. The nurse identifies this as which of the following?

Open reduction

Which of the following orthopedic surgeries is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction

A variety of complications can occur after a leg amputation. All of the following are possibilities in the immediate postoperative period, except?

Osteomyelitis

Which action by the nurse would be inappropriate for the client following casting?

Protect the cast by covering with a sheet.

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?

Pulmonary embolism

A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?

Right shoulder slopes downward and droops inward.

The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is:

Risk for ineffective therapeutic regimen management

A patient arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain?

Sharp and piercing

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?

Short leg cast

Which of the following is an inaccurate principle of traction?

Skeletal traction is interrupted to turn and reposition the patient.

Which of the following devices is designed specifically to support and immobilize a body part in a desired position?

Splint

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan?

Teach the client how to prevent problems caused by immobility.