Chapter 50 complex

A client with chronic osteomyelitis is being discharged from the hospital. What information is important for the nurse to teach this client and family? (Select all that apply.)

Adherence to the antibiotic regimen Eating high-protein and high-carbohydrate foods Proper use of the intravenous equipment

A nurse is assessing a community group for dietary factors that contribute to osteoporosis. In addition to inquiring about calcium, the nurse also assesses for which other dietary components? (Select all that apply.)

Alcohol Caffeine Carbonated beverages Vitamin D

A client with Paget's disease is hospitalized for an unrelated issue. The client reports pain and it is not yet time for more medication. What comfort measures can the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

Applying a heating pad Providing a massage

A client with osteoporosis is going home, where the client lives alone. What action by the nurse is best?

Arrange a home safety evaluation.

A client has been advised to perform weight-bearing exercises to help minimize osteoporosis. The client admits to not doing the prescribed exercises. What action by the nurse is best?

Ask the client about fear of falling.

A client is in the internal medicine clinic reporting bone pain. The client's alkaline phosphatase level is 180 units/L. What action by the nurse is most appropriate?

Assess the client for leg bowing.

A client has scoliosis with a 65-degree curve to the spine. What action by the nurse takes priority?

Assess the client's cardiac and respiratory systems.

A client with bone cancer is hospitalized for a limb salvage procedure. How can the nurse best address the client's psychosocial needs?

Assess the client's coping skills and support systems.

A client is admitted with a bone tumor. The nurse finds the client weak and lethargic with decreased deep tendon reflexes. What actions by the nurse are best? (Select all that apply.)

Assess the daily serum calcium level. Consult the provider about a loop diuretic. Instruct the client to call for help out of bed.

The nurse studying osteoporosis learns that which drugs can cause this disorder? (Select all that apply.

Barbiturates Corticosteroids Loop diuretics

A nurse sees clients in an osteoporosis clinic. Which client should the nurse see first?

Client taking raloxifene (Evista) who reports unilateral calf swelling

The nurse sees several clients with osteoporosis. For which client would bisphosphonates not be a good option?

Client with a spinal cord injury who cannot tolerate sitting up

A nurse is assessing an older client and discovers back pain with tenderness along T2 and T3. What action by the nurse is best?

Consult with the provider about an x-ray.

The nurse is assessing a client for chronic osteomyelitis. Which features distinguish this from the acute form of the disease? (Select all that apply.)

Draining sinus tracts Presence of foot ulcers

A client is suspected to have muscular dystrophy. About what diagnostic testing does the nurse educate the client? (Select all that apply.)

Electromyography Muscle biopsy Serum aldolase Serum creatinine kinase

A client in a nursing home refuses to take medications. She is at high risk for osteomalacia. What action by the nurse is best?

Ensure the client gets 15 minutes of sun exposure daily

A client is scheduled for a bone biopsy. What action by the nurse takes priority?

Ensuring that informed consent is on the chart

What information does the nurse teach a women's group about osteoporosis?

For 5 years after menopause you lose 2% of bone mass yearly."

A client has a metastatic bone tumor. What action by the nurse takes priority?

Handle the affected extremity with caution.

A hospitalized client is being treated for Ewing's sarcoma. What action by the nurse is most important?

Handling and disposing of chemotherapeutic agents per policy

A client has been prescribed denosumab (Prolia). What instruction about this drug is most appropriate?

Make appointments to come get your shot."

A client is admitted with a large draining wound on the leg. What action does the nurse take first?

Obtain cultures of the leg wound.

An older client with diabetes is admitted with a heavily draining leg wound. The client's white blood cell count is 38,000/mm3 but the client is afebrile. What action does the nurse take first?

Place the client on contact isolation.

A client has a bone density score of -2.8. What action by the nurse is best?

Planning to teach about bisphosphonates

A nurse is caring for four clients. After the hand-off report, which client does the nurse see first?

Post-microvascular bone transfer client whose distal leg is cool and pale

A nurse is providing education to a community women's group about lifestyle changes helpful in preventing osteoporosis. What topics does the nurse cover? (Select all that apply.)

Strengthening exercises are important. Take recommended calcium and vitamin D. Walk 30 minutes at least 3 times a week.

A client has an ingrown toenail. About what self-management measure does the nurse teach the client?

Warm moist soaks

A client had a bunionectomy with osteotomy. The client asks why healing may take up to 3 months. What explanation by the nurse is best?

Your feet have less blood flow, so healing is slower."