Ch 40: Musculoskeletal Care Modalities (4)

Which is an inappropriate use of traction? pg. 1139

Decrease space between opposing structures

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? pg. 1141

Maintaining traction continuously to ensure its effectiveness

Which is not a guideline for avoiding hip dislocation after replacement surgery. pg. 1147

The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes.

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? pg. 1151

The left leg is internally rotated.

A patient had a total hip replacement. What recommended leg position should the nurse ensure is maintained to prevent prosthesis dislocation? pg. 1147

Abduction

The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery? pg. 1145

Anticoagulation therapy

Which would be an inappropriate initial pain relief measure for the client with a cast? pg. 1134

Application of a new cast

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied? pg. 1132

Short leg cast

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse? pg. 1133

"A splint is applied when more swelling is expected at the site of injury."

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.) pg. 1147

- "Place pillows between your legs when you lay on your side." - "Avoid bending forward when sitting in a chair." - "Use a raised toilet seat and high-seated chair."

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? pg. 1151

24 hours

Which would be contraindicated as a component of self-care activities for the client with a cast? pg. 1133

Cover the cast with plastic to insulate it

A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client? pg. 1135

Cutting a cast window

The client who had a total hip replacement was discharged home and developed acute groin pain in the affected leg, shortening of the leg, and limited movement of the fractured leg. The nurse interprets these findings as indicating which complication? pg. 1151

Dislocation of the hip

The nurse is caring for a client with a spica cast. What is the nurse's priority intervention? pg. 1137

Keep the cast clean and dry.

Which is an inaccurate principle of traction? pg. 1139

Skeletal traction is interrupted to turn and reposition the client.

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?

Crackles in the lung bases

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homan's sign? pg. 1143

Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.

Which type of cast encloses the trunk and a lower extremity? pg. 1137

Hip spica

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan? pg. 1143

Teach the client how to prevent problems caused by immobility.