61 prepu
A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation?
abduction
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 with go through my skin to my bone
A nurse is caring for a client who is recovering in the hospital following orthopedic surgery. The nurse is performing frequent assessments for signs and symptoms of infection in the knowledge that the client faces a high risk of what infectious complication?
osteomyelitis
A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period?
osteomyelitis
A client with a right leg fracture is returning to the orthopedist to have the cast removed. What would the physician prescribe as further treatment?
physical therapy
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?
sharp, piercing
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."
Which would be an inappropriate initial pain relief measure for the client with a cast?
Application of a new cast
Which cleansing solution is the most effective for use in completing pin site care?
Chlorhexidine
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
A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain?
Elevate the affected extremity and use cold applications pg. 1105
The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery?
Never cross legs when seated
A nurse is assessing the neurovascular status of a client who has had a leg cast recently applied. The nurse is unable to palpate the client's dorsalis pedis or posterior tibial pulse and the client's foot is pale. What is the nurse's most appropriate action?
Promptly inform the primary care provider.
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." pg. 1114
A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?
-Assessing the extremity for neurovascular integrity Although all measures are correct, assessing neurovascular integrity takes priority because a decrease in neurovascular integrity could compromise the limb. The pull of the traction must be continuous to keep the client from sliding. Sufficient countertraction must be maintained at all times by keeping the ropes over the center of the pulley. The line of pull is maintained by allowing the weights to hang free.
Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides?
-Splint A splint may be applied to a fractured extremity initially until swelling subsides. A brace is an externally applied device to support a body part, control movement, and prevent injury. A CPM device is an instrument that moves a body part to promote healing and circulation. A trapeze is an overhead device to promote client mobility in bed.
A client has a compound fracture of the right femur. Due to the nature of the fracture, open reduction will be used to align the femur. What other rationale requires the use of open reduction?
All of the options are correct.
A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse?
Assess for complications -Unrelieved pain can be an indicator of a complication, such as compartment syndrome.
The nursing care plan for a client in traction specifies regular assessments for venous thromboembolism (VT). When assessing a client's lower limbs, what sign or symptom is suggestive of deep vein thrombosis (DVT)?
Increased warmth of the calf
Which 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.
Which is a benefit of a continuous passive motion (PM) device when applied after knee surgery?
It promotes healing by increasing circulation and movement of the knee joint.
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.
A client with a fractured femur is in balanced suspension traction. The client needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do?
Maintain consistent traction tension while repositioning.
A client who had a total hip replacement two days ago reports new onset calf tenderness to the nurse. Which action should the nurse take?
Notify the health care provider.
A client broke his arm in a sports accident and required the application of a cast. Shortly following application, the client reported an inability to straighten his fingers and was subsequently diagnosed with Volkmann contracture. What pathophysiologic process caused this complication?
Obstructed arterial blood flow to the forearm and hand
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
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 only have full strength when dry.
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.
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.
Which statement describes external fixation?
The surgeon inserts metal pins into the bone or bones from outside the skin surface and then attaches a compression device to the pins.
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?
Turning from side to side
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?
Ulna styloid
A 91-year-old client is slated for orthopedic surgery and the nurse is integrating gerontologic considerations into the client's plan of care. What intervention is most justified in the care of this client?
Use of a pressure-relieving mattress
Which is not a guideline for avoiding hip dislocation after replacement surgery.
the hip may be flexed to put on clothes such as pants, stockings, shoes, or socks
A client was brought to the emergency department after a fall. The client is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize?
"Make sure you don't bring your knees close together."
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 Explanation: Patients having orthopedic surgery are particularly at risk for venous thromboembolism, including deep vein thrombosis and pulmonary embolism.
Which statement is accurate regarding care of a plaster cast?
The cast can be dented while it is damp. The cast can be dented while it is damp. A dry plaster case is white and shiny. The cast will dry in 24 to 72 hours. A freshly applied cast should be exposed to circulating air to dry and should not be covered with clothing or bed linens or placed on plastic-coated mats or bedding.
A nurse is caring for a client who has a leg cast. The nurse observes the client using a pencil to scratch the skin under the edge of the cast. How should the nurse respond to this observation?
Provide a fan to blow cool air into the cast to relieve itching
A nurse is providing discharge education to a client who is going home with a cast on his leg. What topic should the nurse emphasize in the teaching session:
Reporting signs of impaired circulation
Which statement is accurate regarding care of a plaster cast?
the cast can be dented while it is wet
A client who has a fractured femur has been put in traction and requires assistance with care activities. A nursing diagnosis associated with the client's procedure is "Impaired Tissue Integrity related to puncture wound from pin placement." Which intervention would not be incorporated into the client's care related to this diagnosis?
Monitor bowel function daily.
The nurse is caring for a client who underwent a total hip replacement yesterday. What should the nurse do to prevent dislocation of the new prosthesis?
Protect the affected leg from internal rotation.
A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis?
Risk for impaired skin integrity
