Acute Care Final

What are appropriate nursing interventions for a client who is hospitalized after a stroke?

· Assess for neurologic dysfunction, such as level of consciousness, motor and sensory deficits, and vital signs. · Position the client properly to prevent complications such as pressure ulcers, contractures, and deep vein thrombosis. Nurses may use pillows, cushions, or splints to support proper body alignment and prevent joint deformities. · Assist with rehabilitation and therapy. Physical and occupational therapy can help clients regain motor function, balance, and mobility. Speech therapy can help clients overcome language and communication deficits. · Administer medications as prescribed. · Monitor for signs of dysphagia and collaborate with dietitians to develop nutrition plans. · Prevent complications by prophylactic anticoagulation, infection control measures, and fall prevention strategies, to minimize the risk of complications such as deep vein thrombosis, pneumonia, or falls.

NGN: meds, vitals, labs and diagnostics, for each body system specify intervention that is appropriate to monitor for or prevent complications.

· Cardiovascular System: Monitor heart rate and blood pressure regularly. · Respiratory System: Monitor respiratory rate and oxygen saturation. · Digestive System: Monitor bowel movements and abdominal pain. · Nervous System: Monitor for changes in consciousness, strength, and sensation. · Musculoskeletal System: Monitor for pain, mobility, and strength. · Endocrine System: Monitor blood glucose levels in diabetic patients, administer insulin or oral hypoglycemics as needed. Thyroid function tests can help monitor thyroid disorders. · Renal System: Monitor urine output and electrolyte levels. · Immune System: Monitor for signs of infection like fever or increased white blood cell count.

An 83-year-old female client was transferred to the medical ICU from a skilled nursing facility. Previously at the facility, the patient reported weakness and shortness of breath. The unlicensed assistive personnel (UAP) reported that the patient had several black tarry stools and increasing pallor. The patient's primary health care provider ordered a hemoglobin check, results were 5.0 g/dL. On arrival to the hospital, a recheck of the patient's hemoglobin level was 4.8 g/dL. The patient was diagnosed with a GI bleed and hypovolemic shock. Which of the following findings require follow up?

· Labs: elevated PT/INR, lactate, BUN, and creatinine. · Assessment: elevated heart rate, low blood pressure, oxygen saturation, lung sounds, and temperature.

1. A 24-year-old man with a history of heroin use is found lying on the floor. It is unknown how long he has been unconscious. He has a low pulse, shallow respirations, and is cool to the touch. A responding officer used narcan and EMS put in an endotracheal tube. The man is admitted to the critical care unit. Increased ICP could be a potential complication, what nursing actions would be appropriate?

· Monitor vitals. · Perform frequent neurological assessments. · Keep the clients head elevated at 30 degrees. · Maintain a patent airway and oxygenation. · Monitor fluid balance. · Promote rest and a quiet environment. · Administer medications as prescribed. · Report any changes to health care provider immediately.

NGN: patient who has pneumothorax, med history, nurses note, vitals, whether the following prescriptions are anticipated, nonessential, or contraindicated.

· Obtain ABGs (Arterial Blood Gases): Anticipated · Prepare for insertion of a chest tube: Anticipated · Obtain intravenous access: Anticipated · Computed tomography (CT) of the chest: Anticipated · Pulmonary Function Tests (PFTs): Nonessential · Thoracentesis: Contraindicated

Labs of hypothyroidism:

· TSH (thyroid stimulating hormone) · T4 (thyroxine) · T3 (triiodothyronine) · Thyroid antibodies

A patient is experiencing dysfunction of the hypothalamus. Which hormones will be affected by this dysfunction? (Select all that apply.)

· Thyrotropin-releasing hormone (TRH) · Corticotropin-releasing hormone (CRH) · Gonadotropin-releasing hormone (Gn-RH) · Growth hormone-releasing hormone (GHRH)

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters?

Platelet count, prothrombin time, and partial thromboplastin time

How to calculate tidal volume:

TV= TLC-(IRV+ERV+RV)

Progression of ARDs:

1. dyspnea and hypoxemia 2. hyperventilation and resp. alkalosis 3. decreased tissue perfusion,organ dysfunction, and metabolic acidosis 4. increased work of breathing, decreased tidal volume, hypoventilation 5. respiratory acidosis and worsening hypoxemia 6. hypotension, decreased cardiac output, death

A nurse is reviewing ECG tracings for the assigned patients. The nurse notes that one patient has first-degree heart block. What part of the ECG tracing is abnormal to make this conclusion and when is it considered abnormal?

