chapter 40 (19 cards)

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? Cutting of a bivalve cast Cutting a cast window Removal of the cast Insertion of an external fixator

Cutting a cast window

spica cast priority intervention

keep cast clean and dry

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? osteomyelitis hematoma hemorrhage infection

osteomyelitis

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? "You would have to stay here much longer because it takes a cast longer to dry." "A splint is applied when more swelling is expected at the site of injury." "It is best if an orthopedic doctor applies the cast." "Not all fractures require a cast."

"A splint is applied when more swelling is expected at the site of injury." 1133

A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan? Keeping the casted arm warm by covering it with a light blanket Avoiding handling the cast for 24 hours or until it is dry Evaluating pedal and posterior tibial pulses every 2 hours Assessing movement and sensation in the fingers of the right hand

Assessing movement and sensation in the fingers of the right hand

Which action would be most important postoperatively for a client who has had a knee or hip replacement?

Assisting in early ambulation.

A client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client?

Changing the client's position within prescribed limits.

Which would be contraindicated as a component of self-care activities for the client with a cast? Cover the cast with plastic to insulate it Cushioning rough edges of the cast with tape Elevate the casted extremity to heart level frequently Do not attempt to scratch the skin under a cast

Cover the cast with plastic to insulate it 1133

A client with a fractured ankle is having a fiberglass cast applied. The client starts yelling, "My leg is burning, take it off." What action by the nurse is most appropriate? Explain that the sensation being felt is normal and will not burn the client. Remove the cast immediately, notifying the physician. Administer antianxiety and pain medication. Call for assistance to hold the client in the required position until the cast has dried.

Explain that the sensation being felt is normal and will not burn the client.

A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign? Have the patient extend both hands while the nurse compares the volume of both radial pulses. Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg. Have the patient plantar flex both feet while the nurse performs the blanch test on all of the patient's toes. Have the patient squeeze the nurse's hands with his or her hands to evaluate any difference in strength.

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

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? Keep the knees together at all times Never cross the affected leg when seated Avoid placing a pillow between the legs when sleeping Bend forward only when seated in a chair

Never cross the affected leg when seated

The client presents with nausea and vomiting, sluggish bowel sounds, and abdominal distention. How does the nurse interpret these findings? Physiologic cast syndrome Impaired physical mobility Psychological cast syndrome Disuse syndrome

Physiologic cast syndrome

A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?

Right shoulder slopes downward and droops inward.

Which is not a guideline for avoiding hip dislocation after replacement surgery. The hip may be flexed to put on clothing such as pants, stockings, socks, or shoes. Keep the knees apart at all times. Put a pillow between the legs when sleeping. Never cross the legs when seated.

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

For which of the following immobility-related complications is the client in traction at risk? Select all that apply. Cachexia Thromboemboli Urinary stasis Diarrhea Lactose intolerance

Thromboemboli Urinary stasis

A client with a fractured distal left radius reports discomfort at the cast site, with pain specifically in the upper forearm. What would the nurse expect the physician to do? Cut a cast window. Remove the cast. Apply a fiberglass cast. Initiate physical therapy.

Cut a cast window.

Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery? It provides active range of motion. It promotes healing by increasing circulation and movement of the knee joint. It promotes healing by immobilizing the knee joint. It prevents infection and controls edema and bleeding.

It promotes healing by increasing circulation and movement of the knee joint.

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective? "Metal pins will go through my skin to the bone." "I will wear a boot with weights attached." "A belt will go around my pelvis and weights will be attached." "The traction can be removed once a day so I can shower."

"Metal pins will go through my skin to the bone."

A continuous passive motion (CPM) machine is used to promote healing and flexibility in the knee and hip joint and increase circulation to the operative area. What is true about the use of CPM? Select all that apply. The physician orders the amount of extension and flexion produced by the machine. The physician orders the frequency of use of the machine. The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine. The amount of flexion for clients with hip replacements should never exceed 60 degrees in the CPM machine.

The physician orders the amount of extension and flexion produced by the machine. The physician orders the frequency of use of the machine. The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine.