Chapter 40
The nurse expects that ___ of weight can be used for a patient in skeletal traction
25 pounds
After a total hip replacement, the patient is usually able to resume daily activities after
3 months
After a total hip replacement, stair climbing is kept to a minimum for
3 to 6 months
The nurse caring for a postoperative hip replacement patient knows the patient shouldn't cross their legs at any time for _____ after surgery
4 months
The nurse is caring for a patient with a total hip replacement. How should the nurse assist the patient to turn
45 degrees onto the unoperated side
What are the five P's that should be assessed as part of a neurovascular check
Pain, Pallor, pulselessness, paresthesia, paralysis
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
The nurse suspects that a patient with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer
ulna styloid
List the danger signs of possible circulatory constriction that the nurse should assess in a casted extremity
unrelieved pain, swelling, discoloration, tingling, numbness, inability to move fingers or toes, temperature changes
Patient with a cast reports pain in the extremity. What is the priority nursing action to reduce complications?
Assess fingers for color and temperature, assess for a pressure sore, determine the exact site of pain
The nurse suspects compartment syndrome for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions?
Decreased sensory function excruciating pain loss of motion
The nurse is caring for a patient who had total hip replacement. What lethal postoperative complication should the nurse monitor for?
Pulmonary embolism
An artificial joint for total hip replacement involves an implant that consists of
acetabular socket, a femoral shift and spherical ball
A patient has a cast removed after bone healing takes place. What should the nurse educate the client to do after removal
apply an emollient lotion to soften the skin, control swelling with elastic bandages as directed, gradually resume activities and exercise
The repair of the joint problems through the operatinfg arthroscope or open joint surgery
arthroplasty
Name four purposes for having a cast application
reducing fracture, correcting deformity, applying pressure, providing support and stability.
An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker
24 hours
The most effective cleansing solution for care of a pin site is
Chlorhexidine solution
Compare the advantages of a fiberglass cast to those of a plaster cast
Fiberglass is lightweight and water resistant. It is more durable than plaster
List four reasons for a patient to have traction application
Minimize muscle spasms, reduce align and immobilize fractures, lessen deformities, increase space between opposing surfaces within a joint
PAtient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation
abduction
The removal of a body part
amputation
Name three major complications of an extremity that is casted, braced, or splinted
compartment syndrome, pressure ulcers, disuse syndrome
The insertion of a tendon to improve function
tendon transfer
Patient with total left hip arthroplasty. What clinical manifestation would indicate the prosthesis is dislocated
the left leg is internally rotated
The nurse knows to assess a patient for DVT by assessing the lower extremities for
unilateral calf tenderness, warmth, redness and swelling
The placement of a bone tissue to promtoe healing, stabilse or replace diseased bone
bone graft
The nurse assesses for perineal nerve injury by checking the patient's casted leg for the primary symptoms of
burning, numbness, and tingling
The incision and diversion of the muscle fascia to relieve muscle constriction, as in compartment syndrome or to reduce fascia contracture
fasciotomy
The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation od 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occuring in the patient
fat emoboli syndrome
The nurse is concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of the complication
footdrop
A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for positve homans sign
have patient extend each leg an dorsiflex each foot
The replacement of one of the articular surfaces
hemiarthroplasty
Unrelieved pain for a patient in a cast must be immediately reported to avoid
impaired tissue perfusion, necrosis, pressure ulcer formation and possible paralysis
stabilization of the reduced fracture by the metal screws, plates, wires, nails and pins
internal fixation
The excision of damaged joint fibrocartilage
meniscectomy
The nurse assesses a patient after a total right hip arthroplasty and observes shortening of the extremity and the patient reports severe pain in the right side of the groin. What is the priority action of the nurse
notify the physician
The correction and alignment of the fracture after a surgical dissection and exposure of the fracture
open reduction
A nursing goal for a patient with skeletal traction is to avoid infection and the development of ___ the site of pin insertion
osteomyelitis
A patient has a long leg cast applied. Where does the nurse understand a common pressure problem may occur
peronal nerve