Care of Patients with Musculoskeletal Trauma

Which statement indicates to the nursing instructor that the nursing student understands the normal healing process of bone after a fracture?

"A hematoma forms at the site of the fracture."

A client with a fracture asks the nurse about the difference between a compound fracture and a simple fracture. Which statement by the nurse is correct?

"Compound fracture involves a break in the bone, with damage to the skin."

The nursing instructor is teaching a group of nursing students about emergency care for extremity fractures. What statement made by a participant indicates a need for further teaching?

"I should not apply direct pressure on the affected area."

A client's short-leg cast has been removed. What does the nurse teach the client about caring for the extremity after cast removal?

Apply elastic bandages around the extremity.

The nurse prepares to perform a neurovascular assessment on a client with closed multiple fractures of the right humerus. Which technique does the nurse use?

Assess sensation of the right upper extremity.

A client's left arm is placed in a plaster cast. Which assessment does the nurse perform before the client is discharged?

Assess that the cast is dry.

Which statement about chronic complications from fractures is accurate?

Avascular necrosis is a chronic complication of fracture.

A client has had surgery for carpal tunnel syndrome (CTS). What does the nurse teach the client before discharge?

Check neurovascular status of the fingers every hour.

A client has a short-leg cast following a fracture of the ankle. What does the nurse teach the client about managing the fracture?

Elevate the affected leg on several pillows.

The nurse is caring for a client with Buck's traction. What care does the nurse provide for this client?

Ensure the weights are freely hanging at all times.

The client has sustained a traumatic

First, the airway must be assessed for breathing problems. Second, the nurse should examine the amputation site. Third, the nurse should apply direct pressure to the amputated site. Finally, the extremity should be elevated above the client's heart to decrease bleeding.

A client has sustained a rotator cuff tear while playing baseball. The nurse anticipates that the client will receive which immediate conservative treatment?

Immobilizer for the affected arm

The nurse is attending to a client with acute compartment syndrome (ACS). What physiologic changes are observed in with this condition? Select all that apply.

Increase in compartment pressure Release of histamine Pressure on nerve endings

An older adult client has had a right open reduction and internal fixation (ORIF) of a fractured hip. Which intervention does the nurse implement for this client?

Keep the client's heels off the bed at all times.

Sensation that is felt in an amputated part immediately after surgery is known as which of the following?

Phantom limb pain

The nurse's next door neighbor has accidentally severed his thumb while working with power tools. What does the nurse do to help preserve the severed thumb until the neighbor is transported to the hospital?

Places the severed thumb in a container of ice.

A client is brought to the emergency department (ED) via ambulance after a motor vehicle crash. What condition does the nurse assess for first?

Respiratory distress

Which type of traction is used to correct bone deformities of the lower extremities?

Russell's traction

An older client recovering from a fracture of the right ankle is prescribed the use of a cane for support. What does the nurse teach the client about the use of a cane?

The top of the cane is parallel to the stylus of the wrist.

A client has a grade III compound fracture of the right tibia. To prevent infection, which intervention does the nurse implement?

Use strict aseptic technique when cleaning the site.

A client has sustained a fracture of the left tibia. The extremity is immobilized using an external fixation device. Which postoperative instruction does the nurse include in this client's teaching plan?

"Use pain medication as prescribed to control pain."

The nurse is instructing a local community group about ways to reduce the risk for musculoskeletal injury. What information does the nurse include in the teaching plan?

"Wear helmets when riding a motorcycle."

A rock climber has sustained an open fracture of the right tibia after a 20-foot fall. The nurse plans to assess the client for which potential complications after the first 24 hours? Select all that apply.

Acute compartment syndrome (ACS) Fat embolism syndrome (FES) Osteomyelitis

A client has a first-degree sprained ankle. What nonsurgical method of treatment does the nurse suggest to the client?

Alternate hot and cold compresses.

The nurse admits an older adult client who sustained a left hip fracture and is in considerable pain. The nurse anticipates that the client will be placed in which type of traction?

Buck's traction

A client with a compound fracture of the left femur is admitted to the emergency department after a motorcycle crash. Which action is most essential for the nurse to take first?

Check the dorsalis pedis pulses.

The nurse is assessing the laboratory report of a client with a fractured hip. Which finding indicates the presence of fat embolism syndrome (FES)?

Decreased erythrocyte sedimentation rate (ESR)

The nurse's next door neighbor has accidentally severed his thumb while working with power tools. What does the nurse do to help preserve the severed thumb until the neighbor is transported to the hospital?

Ensures the severed thumb does not come in contact with water.

What assessment finding typically indicates there is a fracture of the hip?

Groin pain

The incidence of what type of fracture is highest in older adults?

Hip

A client is in skeletal traction. Which nursing intervention ensures proper care of this client?

Inspect the skin at least every 8 hours.

What statements about amputation are correct? Select all that apply.

Lower extremity amputations are more common than upper extremity amputations. In a Syme amputation, most of the foot is removed but the ankle remains. Lisfranc and Chopart amputations are types of midfoot amputations.

An older adult client is undergoing treatment for a fracture. Which pain medication must be avoided in this client?

Meperidine (Demerol)

The nurse is caring for an older client post hip-repair surgery. What postoperative care must the nurse perform for this client?

Monitor the client frequently to prevent falls.

A client has undergone a kyphoplasty. What discharge teaching does the nurse provide to the client and family?

Monitor the puncture site for infection.

A client has undergone an elective below-knee amputation of the right leg as a result of severe peripheral vascular disease. In postoperative care teaching, the nurse instructs the client to notify the health care provider if which change occurs?

Observation of a large amount of serosanguineous or bloody drainage

The nurse anticipates providing collaborative care for a client with a traumatic amputation of the right hand with which health care team members? Select all that apply.

Occupational therapist Physical therapist Psychologist

An older adult client has multiple tibia and fibula fractures of the left lower extremity after a motor vehicle crash. Which pain medication does the nurse anticipate will be requested for this client?

Patient-controlled analgesia (PCA) with morphine

What manifestation is usually seen in fat embolism but not in blood clot embolism?

Petechiae

Which description accurately defines a closed reduction?

Process where the ends of the bones are manually pulled and realigned

A client with bone cancer is most susceptible to what type of fracture?

Spontaneous fracture

In which stage of bone healing is callus formed?

Stage three

Which statement about strains and sprains is accurate?

Strains are classified based on their severity.

For what type of fracture is physical assessment done with the client in a sitting or standing position?

Upper arm

A football player is admitted to the emergency department with a sprained ankle. What emergency care is needed for the client with this type of injury?

Use elastic wrap for the first 24 to 48 hours.