A PR interval consistently longer than 0.20 seconds on the ECG tracings. If the PR interval is consistently longer than 0.20 seconds (or 5 small squares on an ECG paper), this is considered prolonged and indicative of a first-degree heart block.

The emergency department nurse is triaging patients for the urgent or nonurgent track. Which patient should the nurse triage into the nonurgent track?

A middle-aged adult complaining of sinus headache and possible sinus infection.

The nurse provides discharge instruction to a patient who had a transsphenoidal hypophysectomy. Which patient statement indicates a need for additional teaching? A. "My neck will probably be stiff and sore for several days." B. "I will call my provider if I am thirstier than normal." C. "I should use a soft toothbrush to avoid irritating my incision." D. "I won't bend at the waist until I see the provider at my follow-up appointment."

A. "My neck will probably be stiff and sore for several days."

Which patient should the nurse prioritize as needing emergent treatment, assuming no other injuries are present except the ones outlined below? A. A patient with a blunt chest trauma with some difficulty breathing B. A patient with a sore neck who was immobilized in the field on a backboard with a cervical collar C. A patient with a possible fractured tibia with adequate pedal pulses D. A patient with an acute onset of confusion

A. A patient with a blunt chest trauma with some difficulty breathing

A client with a new pulmonary embolism (PE) is anxious. What nursing actions are most appropriate?(Select all that apply.) A. Acknowledge the frightening nature of the illness. B. Delegate a back rub to the unlicensed assistive personnel (UAP). C. Give simple explanations of what is happening. D. Request a prescription for antianxiety medication. E. Stay with the client and speak in a quiet, calm voice.

A. Acknowledge the frightening nature of the illness. B. Delegate a back rub to the unlicensed assistive personnel (UAP). C. Give simple explanations of what is happening. E. Stay with the client and speak in a quiet, calm voice.

The nurse caring for mechanically ventilated clients uses best practices to prevent ventilator-associated pneumonia. What actions are included in this practice? (Select all that apply.) A. Adherence to proper hand hygiene B. Administering anti-ulcer medication C. Elevating the head of the bed D. Providing oral care per protocol E. Suctioning the client on a regular schedule

A. Adherence to proper hand hygiene B. Administering anti-ulcer medication C. Elevating the head of the bed D. Providing oral care per protocol

An emergency department nurse plans care for a client who is admitted with heat stroke. Which interventions should the nurse include in this client's plan of care? (Select all that apply.) A. Administer oxygen via mask or nasal cannula. B. Administer ibuprofen, an antipyretic medication. C. Apply cooling techniques until core body temperature is less than 101° F. D. Infuse 0.9% sodium chloride via a large-bore intravenous cannula. E. Obtain baseline serum electrolytes and cardiac enzymes.

A. Administer oxygen via mask or nasal cannula. D. Infuse 0.9% sodium chloride via a large-bore intravenous cannula. E. Obtain baseline serum electrolytes and cardiac enzymes.

A nurse is caring for a patient who is on mechanical ventilation. What actions will promote comfort in this patient? (Select all that apply.) A. Allow visitors at the patient's bedside. B. Ensure that the patient can communicate if awake. C. Keep the television tuned to a favorite channel. D. Provide back and hand massages when turning. E. Turn the patient every 2 hours or more.

A. Allow visitors at the patient's bedside. B. Ensure that the patient can communicate if awake. D. Provide back and hand massages when turning. E. Turn the patient every 2 hours or more.

A nurse is caring for a client on mechanical ventilation and finds the client agitated and thrashing about. What action by the nurse is most appropriate? A. Assess the cause of the agitation. B. Reassure the client that he or she is safe. C. Restrain the client's hands. D. Sedate the client immediately.

