UNIT 11
The nurse is providing instructions to the client following application of a fiberglass cast. Which statement by the client indicates further education is needed? "Under no circumstances should I get my cast wet." "The cast should not come in contact with other plastics." "I should avoid touching the cast while it is wet." "The cast will be hot while it is drying."
"I should avoid touching the cast while it is wet."
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." "I will wear a boot with weights attached." "A belt will go around my pelvis and weights will be attached." "The traction can be removed once a day so I can shower."
"Metal pins will go through my skin to the bone."
challenges of HIV meds
-Meds are often taken 4-6 times or more a day, per medication. This makes adherence a challenge. -Meds are expensive. Patients need help applying for Medicaid funds for people who are HIV+. Sometimes Medicaid will not pay for the newest meds. -
Interactions with glucocosteriod and calcium interaction with thyroid hormone and calcium foods and calcium
-reduces absorption of calcium; give at least hour apart -decrease absorption of thyroid hormone; at least 4 hour apart of adm of thyroid hormone and calcium -spinach, beets, bran, and whole grains decrease absorbtion take calcium with 8 oz glass of water
Theraputic uses of calcium supplement
-used for hypocalcemia, defiance of parathyroid hormone /-used for adolescents, older adults, postmenopausal, pregnant -Vit D assist with absorption of dietary calcium
What special elements of care should be incorporated into the care of a client in traction? Select all that apply. All of the answers are true. Provide simple and direct explanations about the traction and its purpose. Point out activities that are allowed or contraindicated. When traction is discontinued, prepare the client for further treatment, such as casting, and for the appearance of the affected area---skin and muscles
All of the answers are true.
A physician writes a prescription to discontinue skeletal traction on an orthopedic client. The nurse should anticipate what subsequent intervention? Application of a walking boot Application of a cast Education on how to use crutches Passive range of motion exercises
Application of a cast
Which would be an inappropriate initial pain relief measure for the client with a cast? Application of cold packs Application of a new cast Administration of analgesics Elevation of the involved part
Application of a new cast
A client has suffered a muscle strain and is reporting pain at 6 on a 10-point scale. The nurse should recommend what action? Taking an opioid analgesic as prescribed Applying a cold pack to the injured site Performing passive ROM exercises Applying a heating pad to the affected muscle
Applying a cold pack to the injured site
A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin? As soon as tolerated, after a reasonable period of immobilization In 2 to 3 weeks, when callus ossification prevents easy movements of bony fragments In about 4 to 5 weeks, after new bone is well established In 2 to 3 months, after normal activities are resumed
As soon as tolerated, after a reasonable period of immobilization
A client with an arm cast reports 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. Administer a prescribed analgesic to promote comfort and allay anxiety. Assess for a pressure sore Determine the exact site of the pain. Cut the cast with a cast saw
Assess the fingers for color and temperature. Assess for a pressure sore Determine the exact site of the pain.
Which nursing intervention is appropriate for monitoring the client for the development of Volkmann's contracture? Assess capillary refill in the toes. Assess for paresthesia in the toes. Assess the radial pulse. Assess mobility of the shoulder.
Assess the radial pulse.
An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this? Compound Depressed Impacted Comminuted
Comminuted
A client is reporting pain in her casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. The nurse should identify the warning signs of what complication? Subcutaneous emphysema Skin breakdown Compartment syndrome Disuse syndrome
Compartment syndrome
Which would be consistent as a component of self-care activities for the client with a cast? Cover the cast with plastic to insulate it Cushion rough edges of the cast with tape Frequently place the casted extremity in a dependent position Use a plastic hanger wrapped in gauze to scratch under the cast.
Cushion rough edges of the cast with tape
Which is an inappropriate use of traction? Immobilize a fracture Decrease space between opposing structures Reduce deformity Minimize muscle spasms
Decrease space between opposing structures
The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.) Decreased sensory function Excruciating pain Loss of motion Capillary refill less than 3 seconds 2+ peripheral pulses in the affected distal pulse
Decreased sensory function Excruciating pain Loss of motion
The primary nursing intervention that will control swelling while treating a musculoskeletal injury is: Apply cold (moist or dry). Immobilize the injured area. Elevate the affected area. Apply an elastic compression bandage.
Elevate the affected area.
Which nursing intervention is appropriate for a client with a closed-reduction extremity fracture? Encourage participation in ADLs Promote intake of omega-3 fatty acids Use frequent dependent positioning to prevent edema Administer prescribed enema to prevent constipation
Encourage participation in ADLs
The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing: Complex regional pain syndrome Delayed union Compartment syndrome Fat embolism syndrome
Fat embolism syndrome
-scleorosis
early adloscents in girls; screen at school look at legs and spine to bend have S schape, shoulder blades, hip
Which type of cast encloses the trunk and a lower extremity? Body cast Hip spica Long-leg Short-leg
Hip spica
The nurse is monitoring a patient who sustained a fracture of the left hip. The nurse should be aware that which kind of shock can be a complication of this type of injury? Cardiogenic Hypovolemic Neurogenic Septic
Hypovolemic
Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? It provides active range of motion. It promotes healing by increasing circulation and movement of the knee joint. It promotes healing by immobilizing the knee joint. It prevents infection and controls edema and bleeding.
It promotes healing by increasing circulation and movement of the knee joint.
A nurse is caring for a patient who is postoperative day 1 right hip replacement. How should the nurse position the patient? Keep the client's hips in abduction at all times. Keep hips flexed at no less than 90 degrees. Elevate the head of the bed to high Fowler's. Seat the client in a low chair as soon as possible.
Keep the client's hips in abduction at all times.
what to do before HIV meds given
Monitoring CD4 T cell count helps medical providers decide on plan of care and medication adjustments. This lab level is the best indicator of immune function for the HIV+ client. When providing care to patients who are HIV+ always educate about medication side effects and the importance not to just stop meds if they are having a problem to call the office for help and the reason why. Discuss recognition of infections and give them a plan for sick care and when to call for help.
A client has been diagnosed with a rotator cuff tear. What are the options for treating this condition? Select all that apply. NSAIDs activity modification and joint rest arthroscopic surgery traction
NSAIDs activity modification and joint rest arthroscopic surgery
Which term refers to the failure of fragments of a fractured bone to heal together? Dislocation Subluxation Nonunion Malunion
Nonunion
An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? Document the findings. Notify the physician. Remove the cast immediately. Assess for pedal pulse and mobility of toes.
Notify the physician.
A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply. Pneumonia Necrosis of the humerus Skin breakdown Sepsis Delirium
Pneumonia Skin breakdown Sepsis Delirium
Which nursing intervention is essential in caring for a client with compartment syndrome? Keeping the affected extremity below the level of the heart Wrapping the affected extremity with a compression dressing to help decrease the swelling Removing all external sources of pressure, such as clothing and jewelry Starting an I.V. line in the affected extremity in anticipation of venogram studies
Removing all external sources of pressure, such as clothing and jewelry
A client reports pain in the right knee, stating, "My knee got twisted when I was going down the stairs." The client was diagnosed with an injury to the ligaments and tendons of the right knee. Which terminology, documented by the nurse, best reflects the injury? Sprain Dislocation Subluxation Strain
Sprain
After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client? With the affected hip flexed acutely With the leg on the affected side abducted With the leg on the affected side adducted With the affected hip rotated externally
With the leg on the affected side abducted
traction exercise what LIMBS
UNAFFECTED
A patient falls while skiing and sustains a supracondylar fracture. What does the nurse know is the most serious complication of a supracondylar fracture of the humerus? Hemarthrosis Paresthesia Malunion Volkmann's ischemic contracture
Volkmann's ischemic contracture
A client has a fractured right arm. A plaster of paris cast is advantageous for this client because it: accommodates edema. dries faster. is lighter. is breathable.
accommodates edema.
