HIT II: Chapter 40 (MS Care)

True or False. The cast should be placed on a metallic surface or one with sharp, sturdy edges.

False, The cast should NOT be placed on a metallic surface or one with sharp edges.

True or False. If elevation is requested to reduce swelling, a plastic-covered pillow is preferred to one covered in cloth, which could retain heat and prevent drying.

False, a cloth-covered pillow is preferred to one covered in plastic which could retain heat and prevent drying.

True or False. A musty smell on a wet cast indicates a progressing infection.

False, a wet plaster cast smells musty, feels damp, appears dull and gray, and sounds dull on percussion.

True or False. Skin lacerations and abrasions can heal under a cast, brace, or splint.

False, skin lacerations and abrasions MUST be treated before the cast, brace, or splint is applied.

True or False. Patients can remove their own cast after treatment is finished.

False, the patient should NEVER remove the cast themselves.

Fill in the blank. T: Temperature (extremity infection) R: Ropes hang freely A: Alignment C: Circulation check (6 P's) T: Type & location of fracture I: ________. O: Overhead trapeze N: _______.

Increase fluid intake No weights on bed or floor

Fill in the blank. T: Temperature (extremity infection) R: _________. A: _________. C: Circulation check (6 P's) T: _________. I: Increase fluid intake O: Overhead trapeze N: No weights on bed or floor

Ropes hang freely Alignment Type & location of fracture

Fill in the blank. T: __________. R: Ropes hang freely A: Alignment C: __________. T: Type & location of fracture I: Increase fluid intake O: __________. N: No weights on bed or floor

Temperature (extremity infection) Circulation check (6 P's) Overhead trapeze

True or False. Foul-smelling casts should be removed to prevent skin and wound infections

True, foul-smelling casts should be removed to prevent skin and wound infections. Dry casts are ODORLESS.

True or False. Skeletal traction is never interrupted.

True, skeletal traction is never interrupted.

True or False. Weights on a traction must hang freely and not rest on the bed or floor.

True, weights on a traction must hang freely and not rest on the bed or floor.

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? a. "CPM increases range of motion of the joint." b. "CPM strengthens the muscles of the leg." c. "CPM delivers analgesic agents directly into the joint."

a. "CPM increases range of motion of the 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? a. "Metal pins will go through my skin to the bone." b. "I will wear a boot with weights attached." c. "A belt will go around my pelvis and weights will be attached." d. "The traction can be removed once a day so I can shower."

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

Needs of Patients with Hip or Knee Replacement Surgery Patients usually begin ambulation within _____ after surgery using walker or crutches. a. 1 day b. 3 days c. 12 days

a. 1 day

Neurovascular checks for external fixators should be checked every _______. a. 2 hours b. 3-6 hours c. 36-48 hours

a. 2 hours

An older adult patient had a hip replacement. When should the patient begin with assisted ambulation with a walker? a. 24 hours b. 72 hours c. 1 week d. 2 to 3 weeks

a. 24 hours

Patients with Total Hip Arthroplasty (THA) Prone: a. 30 mins 2x/day b. 60 mins 1x/day c. never put in prone position

a. 30 mins 2x/day

Patient Education for Cast of Extremity Hardening plaster Heat felt in _____. a. 5-15 mins b. 30 mins c. 24-72hrs

a. 5-15 mins

A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast? a. Better molding to the client b. Quicker drying c. Longer-lasting d. More breathable

a. Better molding to the client

______ is skin traction to the lower leg. The pull is exerted in one plane when partial or temporary immobilization is desired. a. Buck's extension traction b. Gardner-Wells traction c. Brace

a. Buck's extension traction

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.) a. Decreased sensory function b. Excruciating pain c. Loss of motion d. Capillary refill less than 3 seconds e. 2+ peripheral pulses in the affected distal pulse

a. Decreased sensory function b. Excruciating pain c. Loss of motion

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain? a. Elevate the affected extremity and use cold applications. b. Breathe deeply and cough every 2 hours until ambulation is possible. c. Do ROM exercises as indicated. d. Apply antiembolism stockings as indicated.

a. Elevate the affected extremity and use cold applications.

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? a. Explain that the sensation being felt is normal and will not burn the client. b. Remove the cast immediately, notifying the physician. c. Administer antianxiety and pain medication. e. Call for assistance to hold the client in the required position until the cast has dried.

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

The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Fahrenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication? a. Hypovolemic shock b. Osteomyelitis c. Urinary retention d. Atelectasis

a. Hypovolemic shock Explanation: Indicators of hypovolemic shock include a heart rate greater than 100 beats per minute, a blood pressure less than 90/60 mm Hg, and urine output less than 30 ml per hour.

A client returns to the nursing unit following an open reduction with internal fixation of the right hip. Which nursing interventions would be appropriate for the prophylactic treatment of deep vein thrombosis? Select all that apply. a. Increasing fluid intake b. Maintaining antiembolic stockings c. Administering enoxaparin d. Encouraging coughing exercises e. Increasing fiber intake

a. Increasing fluid intake b. Maintaining antiembolic stockings c. Administering enoxaparin

Common pressure areas (select all that apply): a. Lateral epicondyle b. Tibial tuberosity c. Talus d. Lateral malleolus e. Interphalangeal joints

a. Lateral epicondyle b. Tibial tuberosity d. Lateral malleolus

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

a. Never cross the affected leg when seated Explanation: Crossing the affected leg may result in dislocation of the hip joint after total hip replacement. The client should be taught to keep the knees apart at all times, to put a pillow between the legs when sleeping, and to avoid bending forward when seated in a chair.

