Chapter 37: Management of Patients with Musculoskeletal Trauma

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?

"Keep your right leg elevated above heart level."

When is it advisable for the nurse to apply heat to a sprain or a contusion?

After 2 days

Which nursing action would help prevent deep vein thrombosis in a client who has had an orthopedic surgery?

Apply antiembolism stockings

A nurse is reviewing a client's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?

Bending down to put socks on

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

Changing the client's position within prescribed limits.

Which of the following is a term used to describe a soft tissue injury produced by a blunt force?

Contusion

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear?

Difficulty lying on affected side

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?

Fasciotomy

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient?

Fat Emboli

Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?

Impacted

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

Incomplete

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

Keeping a pillow between the client's legs at all times

Which factor inhibits fracture healing?

Local Malignancy

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

Open Reduction

Elderly clients who fall are most at risk for which injuries?

Pelvic fracture

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate?

Provide feedback on the client's strengths and available resources.

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

Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain?

Rotator cuff tears

An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment?

Signs of neurovascular compromise

Conservative treatment of a compressed nerve root is first line treatment. What conservative treatment is used to increase the distance between vertebrae and decrease severe muscle spasm?

Skin traction

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this?

Comminuted

The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg?

Within 30 minutes, then every 1 to 2 hours

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client?

Compartment Syndrome