Chapter 40--Musculoskeletal Care Modalities
What does The continuous passive motion device help prevent?
adhesions
fusion of a joint (most often the wrist or knee) for stabilization and pain relief.
arthrodesis
the cutting and removal of a wedge of bone to change the bone's alignment, thereby improving function and relieving pain.
osteotomy
why should a casted extremity should be elevated frequently to heart level?
to prevent swelling
instructions after a hip replacement
-The affected leg should not cross midline or be turned inward. -A pillow is used to keep the legs in abduction. -The hip should not bend more than 90 degrees when seated. -The head of bed should be kept at 60 degrees or less.
after hip surgery hip flexion should be limited to what?
90 degrees
how long does it take a cast to dry?
24-72 hours
spica cast
A hip spica cast keeps your child's pelvis and one or both legs from moving. This type of cast is used if a child has a broken bone in the thigh or has had hip surgery.
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.
A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?
Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg.
concerns after leg amputation in immediate postoperative period?
Hematoma, hemorrhage, and infection
Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?
It promotes healing by increasing circulation and movement of the knee joint.
What symptoms of a fractured clavicle does the nurse recognize?
The client with a fractured clavicle has restricted motion, and the affected shoulder appears to slope downward and droop inward.
indicators of hypovolemic shock
-a heart rate greater than 100 beats per minute -a blood pressure less than 90/60 mm Hg -urine output less than 30 ml per hour.
purpose of traction devices
-to increase the space between opposing surfaces. -to minimize muscle spasms, to reduce, align, and immobilize fractures, and to reduce deformity.
What should the nurse inform the client prior to the cast being removed?
The skin may be covered with a yellowish crust that will shed in a few days.
Which statement describes external fixation?
The surgeon inserts metal pins into the bone or bones from outside the skin surface and then attaches a compression device to the pins.
Which intervention will increase client independence when moving in bed?
applying a trapeze to the bed frame
an advantage of a plaster cast
better molding to client
A treatment option for compartment syndrome
fasciostomy
Manifestations of a dislocated hip prosthesis
increased pain at the surgical site, acute groin pain in the affected leg, shortening of the leg, abnormal external or internal rotation, and limited movement of the fractured leg
The nurse is caring for a client with a spica cast. What is the nurse's priority intervention?
keep cast clean and dry
A client has undergone an external fixation. Which actions would be the priority for this client?
maintaining pin care
Compartment syndrome is characterized by
neurovascular compromise
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as?
open reduction
Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?
open reduction
when is a splint typically applied instead of a cast?
when more swelling is expected at the site of injury."