A. Assess the cause of the agitation.

The nurse is admitting a patient with a penetrating abdominal injury from a knife wound. What are the priority actions by the nurse for this patient? (Select all that apply.) A. Assessing for manifestations of hemorrhage B. Covering any protruding viscera with sterile dressings soaked in normal saline solution C. Looking for any associated chest injuries D. Exploring the abdominal wound with a gloved finger E. Irrigating the wound with normal saline and a syringe

A. Assessing for manifestations of hemorrhage B. Covering any protruding viscera with sterile dressings soaked in normal saline solution C. Looking for any associated chest injuries

The nurse is reviewing the medical history of a patient with adrenal insufficiency. What should the nurse identify as possible causes for the disorder in this patient? Select all that apply. A. Cancer B. Trauma C. Infection D. Medications E. Autoimmune disorder

A. Cancer B. Trauma C. Infection E. Autoimmune disorder

Which assessment findings would indicate to the nurse that a client has suffered from a heat stroke? (Select all that apply.) A. Confusion and bizarre behavior B. Headache and fatigue C. Hypotension D. Presence of perspiration E. Tachycardia and tachypnea F. Body temperature more than 104° F (40° C)

A. Confusion and bizarre behavior C. Hypotension E. Tachycardia and tachypnea F. Body temperature more than 104° F (40° C)

The nurse is conducting a secondary survey as part of the emergency assessment. Which is the priority nursing action during the health history portion of the assessment? A. Determining drug allergies B. Noting the general appearance C. Examining the neck for stiffness D. Auscultating for heart and lung sounds

A. Determining drug allergies

Which assessment data would cause the nurse to document the patient is experiencing early respiratory distress? Select all that apply. A. Dyspnea B. Restlessness C. Tachycardia D. Confusion E. Cyanosis

A. Dyspnea B. Restlessness C. Tachycardia

Which of the following are the 5 characteristics of ARDS? A. Dyspnea B. Myasthenia Gravis C. Refractory hypoxemia D. Cyanosis E. Dense pulmonary infiltrates on CXR F. Decreased pulmonary compliance G. Non-cardiac pulmonary edema H. Chest pain

A. Dyspnea C. Refractory hypoxemia E. Dense pulmonary infiltrates on CXR F. Decreased pulmonary compliance G. Non-cardiac pulmonary edema

A 40-year-old female client has a family history of "thyroid problems" and is being seen by the primary health care provider for unintentional weight loss, irritability, and chest discomfort. Her probable diagnosis is hyperthyroidism, which the HCP plans to confirm by laboratory testing. What additional physical assessment findings would the nurse expect to be present in this client? Select all that apply. A. Heat intolerance B. Diaphoresis C. Insomnia D. Bradycardia E. Hypotension F. Anorexia G. Constipation H. Decreased deep tendon reflexes

A. Heat intolerance B. Diaphoresis C. Insomnia

A client has a deficiency of aldosterone. Which assessment finding does the nurse correlate with this condition? A. Increased urine output B. Vasoconstriction C. Blood glucose, 98 mg/dL D. Serum sodium, 144 mEq/L

A. Increased urine output

The nurse is reviewing orders written for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which order should the nurse clarify? A. No added salt diet B. Fluid restriction 1L/day C. IV fluids 0.9% normal saline 125 mL/hr D. Furosemide (Lasix) 20 mg by mouth every day

A. No added salt diet

The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of the escharotomy? A. Return of distal pulses B. Brisk bleeding from the site C. Decreasing edema formation D. Formation of granulation tissue

A. Return of distal pulses

The nursing instructor is preparing to speak to a group of nursing students about direct and indirect insults to the lungs that may lead to the development of acute respiratory distress syndrome (ARDS). The nurse educator is aware that which conditions may lead to the development of ARDS? Select all that apply. A. Septic shock B. Viral pneumonia C. Aspirin overdose D. Head injury E. Percutaneous intervention

A. Septic shock B. Viral pneumonia C. Aspirin overdose D. Head injury

What discharge instructions should the nurse include for a client following a transsphenoidal hypophysectomy? A. Sleep with head of bed at 35 degrees. B. Notify the primary healthcare provider for an increased urinary output. C. Brush the teeth three times a day followed by rinsing with a commercial mouthwash. D. Nasal packing will need to be removed in 48 hours. E. Use a humidifier in the room.

A. Sleep with head of bed at 35 degrees. B. Notify the primary healthcare provider for an increased urinary output. E. Use a humidifier in the room.

A nurse explains the homeostatic mechanisms involved in fluid homeostasis to a student nurse. Which of the following statements accurately describe this process? Select all that apply.