individuals stop meds
because N/V and pain and the side effects and causes drug resistance
how should you handle cast when drying
by palms
-traction will need more
calories for wound healing, more calcium, iron, vitamins, protein
The client who has had an arm amputated is assigned to nursing care. What potential complications should the nurse closely monitor for in the late postoperative period of the client? chronic osteomyelitis and causalgia sleeplessness, nausea, and vomiting hematoma, hemorrhage, and infection kidney dysfunction
chronic osteomyelitis and causalgia
yellow marrow can cause
fat embolism (similar to stroke) facial dropping and confusion
what is an indicator of pain
increase HR with discomfort use pain scale
A fracture is considered pathologic when it results in a fragment of bone being pulled away by a ligament or tendon and its attachment. occurs through an area of diseased bone. involves damage to the skin or mucous membranes. presents as one side of the bone being broken and the other side being bent.
occurs through an area of diseased bone.
rhemuatoid arthritis impact
organs will need cortisteriods
What are general nursing measures for a client with a fracture reduction? Select all that apply. preventing constipation assisting with ADLs promoting intake of omega-3 fatty acids examining the abdomen for enlarged liver or spleen
preventing constipation assisting with ADLs
MS important
preventing infection and communicate and safe environment will have hard time ambulatoting and will have an ambulatory aid eventually clear pathways
RA vs OA
rheumatoid quickly vs OA slow progressive
A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply. skin breakdown wound infection pneumonia diarrhea
skin breakdown wound infection pneumonia
A client reports swelling and severe pain in the right wrist. After examination and radiographs negate a fracture, what would the physician likely prescribe as treatment? splint brace cast All options are correct.
splint
what precautions HIV
standard
A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"? stretched or pulled beyond its capacity injury resulting from a blow or blunt trauma injuries to ligaments surrounding a joint subluxation of a joint
stretched or pulled beyond its capacity
A school nurse is assessing a student who was kicked in the shin during a soccer game. The area of the injury has become swollen and discolored. The triage nurse should organize care for a: sprain. strain. contusion. dislocation.
contusion.
A nurse admits a client who has a fracture of the nose that has resulted in a skin tear and involvement of the mucous membranes of the nasal passages. The orthopedic nurse should plan to care for what type of fracture? Compression Compound Impacted Transverse
Compound fracture in which damage also involves the skin or mucous membranes
different pulses to check (5)
dorsalis pedis (top of foot) popliteal (back of knee femoral (near groin) radial (near thumb) brachial (inner elbow)
Which is a hallmark sign of compartment syndrome? Motor weakness Edema Pain Weeping skin surfaces
pain
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 the client doesn't need a continuous passive motion device." "The continuous passive motion device can decrease the development of adhesions." "Bleeding is a complication associated with the continuous passive motion device." "Monitoring skin integrity is important while the continuous passive motion device is in place."
"The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device."
ART meds does
ART meds impact the viruses ability to replicate. This may be by interfering with specific enzymes etc. but the key is if the HIV virus cannot replicate then it does less damage to the person's immune system.
Which interventions should a nurse implement as part of initial pain relief for the client with a cast? Select all that apply. Apply cold packs Apply a new cast Administer analgesics Elevate the involved part Provide passive range of motion
Apply cold packs Administer analgesics Elevate the involved part
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 Assuring the cast cutter blade is sharp Assuring pedal pulses are present All options are correct
Assuring the client she won't be cut
Which cleansing solution is the most effective for use in completing pin site care? Betadine Chlorhexidine Hydrogen peroxide Alcohol
Chlorhexidine
The nurse educator on an orthopedic trauma unit is reviewing the safe and effective use of traction with some recent nursing graduates. What principle should the educator promote? Knots in the rope should not be resting against pulleys. Weights should rest against the bed rails. The end of the limb in traction should be braced by the footboard of the bed. Skeletal traction may be removed for brief periods to facilitate the client's independence.
Knots in the rope should not be resting against pulleys.
Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply. Placing a trapeze on the bed Ensuring that the weights are hanging freely Assessing the client's alignment in the bed Removing skeletal traction to turn and reposition the client Frequently assessing pain level
Placing a trapeze on the bed Ensuring that the weights are hanging freely Assessing the client's alignment in the bed Frequently assessing pain level
Which is an inaccurate principle of traction? The weights are not removed unless intermittent treatment is prescribed. The weights must hang freely. The client must be in good alignment in the center of the bed. Skeletal traction is interrupted to turn and reposition the client.
