Musculoskeletal Trauma
A client with a recent left above-the-knee amputation states, "I can feel pain in my left toes." Which is the best response by the nurse?
"Describe the pain and rate it on the pain scale."
A client is being discharged from the Emergency Department after being diagnosed with a sprained ankle. Which client statement indicates the client understands the discharge teaching?
"I'll make sure to keep my ankle elevated as much as possible."
A 14-year-old client is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the client's parent. The nurse instructs the parent that the acute inflammatory stage will last how long?
24 to 48 hours
Two days after surgery to amputate the left lower leg, a client reports pain in the missing extremity. Which action by the nurse is most appropriate?
Administer medication, as ordered, for the reported discomfort.
When is it advisable for the nurse to apply heat to a sprain or a contusion?
After 2 days
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?
Apply a tourniquet.
Which nursing intervention is appropriate for monitoring the client for the development of Volkmann's contracture?
Assess the radial pulse.
Emergency medical technicians transport a client to the emergency department and inform the nurse that the client fell from a two-story building. The comatose client has a large contusion on the left side of the chest, a hematoma in the left parietal area, and a compound fracture of the left femur. The client was intubated and is maintaining an arterial oxygen saturation of 92% by pulse oximeter with a manual-resuscitation bag. Which intervention by the nurse has the highest priority?
Assessing the left leg
A client who has sustained a fracture reports an increase in pain and decreased function of the affected extremity. What will the nurse suspect?
Avascular necrosis
The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding?
Claw-like deformity of the right hand without ability to extend fingers
A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?
Compound
A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect?
Contusion
Which of the following would lead a nurse to suspect that a client has a rotator cuff tear?
Difficulty lying on affected side
Colles fracture occurs in which area?
Distal radius
The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client?
Do not flex the hip more than 90 degrees.
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?
Fat embolism
The nurse assesses subtle personality changes, restlessness, irritability, and confusion in a client who has sustained a fracture. The nurse suspects which complication?
Fat embolism syndrome
The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the:
Femoral neck.
Which factor inhibits fracture healing?
History of diabetes
A classic indicator of edema and alveolar hemorrhage associated with FES is:
Hyperventilation.
A patient sustains an open fracture with extensive soft tissue damage. The nurse determines that this fracture would be classified as what grade?
III
Radiographic evaluation of a client's fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?
Impacted
A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture?
Incomplete
Which type of fracture involves a break through only part of the cross-section of the bone?
Incomplete
Which nursing diagnosis takes highest priority for a client with a compound fracture?
Infection related to effects of trauma
A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?
Keeping a pillow between the client's legs at all times
Which factor inhibits fracture healing?
Local malignancy
Which is a hallmark sign of compartment syndrome?
Pain
A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate?
Provide feedback on the client's strengths and available resources.
Which of the following musculoskeletal injuries is manifested by acromioclavicular joint pain?
Rotator cuff tears
A client sustains an injury to the ligaments surrounding a joint. What will the nurse identify this injury as?
Sprain
A client comes to the emergency department and it is found that the client's radial head is partially dislocated. What is this partially dislocated radial head documented as?
Subluxation
A client is diagnosed with a first-degree strain of the left ankle related to running 5 miles daily. How would the nurse differentiate the first-degree strain from other strains and sprains?
The client has some edema of the left ankle with muscle spasms but is able to walk without assistive devices.
There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head?
avascular necrosis
The type of fracture described as having one side of the bone broken and the other side bent would be:
greenstick.
A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction?
"Apply ice packs for the first 24 to 48 hours, then apply heat packs."
A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?
"I don't know if I'll be able to get off that low toilet seat at home by myself."
A client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? Select all that apply.
"Immobilization of the fracture will promote healing by maximizing contact of bone fragments." "Fractured bones require a good blood supply and adequate nutrition for healing." "Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized."
A client presents at an ambulatory clinic and reports pain and aching in the lower left leg. After examining the client, a health care provider determines the client has experienced a strain related to the client's exercise regimen. The treatment plan includes analgesics, rest, and cold and heat therapies. Which guideline should be included in the care plan?
After 24 hours, apply heat for periods of 15 to 30 minutes.
Which term refers to a fracture in which one side of a bone is broken and the other side is bent?
Greenstick
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
A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"?
stretched or pulled beyond its capacity
