Musculoskeletal Saunders Practice

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A client is being discharged after application of a plaster leg cast . The nurse determines that the client understands proper care of the cast if the client makes which statement ?

" I need to avoid getting the cast wet . "

A client with acute muscle spasms has been taking baclofen . The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication . The nurse would make which appropriate response to the client ?

" Weakness and fatigue commonly occur and will diminish with continued medication use . "

The nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action would the nurse take first?

Check the client's alignment in bed.

The nurse is caring for a client with a fresh application of a plaster leg cast . The nurse would plan to prevent the development of compartment syndrome by which action ?

Elevating the limb and applying ice to the affected leg

The nurse is reviewing the record of a client who has been prescribed baclofen . Which disorder would alert the nurse to contact the primary health care provider ( PHCP ) ?

A seizure disorder

The nurse is planning to reinforce instructions to the client about how to stand on crutches . In the instructions , the nurse would plan to tell the client to place the crutches in which position ?

8 inches to the front and side of the client's toes

Dantrolene sodium is prescribed for a client experiencing flexor spasms , and the client asks the nurse about the action of the medication . The nurse responds knowing that which is the therapeutic action of this medication ?

Acts directly on the skeletal muscle to relieve spasticity

The nurse is reinforcing discharge instructions to a client receiving baclofen . Which would the nurse include in the instructions ?

Avoid the use of alcohol

The nurse is monitoring a client receiving baclofen for side effects related to the medication . Which would indicate that the client is experiencing a side effect ?

Drowsiness

The nurse is assigned to care for a client with multiple traumas who is admitted to the hospital . The client has a leg fracture , and a plaster cast has been applied . In positioning the casted leg , the nurse would perform which intervention ?

Elevate the leg on pillows continuously for 24 to 48 hours

Cyclobenzaprine is prescribed for a client to treat muscle spasms , and the nurse is reviewing the client's record . Which disorder would indicate a need to contact the primary health care provider ( PHCP) regarding the administration of this medication ?

Glaucoma

The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured. Which action is the priority?

Immobilize the leg before moving the client.

A client has sustained a closed fracture and has just had a cast applied to the affected arm . The client is complaining of intense pain . The nurse has elevated the limb , applied an ice bag , and administered an analgesic , which was ineffective in relieving the pain . The nurse interprets that this pain may be caused by which condition ?

Impaired tissue perfusion

The nurse is preparing a list of cast care instructions for a client who just had a plaster cast applied to his right forearm . Which instructions would the nurse include on the list ? Select all that apply .

Keep the cast and extremity elevated The cast needs to be kept clean and dry Allow the wet cast 24 to 72 hours to dry

The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium . Which laboratory test ( s ) would identify an adverse effect associated with the administration of this medication ?

Liver function tests

A client is complaining of skin irritation from the edges of a cast applied the previous day . The nurse would plan for which intervention ?

Petaling the cast edges with adhesive tape

The nurse is evaluating the client's use of a cane for left-sided weakness. The nurse would intervene and correct the client if the nurse obseved that the client performed which action?

Moves the cane when the right leg is moved

The nurse has provided instructions regarding specific leg exercises for the client immobilized in right skeletal lower leg traction. The nurse determines that the client needs further teaching if the nurse observes the client doing which activity?

Performing active range of motion (ROM) to the right ankle and knee.

The nurse is checking the casted extremity of a client . The nurse needs to check for which sign indicative of infection ?

Presence of a " hot spot " on the cast

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery. the nurse's response is based on the understanding that Buck's ectension traction has which primary function?

Provides comfort by reducing muscle spasms and provides fracture immobilization.

The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?

Serous drainage

The nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street. The individual is dazed and tries to get up, and the leg appears fractured. The nurse should perform which action?

Stay with the person and encourage the person to remain still.

During the monitoring of a client's response to disease - modifying antirheumatic drugs ( DMARDs ) , which findings would the nurse interpret as acceptable responses? Select all that apply.

Symptom control during periods of emotional stress Normal white blood cell , platelet , and neutrophil counts Radiological findings that show nonprogression of joint degeneration An increased range of motion in the affected joints 3 months into therapy

Alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions for the administration of the medication . Which instruction would the nurse reinforce ?

Take the medication with a full glass of water after rising in the morning .

The client has been taking medication for rheumatoid arthritis for 3 weeks . During the administration of etanercept , it is most important for the nurse to collect which data ?

The white blood cell and platelet counts


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