Skeletal traction is interrupted to turn and reposition the client.
An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education? The need to take analgesia regardless of the short-term absence of pain The importance of adhering to the prescribed treatment and rehabilitation regimen The fact that he has a permanently increased risk of future shoulder dislocations The importance of monitoring for intracapsular bleeding once he resumes playing
The importance of adhering to the prescribed treatment and rehabilitation regimen
A nurse is caring for an older adult client who is preparing for discharge following recovery from a total hip replacement. What outcome must be met prior to discharge? Client is able to perform ADLs independently. Client is able to perform transfers safely. Client is able to weight-bear equally on both legs. Client is able to demonstrate full ROM of the affected hip.
Client is able to perform transfers safely.
After a car accident, a client is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24 to 48 hours after the accident, the nurse must monitor the client closely for which potential complication of a fractured pelvis? Compartment syndrome Fat embolism Infection Volkmann's ischemic contracture
Fat embolism
Arthrodesis is: fusion of a joint (most often the wrist or knee) for stabilization and pain relief. total reconstruction or replacement of a joint (most often the knee or hip) with an artificial joint to restore function and relieve pain. replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. cutting and removal of a wedge of bone (most often the tibia or femur) to change the bone's alignment, thereby improving function and relieving pain.
fusion of a joint (most often the wrist or knee) for stabilization and pain relief.
A client asks the nurse why his residual limb cannot be elevated on a pillow. What is the best response by the nurse? "Elevating the leg might lead to a flexion contracture." "You need to turn yourself side to side. If your leg is on a pillow, you would not be able to do that." "Elevating the extremity may increase your chances of compartment syndrome." "I am sorry. We ran out of pillows. I can elevate it on a few blankets."
"Elevating the leg might lead to a flexion contracture."
Which statement about traction pin care is incorrect? The pin should be cleaned from the distal point inward toward the insertion site. Gently remove crusts from around pin sites. Use at least one applicator per pin; do not use applicator more than once. Using aseptic technique, the nurse or caretaker uses cotton-tipped applicators and sterile water, saline, or other prescribed solution, such as chlorhexidine solution, to cleanse pin sites.
The pin should be cleaned from the distal point inward toward the insertion site.
A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action? Apply heat for the first 24 to 48 hours after the injury. Maintain the ankle in a dependent position. Exercise hourly by performing rotation exercises of the ankle. Keep an elastic compression bandage on the ankle.
Keep an elastic compression bandage on the ankle.
Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse? "CPM increases range of motion of the joint." "CPM strengthens the muscles of the leg." "CPM delivers analgesic agents directly into the joint." "CPM prevents injury by limiting flexion of the knee."
"CPM increases range of motion of the joint."
how to transfer hip fracture
-Place your surgical leg forward. -Reach back for the bed surface, lowering yourself slowly to the edge -Lean back as you push with your hands to help move your body forward until you are sitting at the edge of the bed. -Place your surgical leg forward. -Push up from the bed and stand up.
HIV+ patients take at least
2-3 medications or a combination medication that is made up of 2-3+ antiretroviral meds. -have to take as directed and be very diligent to avoid drug resistance and drugs not working any longer
A client is scheduled for a total hip replacement and the surgeon has explained the risks of blood loss associated with orthopedic surgery. The risk of blood loss is the indication for which of the following actions? Use of a cardiopulmonary bypass machine Postoperative blood salvage Prophylactic blood transfusion Autologous blood donation
Autologous blood donation
A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last? Less than 24 hours Between 24 and 48 hours About 72 hours At least 1 week
Between 24 and 48 hours
A client is being treated for severe pain in the left foot. After radiographs, the orthopedist diagnoses a stress fracture and prescribes treatment. Why doesn't the orthopedist surgically reduce the foot? Bones are already aligned. Foot fractures don't need to be reduced. Bones usually realign eventually. Open reduction is only used for compound fractures.
