Care of Patients with Musculoskeletal Trauma

A client asks why a plaster cast is not applied to the fractured clavicle. Which is the nurse's best response?

"A splint or a bandage is sufficient to keep the bones in alignment

A nurse delegates care of a client in traction to an unlicensed assistive personnel (UAP). Which statement should the nurse include when delegating hygiene care for this client?

"Ensure that the weights remain freely hanging at all times."

A nurse is caring for a client who is recovering from an above-the-knee amputation. The client reports pain in the limb that was removed. How should the nurse respond?

"How would you describe the pain that you are feeling?"

After teaching a client who is recovering from a vertebroplasty, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?

"I can drive myself home after the procedure."

A client for whom skeletal traction is planned asks for an explanation regarding the purpose of this type of traction. Which is the nurse's best response?

"It aids in realigning the bone."

A client has an arm cast and reports that it feels really tight and the fingers are puffy. What is the nurse's best response?

"Please come to the clinic today to have your arm checked by the health care provider."

The nurse is caring for an older adult client who had leg amputation surgery the previous day. During the admission assessment, the client tells the nurse, "I don't want to live with only one leg, so I should have died during the surgery." Which is the nurse's best response?

"Remember that you are still the same person inside, with a missing body part."

A nurse cares for a client placed in skeletal traction. The client asks, "What is the primary purpose of this type of traction?" How should the nurse respond?

"Skeletal traction will assist in realigning your fracture bone."

A nurse teaches a client about prosthesis care after amputation. Which statements should the nurse include in this client's teaching?

"The device has been custom made specifically for you." "Make sure that you wear the correct liners with your prostetic." "I have scheduled a follow-up appointment for you."

A nurse cares for an older adult client who is recovering from a leg amputation surgery. The client states, "I don't want to live with only one leg. I should have died during the surgery." How should the nurse respond?

"This is a big change for you. What support system do you have to help you cope?"

A nurse coordinates care for a client with a wet plaster cast. Which statement should the nurse include when delegating care for this client to an unlicensed assistive personnel (UAP)?

"Use a cloth-covered pillow to elevate the client's leg."

A client who had a wrist cast applied 3 days ago calls from home, reporting that the cast is loose enough to slide off. How does the nurse respond?

"You need a new cast now that the swelling is decreased."

A trauma nurse cares for several clients with fractures. Which client should the nurse identify as at highest risk for developing deep vein thrombosis?

A 74-year-old man who smokes and has a fractured pelvis

A nurse cares for a client with a fracture injury. Twenty minutes after an opioid pain medication is administered, the client reports pain in the site of the fracture. which actions should the nurse take?

Administer additional opioids as prescribed Elevate the extremity on pillows Apply ice to the fracture site

A nurse cares for a client who had along-leg case applied last week. The client states, "I cannot seem to catch my breath and I feel a bit light-headed." Which action should the nurse take next?

Administer oxygen to keep saturations greater than 92%

A nurse assesses an older adult client who was admitted 2 days ago with a fractured hip. The nurse notes that the client is confused and restless. The client's vital signs are heart rate 98 beats/min, respiratory rate 32 breaths/min, blood pressure 132/78 mm Hg, and SpO2 88%. Which action should the nurse take first?

Administer oxygen via nasal cannula

While assessing an older client admitted 2 days ago with a fractured hip, the nurse notes that the client is confused, tachypneic, and restless. Which is the nurse's first action?

Administer oxygen via nasal cannula

A client with a new fracture reports pain in the site of the fracture. An opiod pain medication was administered 20 minutes ago. Which is the nurse's best intervention?

Administration of additional opioids Elevation of the extremity Application of ice

A client has left-sided weakness. Which action by the client indicates that additional teaching about proper can use is needed?

Advancing the can while the right leg moves forward

A client who has sustained a crush injury to the right lower leg reports numbness and tingling of the affected extremity. The skin of the right leg appears pale. Which is the nurse's first intervention?

Assess pedal pulses

An older woman is admitted after falling down the stairs. Which assessment findings require immediate intervention?

Blood pressure, 80/50 mm Hg Potassium, 6.0 mEq/L Dark brown urine

A client who has a long-leg cast applied last week reports to the clinic nurse, "I can't seem to catch my breath and I feel a bit lightheaded." Which is the priority action of the nurse?

Check the client's pulse oximetry and arrange emergency transfer to the hospital

The nurse is caring for clients with above-knee amputations. Which client does the nurse treat first?

Client with regional pain syndrome

The nurse notes that the skin around the client's skeletal traction pin site is swollen, red, and crusty, with dried drainage. Which is the nurse's priority intervention?

Culture the drainage

A nurse assesses a client with a cast for potential compartment syndrome. Which clinical manifestations are correctly paired with the physiologic changes of compartment syndrome?

Edema - Increased capillary permeability Unequal pulses - Increased production of lactic acid Cyanosis - Anaerobic metabolism

A nurse plans care for a client who is recovering from open reduction and internal fixation (ORIF) surgery for a right hip fracture. Which interventions should the nurse include in this client's plan of care?

Elevate heels off the bed with a pillow Ambulate the client on the first postoperative day Re-position the client every 2 hours

A nurse plans care for a client who is recovering from a below-the-knee amputation of the left leg. Which intervention should the nurse include in this client's plan of care?

