Ch 41 CS
Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse? "CPM strengthens the muscles of the leg." "CPM increases range of motion of the joint." "CPM delivers analgesic agents directly into the joint." "CPM prevents injury by limiting flexion of the knee."
"CPM increases range of motion of the joint."
A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first? "My toes are stiff." "My toes are pink." "My cast is still wet." "My pain is a 3."
"My toes are stiff."
A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem? Scrub the area vigorously to remove the crust. Consult a skin specialist. Avoid exposure to direct sunlight. Apply lotions and take warm baths or soaks.
Apply lotions and take warm baths or soaks.
A client has undergone an external fixation. Which actions would be the priority for this client? Maintaining pin care. Planning the client's diet. Monitoring the client's urine output. Monitoring the client's blood pressure.
Maintaining pin care.
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing? Obtaining a culture Applying iodine-based solution Scrubbing the drainage from around the pin site Apply ointment to the pin site.
Obtaining a culture
The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? Hypovolemia Urinary tract infection Pulmonary embolism Atelectasis
Pulmonary embolism
A patient arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain? Sore and aching Similar to "muscle cramps" A dull, deep, boring ache Sharp and piercing
Sharp and piercing
Which statement is accurate regarding care of a plaster cast? The cast can be dented while it is damp. A dry plaster cast is dull and gray. The cast must be covered with a blanket to keep it moist during the first 24 hours. The cast will dry in about 12 hours.
The cast can be dented while it is damp.
For which of the following immobility-related complications is the client in traction at risk? Select all that apply. Cachexia Thromboemboli Urinary stasis Lactose intolerance Diarrhea
Thromboemboli Urinary stasis
The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? A fasciotomy A total knee replacement An open reduction A total hip replacement
A fasciotomy
A client with a long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse? Assess for complications. Assess for previous opioid drug use. Teach relaxation techniques. Reposition the client for comfort.
Assess for complications.
A client has a Fiberglass cast on the right arm. Which action should the nurse include in the care plan? Evaluating pedal and posterior tibial pulses every 2 hours Keeping the casted arm warm by covering it with a light blanket Assessing movement and sensation in the fingers of the right hand Avoiding handling the cast for 24 hours or until it is dry
Assessing movement and sensation in the fingers of the right hand
A group of students is studying for a test on traction. The students demonstrate understanding of the types of traction when they identify which of the following as an example of skin traction? Balanced suspension Buck's Thomas splint Crutchfield tongs
Buck's
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 Removal of the cast Cutting a cast window Insertion of an external fixator
Cutting a cast window
The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery? Avoid placing a pillow between the legs when sleeping Never cross the affected leg when seated Keep the knees together at all times Bend forward only when seated in a chair
Never cross the affected leg when seated
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? Client complains of pain in the unaffected shoulder. Right shoulder is elevated above the left. Client complains of tingling and numbness in the right shoulder. Right shoulder slopes downward and droops inward.
Right shoulder slopes downward and droops inward.
Which is an inaccurate principle of traction? The weights are not removed unless intermittent treatment is prescribed. The client must be in good alignment in the center of the bed. The weights must hang freely. Skeletal traction is interrupted to turn and reposition the client.
Skeletal traction is interrupted to turn and reposition the client.
A client with a right leg fracture is returning to the orthopedist to have the cast removed. What would the physician prescribe as further treatment? discontinue use of crutches No options are correct. cold compresses to leg for swelling physical therapy
physical therapy
A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? Breathe deeply and cough every 2 hours until ambulation is possible. Elevate the affected extremity and use cold applications. Do ROM exercises as indicated. Apply antiembolism stockings as indicated.
Elevate the affected extremity and use cold applications.
The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is: Risk for ineffective therapeutic regimen management Disturbed body image Situational low self-esteem Risk for avascular necrosis of the joint
Risk for ineffective therapeutic regimen management