Bones are already aligned.
A client is admitted to the unit in traction for a fractured proximal femur and requires traction prior to surgery. What is the most appropriate type of traction to apply to a fractured proximal femur? Russell traction Dunlop traction Buck's extension traction Cervical halter
Buck's extension traction
A client with a fractured distal left radius reports discomfort at the cast site, with pain specifically in the upper forearm. What would the nurse expect the physician to do? Cut a cast window. Remove the cast. Apply a fiberglass cast. Initiate physical therapy.
Cut a cast window.
A client with a tibia fracture was placed in an external fixator 24 hours ago. The nurse is completing pin care and notices redness at the pin site and a small amount of serous drainage. What action by the nurse is appropriate? Notify the physician. Document the findings. Prepare for surgical removal of the fixator. Assess the client's hemoglobin and hematocrit.
Document the findings.
A nurse is admitting a client to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the client may have a peroneal nerve injury? Numbness and burning of the foot Pallor to the dorsal surface of the foot Visible cyanosis in the toes Inadequate capillary refill to the toes
Numbness and burning of the foot
Which statement is accurate regarding care of a plaster cast? The cast must be covered with a blanket to keep it moist during the first 24 hours. The cast will dry in about 12 hours. The cast can be dented while it is damp. A dry plaster cast is dull and gray.
The cast can be dented while it is damp.
A continuous passive motion (CPM) machine is used to promote healing and flexibility in the knee and hip joint and increase circulation to the operative area. What is true about the use of CPM? Select all that apply. The physician orders the amount of extension and flexion produced by the machine. The physician orders the frequency of use of the machine. The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine. The amount of flexion for clients with hip replacements should never exceed 60 degrees in the CPM machine.
The physician orders the amount of extension and flexion produced by the machine. The physician orders the frequency of use of the machine. The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine.
A nurse is caring for a client in skin traction. In order to prevent bony fragments from moving against one another, the nurse should caution the client against performing what action? Shifting one's weight in bed Bearing down while having a bowel movement Turning from side to side Coughing without splinting
Turning from side to side
When the client who has experienced trauma to an extremity reports severe burning pain, vasomotor changes, and muscles spasms in the injured extremity, the nurse recognizes that the client is likely demonstrating signs of complex regional pain syndrome. avascular necrosis of bone. a reaction to an internal fixation device. heterotrophic ossification.
complex regional pain syndrome.
Which is not one of the general nursing measures employed when caring for the client with a fracture? cranial nerve assessment administering analgesics providing comfort measures assisting with ADLs
cranial nerve assessment
The nurse is very concerned about the potential debilitating complication of peroneal nerve injury. What symptom does the nurse recognize as a result of that complication? Permanent paresthesias Foot drop Deep vein thrombosis (DVT) Infection
foot drop
A client with a lengthy history of degenerative joint disease is being seen by an orthopedic surgeon. What joints are most commonly replaced? Select all that apply. hip knee shoulder finger
hip knee
goals of medication
inhibit replication HIV virus; prevents virus to replicate so wont impact pt immune
A nurse is caring for a client in skeletal leg traction. Which nursing assessment findings indicate the client has met expected outcomes? Select all that apply. Capillary refill less than 3 seconds Repositions self with trapeze Peripheral pulses +2 bilaterally Right calf warm and swollen Elbows are free of skin breakdown
Capillary refill less than 3 seconds Repositions self with trapeze Peripheral pulses +2 bilaterally Elbows are free of skin breakdown
Which nursing assessment finding would be indicative of compartment syndrome in the client with a cast applied to the left forearm 3 hours earlier? Fingers pink and warm and move freely Capillary refill of left fingers greater than 3 seconds Radial pulses palpable and +2 bilaterally Absence of numbness and tingling
Capillary refill of left fingers greater than 3 seconds
Which would be contraindicated as a component of self-care activities for the client with a cast? Cover the cast with plastic to insulate it Cushioning rough edges of the cast with tape Elevate the casted extremity to heart level frequently Do not attempt to scratch the skin under a cast
Cover the cast with plastic to insulate it
The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occurring with this patient? Polyethylene-induced infection Pneumonia Fat emboli syndrome Disseminated intravascular coagulation
Fat emboli syndrome
Side effects of HIV
ide effects make this hard, GI side effects like N/V/D can be extreme and can impact appetite and weight. Patients often say this is their #1 reason for quitting a med.