Encourage range-of-motion exercises

A client who had a plaster cast applied to the right arm 3 weeks ago presents to the clinic with an erythrocyte sedimentation rate (ESR) that has increased from 15 to 25 mm/hr. Which is the nurse's best action?

Evaluate temperature and vital signs

The home care nurse is visiting a client with diabetes who has a new cast on the arm. On assessment, the nurse finds the client's fingers to be pale, cool, and slightly swollen. Which is the nurse's first intervention?

Evaluate the arm above the level of the heart

A nurse teaches a client who is at risk for carpal tunnel syndrome. Which health promotion activities should the nurse include in this client's teaching?

Frequently assess the ergonomics of the equipment being used Take breaks to stretch fingers and wrists during working hours Adjust chair height to allow for good posture

A nurse assesses a client with a pelvic fracture. Which assessment finding should the nurse identify as a complication of this injury?

Hematuria

A client who has had an above-knee amputation of the right leg reports pain in the right foot. WHich priority medication does the nurse administer?

IV calcitonin

The nurse is performing an assessment on a client admitted with a fractured left humerus. WHen the client moves the extremity, the nurse notes the presence of a grating sound. Which is the nurse's best intervention?

Immobilize the arm

A nurse notes crepitation when performing range-of-motion exercises on a client with a fractured left humerus. Which action should the nurse take next?

Immobilize the left arm

A nurse assesses a client with a rotator cuff injury. Which finding should the nurse expect to assess?

Inability to initiate or maintain abduction of the affected arm at the shoulder

A nurse teaches a client with a fractured tibia about external fixation. Which advantages of external fixation for the immobilization of fractures should the nurse share with the client?

It leads to minimal blood loss It allows for early ambulation It promotes healing

A client has a fractured tibia and is asking the nurse about external fixation. What are some advantages for the use of external fixation for the immobilization of fractures?

Leads to minimal blood loss Allows for early ambulation Promotes healing

A client has a fractured humerus. Which dietary choice indicates that the client understands the nutrition to assist in healing the fracture?

Low-fat milk, vitamin C supplements, and roast beef

A nurse reviews prescriptions for an 82-year-old client with a fractured left hip. Which prescription should alert the nurse to contact the provider and express concerns for client safety?

Meperidine (Demerol) 50 mg IV every 4 hours

The nurse is caring for a client with a pelvic fracture. Which is the nurse's priority action to prevent complications?

Monitor blood pressure frequently

A client has been diagnosed with carpal tunnel syndrome. Which intervention does the nurse question in the treatment of this injury?

Morphine 30 mg to be taken orally every 4 hours

The nurse is caring for a client 3 days after a below-knee amputation. Which is a priority intervention?

Muscle-strengthening exercises

The nurse is caring for a client with a fractured fibula. Which assessment prompts immediate action by the nurse?

Numbness and tingling in the extremity

A nurse cares for a client with a fractured fibula. Which assessment should alert the nurse to take immediate action?

Numbness in the extremity

The nurse is caring for several clients with fractures. Which client does the nurse consider at highest risk for developing deep vein thrombosis?

Older man who smokes and has a fractured pelvis

The nurse is rounding on assigned orthopedic clients. The client with which type of fracture requires interventions to prevent infection?

Open fracture of the tibia

The nurse is caring for a client with a fractured femur. Which factor in the client's history may impede healing of the fracture?

Paget's disease

The nurse assesses a client with a below-knee amputation. Which assessment of the skin flap requires immediate action?

Pale and cool to the touch

The nurse is caring for an older adult client with multiple fractures. How does the nurse manage pain in this client?

Patient-controlled analgesia (PCA) pump with morphine

The nurse is teaching a client who has left leg weakness to walk with a cane. Which gair training technique is correct?

Place the cane in the client's right hand and move the cane forward, followed by moving the left leg one step forward

A home health nurse assesses a client with diabetes who has a new cast on the arm. The nurse notes the client's fingers are pale, cool, and slightly swollen. Which action should the nurse take first?

Raise the arm above the level of the heart

An emergency department nurse triages a client with diabetes mellitus who has fractured her arm. Which action should the nurse take first?

Remove the medical alert bracelet from the fractured arm

A nurse plans care for a client who is prescribed skeletal traction. Which intervention should the nurse include in this plan on care to decrease the client's risk for infection?

Schedule for pin care to be provided every shift

The nurse is caring for a client with an external fixator in place on the leg. What does the nurse assess for first?

Signs of infection

The nurse is caring for a client after arthroscopy surgery. Which intervention is a postoperative priority for this client?

Straight leg raises with the involved leg

The client is being assessed for rotator cuff injury. Which physical assessment finding is consistent with this type of injury?

The client is unable to initiate or maintain abduction of the affected arm at the shoulder

A client has a fracture and is being treated with skeletal traction. Which assessment causes the nurse to take immediate action?

The traction weights are resting on the floor

An emergency nurse assesses a client who is admitted with a pelvic fracture. Which assessments should the nurse monitor to prevent a complication of this injury?

Urinary output Blood pressure Skin color

The nurse is assessing a client with a body cast. Which assessment finding indicates a complication that must be reported to the health care provider?

Vomiting after meals