A. The kidneys selectively retain electrolytes and water and excrete wastes and excesses according to the body's needs. B. The cardiovascular system is responsible for pumping and carrying nutrients and water throughout the body. D. The lungs regulate oxygen and carbon dioxide levels of the blood, which is especially crucial in maintaining acid-base balance. F. The parathyroid glands secrete parathyroid hormone, which regulates the level of calcium and phosphorus.

A nurse cares for a client with a hypofunctioning anterior pituitary gland. Which hormones should the nurse expect to be affected by this condition? (Select all that apply.) A. Thyroid-stimulating hormone B. Vasopressin C. Follicle-stimulating hormone D. Calcitonin E. Growth hormone

A. Thyroid-stimulating hormone C. Follicle-stimulating hormone E. Growth hormone

For a patient with symptomatic sinus bradycardia, appropriate nursing interventions include establishing IV access to administer: A. atropine B. anticoagulants C. calcium channel blocker D. beta-adrenergic blocker

A. atropine

What mechanisms does nurse anticipate for patient to maintain homeostasis to a patient with increasing serum calcium levels?

If the serum calcium level rises, the thyroid gland releases calcitonin into the blood, which signals osteoclasts to slow down the removal of calcium from bone, thereby lowering the levels of blood calcium.

A nurse is caring for a patient who has symptomatic bradycardia. What are some appropriate nursing interventions?

Initial stabilization, respiratory and circulation support, continuous telemetry monitoring, management of any symptoms and underlying causes, and the prevention of complications.

A telemetry nurse assesses a client with third-degree heart block who has wide QRS complexes and a heart rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete next?

Level of consciousness

NGN: client with pneumonia and dyspnea, rapid breathing, high blood pressure, o2 increased. What condition is client most likely experiencing?

ARDS · The client is most likely experiencing a condition known as Respiratory Distress Syndrome (RDS) or Acute Respiratory Distress Syndrome (ARDS). Here's why: Pneumonia: This is an infection that inflames the air sacs in one or both lungs, which may fill with fluid or pus, causing cough with phlegm or pus, fever, chills, and difficulty breathing. Dyspnea: This is a term used for shortness of breath or difficulty in breathing, which is a common symptom of respiratory diseases. Rapid Breathing: This is also known as tachypnea, which is a respiratory rate that is too fast. This can be a response to low oxygen levels in the body. High Blood Pressure: This could be a response to stress or could be a part of the underlying disease process. Increased O2: If the client's oxygen (O2) is being increased, it suggests that they are having difficulty getting enough oxygen on their own, which is a common symptom of severe respiratory diseases like ARDS. ARDS is a serious condition characterized by widespread inflammation in the lungs, severe shortness of breath, and low oxygen levels in the blood. It's often a complication of pneumonia and other conditions that cause fluid buildup in the lungs. It's a medical emergency that usually requires hospitalization.

Which are the top priorities when conducting a primary patient survey during the emergency assessment? (Select all that apply.)

Airway Cervical spine

Labs of DIC:

All are increased: PT, PTT, bleeding time, TT, fibrin split products, D-dimer All are decreased: fibrinogen level, platelet count Schistocytes on peripheral smear

A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate?

Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury.

The nurse is caring for a patient who is receiving oxygen therapy for pneumonia. How should the nurse best assess whether the patient is hypoxemic?

Assess the patient's oxygen saturation level.

Which statement by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the family members of a patient with ARDS is accurate? A. "PEEP will push more air into the lungs during inhalation." B. "PEEP prevents the lung air sacs from collapsing during exhalation." C. "PEEP will prevent lung damage while the patient is on the ventilator." D. "PEEP allows the breathing machine to deliver 100% oxygen to the lungs."

B. "PEEP prevents the lung air sacs from collapsing during exhalation."

The nurse is preparing a teaching tool that focuses on the endocrine system. How should the nurse explain the negative feedback system? A. Hormone secretion increases when circulating levels drop. B. Hormone secretion increases when target organs send signals. C. Hormone secretion increases when circulating levels increase. D. Hormone secretion increases when the target tissue does not recognize the level.