A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? osteomyelitis hematoma hemorrhage infection
osteomyelitis
Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides? Brace Continuous passive motion (CPM) device Splint Trapeze
splint
counteraction
using patients weight elevating foot of the bed
The client is scheduled for a meniscectomy of the right knee. The nurse would plan postoperative care based on what surgical procedure? Replacement of one of the articular surfaces of a joint Incision and diversion of the muscle fascia Excision of damaged joint fibrocartilage Replacement of knee with artificial joint
Excision of damaged joint fibrocartilage
Which nursing diagnosis takes highest priority for a client with a compound fracture? Imbalanced nutrition: Less than body requirements related to immobility Impaired physical mobility related to trauma Infection related to effects of trauma Activity intolerance related to weight-bearing limitations
Infection related to effects of trauma
A client is involved in a motorcycle accident and injures his arm. The physician diagnoses the man with an intra-articular fracture and splints the injury. The nurse implements the teaching plan developed for this client. What sequela of intra-articular fractures should the nurse describe regarding this client? Posttraumatic arthritis Fat embolism syndrome (FES) Osteomyelitis Compartment syndrome
Posttraumatic arthritis
The nursing care plan for a client in traction specifies regular assessments for venous thromboembolism (VTE). When assessing a client's lower limbs, what sign or symptom is suggestive of deep vein thrombosis (DVT)? Increased warmth of the calf Decreased circumference of the calf Loss of sensation to the calf Pale-appearing calf
Increased warmth of the calf
A client is being prepared for a total hip arthroplasty, and the nurse is providing relevant education. The client is concerned about being on bed rest for several days after the surgery. The nurse should explain what expectation for activity following hip replacement? "Actually, clients are only on bed rest for 2 to 3 days before they begin walking with assistance." "The physical therapist will likely help you get up using a walker the day after your surgery." "Our goal will actually be to have you walking normally within 5 days of your surgery." "For the first 2 weeks after the surgery, you can use a wheelchair to meet your mobility needs."
"The physical therapist will likely help you get up using a walker the day after your surgery."
The client scheduled for a Syme amputation is concerned about the ability to eventually stand on the amputated extremity. How should the nurse best respond to the client's concern? "You will eventually be able to withstand full weight-bearing after the amputation." "You will have minimal weight-bearing on this extremity but you'll be taught how to use an assistive device." "You likely will not be able to use this extremity but you will receive teaching on use of a wheelchair." "You will be fitted for a prosthesis which may or may not allow you to walk."
"You will eventually be able to withstand full weight-bearing after the amputation."
How long does it take for the bone to regain its former structural strength after a break? 1 year 8 months 6 months 2 years
1 year
A client is to undergo surgery to repair a ruptured Achilles tendon and application of a brace. The client demonstrates understanding of activity limitations when stating that a brace must be worn for which length of time? 2 to 4 weeks 6 to 8 weeks 10 to 12 weeks 14 to 16 weeks
6 to 8 weeks
A client had an above-the-knee amputation of the left leg related to complications from peripheral vascular disease. The nurse enters the client's room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse? Notify the health care provider. Apply a tourniquet. Use skin clips to close the wound. Reinforce the dressing.
Apply a tourniquet.
A nurse is planning the care of a client who has undergone orthopedic surgery. What main goal should guide the nurse's choice of interventions? Improving the client's level of function Helping the client come to terms with limitations Administering medications safely Improving the client's adherence to treatment
Improving the client's level of function
A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate? Explain that the sensation being felt is normal and will not burn the client. Remove the cast immediately, notifying the physician. Administer antianxiety and pain medication. Call for assistance to hold the client in the required position until the cast has dried.
Explain that the sensation being felt is normal and will not burn the client.
