Chapter 61: Caring for Clients Requiring Orthopedic Treatment
A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse?
"The joint above the fracture and below the fracture must be immobilized."
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.
A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan?
Assessing movement and sensation in the fingers of the right hand
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 on socks
Which nursing assessment finding would be indicative of compartment syndrome in the client with a cast applied to the left forearm 3 hours earlier?
Capillary refill of left fingers greater than 3 seconds
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 transfers safely.
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.)
Excruciating pain Decreased sensory function Loss of motion
A nurse is caring for a client with a cast on the left arm after sustaining a fracture. Which assessment finding is most significant for this client?
Fingers on the left hand are swollen and cool
A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?
Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.
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
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.
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.
The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery?
Never cross the affected leg when seated
The nurse assesses a client after total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse?
Notify the health care provider.
Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?
Open reduction
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
While assessing a client who has had knee replacement surgery, the nurse notes that the client has developed a hematoma at the surgical site. The affected leg has a decreased pedal pulse. What would be the priority nursing diagnosis for this client?
Risk for Ineffective Peripheral Tissue Perfusion
Which is an inaccurate principle of traction?
Skeletal traction is interrupted to turn and reposition the client.
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
A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period?
osteomyelitis