B. Hormone secretion increases when target organs send signals.

A nurse is caring for five patients. For which patients would the nurse assess a high risk for developing a pulmonary embolism (PE)? (Select all that apply.) A. Patient who had a reaction to contrast dye yesterday B. Patient with a new spinal cord injury on a rotating bed C. Middle-aged man with an exacerbation of asthma D. Older patient who is 1 day post-hip replacement surgery E. Young obese patient with a fractured femur

B. Patient with a new spinal cord injury on a rotating bed D. Older patient who is 1 day post-hip replacement surgery E. Young obese patient with a fractured femur

On a hot humid day, an emergency department nurse is caring for a client who is confused and has these vital signs: temperature 104.1 F (40.1 C), pulse 132 beats/min, respirations 26 breaths/min, blood pressure 106/66 mm Hg. Which action should the nurse take? A. Encourage the client to drink cool water or sports drinks. B. Start an intravenous line and infuse 0.9% saline solution. C. Administer acetaminophen (Tylenol) 650 mg orally. D. Encourage rest and re-assess in 15 minutes.

B. Start an intravenous line and infuse 0.9% saline solution.

While caring for a patient with an endotracheal tube, the nurses recognizes that suctioning is required how often? A. Every 2 hours when the patient is awake B. When adventitious breath sounds are auscultated C. When there is a need to prevent the patient from coughing D. When the nurse needs to stimulate the cough reflex

B. When adventitious breath sounds are auscultated

A client remains intubated after surgery. The RN understands that extubation will occur when which of the following happens? A. Clients O2 is 99% B. Supplemental oxygen delivered for 60 min C. Client regained control of coughing and swallowing reflexes D. The client is awake and requests the ET tube be removed

C. Client regained control of coughing and swallowing reflexes

A patient is being mechanically ventilated. A high-pressure ventilation alarm sounds. The nurse should assess for what cause of this type of alarm? A. Power failure B. Insufficient gas flow C. Condensation in tubing D. Tracheotomy cuff leak

C. Condensation in tubing

An intubated client's oxygen saturation has dropped to 88%. What action by the nurse takes priority? A. Determine if the tube is kinked. B. Ensure all connections are patent. C. Listen to the client's lung sounds. D. Suction the endotracheal tube.

C. Listen to the client's lung sounds.

A nurse is caring for a client who has just been admitted to the nursing unit after receiving flame burns to the face and chest. The nurse notes a hoarse cough and that the client is expectorating sputum with black flecks. The client's eyelashes and eyebrows are singed, and the eyelids are swollen. The client suddenly becomes restless, and his color becomes dusky. The nurse interprets this data as indicating which of the following? A. The client is hypotensive. B. Pain is present from the burn injury. C. The burn has probably caused laryngeal edema, which has occluded the airway. D. The client is afraid and is having a panic attack as a result of the unfamiliar surroundings.

C. The burn has probably caused laryngeal edema, which has occluded the airway.

A nurse is caring for a client who is receiving mechanical ventilation when the low pressure alarm sounds. Which of the following situations should the nurse recognize as a possible cause of the alarm? A. excess secretions B. kinks in the tubing C. artificial airway cuff leak D. biting on the endotracheal tube

C. artificial airway cuff leak

Rule of 9s:

Calculations for assessing percentage of body surface burned.

The nurse is assessing a patient diagnosed with Graves' disease. What physical characteristics of Graves' disease would the nurse expect to find?

Clinical manifestations of the endocrine disorder Graves' disease include exophthalmos (bulging eyes) and fine tremor in the hands.

A nurse is caring for a client in urosepsis, which of the following actions would be appropriate for the patient?

Close monitoring, administering antibiotic therapy, and preventing complications like septic shock, coma, and death.

Crofab:

CroFab [crotalidae polyvalent immune fab) (ovine)] is an antivenin product used as an anti-venom to bites from certain snakes (e.g., rattlesnakes, cottonmouths/water moccasins, copperheads). · Side effects: i. allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue ii. breathing problems iii. dark urine iv. dark, tarry stools v. fever vi. low blood pressure vii. unusual bleeding or bruising

A client is on mechanical ventilation and the client's spouse wonders why ranitidine (Zantac) is needed since the client "only has lung problems." What response by the nurse is best? A. "It will increase the motility of the gastrointestinal tract." B. "It will keep the gastrointestinal tract functioning normally." C. "It will prepare the gastrointestinal tract for enteral feedings." D. "It will prevent ulcers from the stress of mechanical ventilation."

D. "It will prevent ulcers from the stress of mechanical ventilation."

A patients plan of care specifies postural drainage. What action should the nurse perform when providing this noninvasive therapy? A. Administer the treatment with the patient in a high Fowlers or semi-Fowlers position. B. Perform the procedure immediately following the patients meals. C. Apply percussion firmly to bare skin to facilitate drainage. D. Assist the patient into a position that will allow gravity to move secretions.