A patient has suffered a femoral shaft fracture in an industrial accident. What is an immediate nursing concern for this patient? Hypovolemic shock Infection Knee and hip dislocation Pain resulting from muscle spasm
Hypovolemic shock
A client returns to the nursing unit following an open reduction with internal fixation of the right hip. Which nursing interventions would be appropriate for the prophylactic treatment of deep vein thrombosis? Select all that apply. Increasing fluid intake Maintaining antiembolic stockings Administering enoxaparin Encouraging coughing exercises Increasing fiber intake
Increasing fluid intake Maintaining antiembolic stockings Administering enoxaparin
A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk? Infection Malunion Complex regional pain syndrome Depression
Infection
An older adult client experienced a fall and required treatment for a fractured hip on the orthopedic unit. Which of the following are contributory factors to the incidence of falls and fractured hips among the older adult population? Select all that apply. Loss of visual acuity Adverse medication effects Slowed reflexes Hearing loss Muscle weakness
Loss of visual acuity Adverse medication effects Slowed reflexes Muscle weakness
A nurse is caring for a client who has suffered an unstable thoracolumbar fracture. What goal should the nurse prioritize during nursing care? Preventing skin breakdown Maintaining spinal alignment Maximizing function Preventing increased intracranial pressure
Maintaining spinal alignment
After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? Monitoring the client for skin breakdown Maintaining traction continuously to ensure its effectiveness Supporting the traction weights with a chair or table to prevent accidental slippage Restricting the client's fluid and fiber intake to reduce the movement required for bedpan use
Maintaining traction continuously to ensure its effectiveness
A patient has a long leg cast applied. Where does the nurse understand a common pressure problem may occur? Dorsalis pedis Peroneal nerve Popliteal artery Posterior tibialis
Peroneal nerve
A client has had a brace prescribed to facilitate recovery from a knee injury. What are the potential therapeutic benefits of a brace? Select all that apply. Preventing additional injury Immobilizing prior to surgery Providing support Controlling movement Promoting bone remodeling
Preventing additional injury Providing support Controlling movement
An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment? The presence of leg shortening The client's complaints of pain Signs of neurovascular compromise The presence of internal or external rotation
Signs of neurovascular compromise
Which term refers to an injury to ligaments and other soft tissues surrounding a joint? Sprain Dislocation Subluxation Strain
Sprain
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? Apply the traction straps snugly. Assess the client's level of consciousness. Remove the traction at least every 8 hours. Teach the client how to prevent problems caused by immobility.
Teach the client how to prevent problems caused by immobility.
A nurse is caring for a client who has had a plaster arm cast applied. Immediately after application, the nurse should provide what teaching to the client? The cast will feel cool to touch for the first 30 minutes. The cast should be wrapped snuggly with a towel until the client gets home. The cast should be supported on a board while drying. The cast will only have full strength when dry.
The cast will only have full strength when dry.
A nurse is assessing a client who is receiving traction. The nurse's assessment confirms that the client is able to perform plantar flexion. What conclusion can the nurse draw from this finding? The leg that was assessed is free from DVT. The client's tibial nerve is functional. Circulation to the distal extremity is adequate. The client does not have peripheral neurovascular dysfunction.
The client's tibial nerve is functional.
Which is not a guideline for avoiding hip dislocation after replacement surgery. The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. Keep the knees apart at all times. Put a pillow between the legs when sleeping. Never cross the legs when seated.
The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes.
The nurse suspects that a client with an arm cast has developed a pressure ulcer. Where should the nurse assess for the presence of the ulcer? Lateral malleolus Olecranon Radial styloid Ulna styloid
Ulna styloid
Compound Compression: Impacted: Oblique
a fracture in which damage also involves the skin or mucous membranes fracture in which bone has been compressed (seen in vertebral fractures) a fracture in which a bone fragment is driven into another bone fragment fracture occurring at an angle across the bone (less stable than transverse)
A hip spica cast: encloses the trunk and a lower extremity. encircles the trunk. is a short or long leg cast reinforced for strength. extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed.
encloses the trunk and a lower extremity