D. Assist the patient into a position that will allow gravity to move secretions.

Which patient requires the nurse's immediate intervention to decrease the risk for developing a deep vein thrombosis (DVT)? A. The patient who is obese and scheduled for laparoscopic day surgery B. The patient who is admitted for an exacerbation of asthma C. The patient who is admitted for an exacerbation of congestive heart failure D. The patient who is immobile due to a fractured hip

D. The patient who is immobile due to a fractured hip

A nurse is assessing a client who has urosepsis. Which of the following findings should the nurse expect?

Decreased urinary output.

A client has newly diagnosed acromegaly. What should a nurse expect to find in an assessment?

Enlarged facial bones, coarse skin, and large hands and feet.

An 83-year-old female client was transferred to the medical ICU from a skilled nursing facility. Previously at the facility, the patient reported weakness and shortness of breath. The unlicensed assistive personnel (UAP) reported that the patient had several black tarry stools and increasing pallor. The patient's primary health care provider ordered a hemoglobin check, results were 5.0 g/dL. On arrival to the hospital, a recheck of the patient's hemoglobin level was 4.8 g/dL. The patient was diagnosed with a GI bleed and hypovolemic shock. nurse infuses 4 units of packed red blood cells and 2 units of platelets and performs a head-to-toe assessment Selected patient assessment findings are presented in the table below.

Heart rate, blood pressure, oxygen saturation, lung sounds, and temperature.

The nurse responds to a ventilator alarm and finds the patient lying in bed gasping and holding the endotracheal tube (ET) in her hand. Which action should the nurse take next?

Manually ventilate the patient with 100% oxygen

A nurse is assigned to care for four clients. The client with which of the following drainage tubes is at an increased risk for hypokalemia?

NG Tube to suction

What would be an appropriate action for nurse to take if anticipating possibility of thyroid storm?

Nursing interventions: Monitor HR, BP, RR (respiratory failure- may need mechanical ventilation), EKG, and temperature. Keep environment quiet and patient cool (cooling blankets and sedatives as prescribed). No foods containing iodine (seafood, seaweed, dairy, eggs).

The nurse is caring for a patient with third-degree heart block. the patient has a low heart rate and blood pressure, what actions should nurse perform first?

Prepare the patient for temporary pacing.

A client is on a ventilator and is sedated. What care may the nurse delegate to the unlicensed assistive personnel (UAP)?

Provide frequent oral care per protocol

The nurse is caring for a client receiving mechanical ventilation. The nurse understands which are the possible causes for a high-pressure alarm? (Select all that apply.)

Secretions Bronchospasms Kinked tubing

The nurse suctions a mechanically ventilated patient using in-line sectioning. Which information should the nurse document in the medical record after procedure is completed?

The amount of secretions, color of secretions, consistency of secretions, patient's response to procedure.

The occupational health nurse is assessing new employees at a company. What would be important to assess in employees with a potential occupational respiratory exposure to a toxin? Select all that apply.

Time frame of exposure Type of respiratory protection used Breath sounds Intensity of exposure

Bone Fractures:

Transverse: run horizontally perpendicular to your bone (opposite the direction of your bone). You might see them referred to as complete fractures. This means the line of the break goes all the way through your bone. Linear: The break runs parallel to the bone; there is a break in the bone, but it does not move the bone. Oblique: occur when your bone is broken at an angle. The fracture is a straight line that's angled across the width of your bone. Spiral: They happen when one of your bones is broken with a twisting motion. They create a fracture line that wraps around your bone and looks like a corkscrew. You might see spiral fractures referred to as complete fractures. Greenstick: A bone cracks on one side only, not all the way through the bone. It is called a "greenstick" fracture because it can look like a branch that has broken and splintered on one side. Comminuted: The bone is broken into more than two pieces.

A nurse cares for a male client with hypopituitarism who is prescribed testosterone hormone replacement therapy. The client asks, How long will I need to take this medication? How should the nurse respond?

When your beard thickens and your voice deepens, the dose is decreased, but treatment will continue forever. *If a patient has hypopituitarism with FSH or LH deficiency, they may also be deficient in sex hormones. Thus, they may need to take replacement sex hormone medications like estradiol or testosterone.