Common pressure areas (select all that apply): a. Olecranon b. Carpals c. Interphalangeal joints d. Radial styloid e. Ulna styloid

a. Olecranon d. Radial styloid e. Ulna styloid

_______: correction and alignment of the fracture after surgical dissection and exposure of the fracture. a. Open reduction b. Internal fixation c. Arthroplasty d. Hemiarthroplasty

a. Open reduction

Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply. a. Placing a trapeze on the bed b. Ensuring that the weights are hanging freely c. Assessing the client's alignment in the bed d. Removing skeletal traction to turn and reposition the client e. Frequently assessing pain level

a. Placing a trapeze on the bed b. Ensuring that the weights are hanging freely c. Assessing the client's alignment in the bed e. Frequently assessing pain level

Which of the following is an inappropriate nursing diagnosis for the client following casting? a. Risk for deficient knowledge: procedure b. Risk for impaired tissue perfusion c. Risk for impaired skin integrity d. Risk for disuse syndrome

a. Risk for deficient knowledge: procedure

A client is having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied? a. Short leg cast b. Long leg cast c. Walking cast d. Hip spica cast

a. Short leg cast

_______: Extends from below the elbow to the palmar crease, secured around the base of the thumb. a. Short-arm cast b. Long-arm cast c. Short-leg cast d. Long-leg cast

a. Short-arm cast

Casts are used to (select all that apply): a. Support or stabilize a weak joint b. Allow for moderate joint movement c. Provide extra support for a healthy joint d. Cure a disease e. Made of fiberglass or plaster

a. Support or stabilize a weak joint e. Made of fiberglass or plaster

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

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

A client had a total left hip arthroplasty. What clinical manifestation would indicate to the nurse that the prosthesis is dislocated? a. The left leg is internally rotated. b. The leg length is the same as the right leg. c. The client has discomfort when moving in bed. d. There are diminished peripheral pulses on the affected extremity.

a. The left leg is internally rotated.

________: replacement of both articular surfaces within a joint with metal or synthetic materials. a. Total joint arthroplasty or replacement b. Meniscectomy c. Bone graft d. Tendon transfer e. Fasciotomy

a. Total joint arthroplasty or replacement

Patients with Total Hip Arthroplasty (THA) Positioning of the leg in _______ to prevent dislocation of the prostheses. a. abduction b. adduction c. circumduction

a. abduction

Use of an ________ to prevent dislocation after THA. a. abduction pillow b. trapeze bar c. adduction pillow

a. abduction pillow

A wet plaster cast feels (select all that apply): a. damp b. dry c. appears dull and gray d. hard and firm e. white and shiny

a. damp c. appears dull and gray

Assessments of immobilization devices are performed at least _____ for the first 24 hours. a. every hour b. every 1 to 4 hours c. every shift

a. every hour

Advantages of splints over casts (select all that apply): a. faster b. provides stronger immobilization c. easier to apply and remove d. provides stronger support e. noncircumferential

a. faster c. easier to apply and remove e. noncircumferential

Frequently replaced joints include (select all that apply): a. hip b. neck c. knee d. fingers e. vertebrae

a. hip c. knee d. fingers

Patient Education for Cast of Extremity Avoid (select all that apply): a. inserting foreign objects in cast b. c. removing padding d. getting cast wet e.

a. inserting foreign objects in cast c. removing padding d. getting cast wet

Patients with Total Hip Arthroplasty should AVOID (select all that apply): a. internal rotation b. calcium-containing foods c. acute flexion d. pressure on heel e. drinking fluids

a. internal rotation c. acute flexion d. pressure on heel

To prevent skin breakdown, ______ can be used over any rough area of the cast that may rub against the patient's skin. a. moleskin b. vaseline c. hydrocortisone

a. moleskin

Patients in traction should have an (select all that apply): a. overhead frame b. constant supervision c. trapeze bar d. extendable drink tray e. extendable straws

a. overhead frame c. trapeze bar

What are the 6 P's (select all that apply): a. pain b. pallor c. polyhydramnios d. polymyositis e. pulselessness

a. pain b. pallor e. pulselessness

What are the 6 P's (select all that apply): a. poikilothermia b. polymyositis c. pounding pulse d. paresthesia e. paralysis

a. poikilothermia d. paresthesia e. paralysis

Joints that may also be replaced includes (select all that apply): a. shoulder b. elbow c. neck d. wrist e. ankle

a. shoulder b. elbow d. wrist e. ankle

Buck's extension is an example of a: a. skin traction b. skeletal traction c. truss

a. skin traction

______ are usually more practical and common and is the preferred method of fracture immobilization in the acute care setting and for the initial treatment of fracture. a. splints b. casts c. braces

a. splints

Pressure ulcer symptoms (select all that apply): a. tightness under the cast with very painful "hot spot" b. dusky c. pale coloring d. drainage w unpleasant odor e. cool to touch

a. tightness under the cast with very painful "hot spot" d. drainage w unpleasant odor

Compartment syndrome symptoms (select all that apply): a. unrelenting pain b. headache c. delayed capillary refill d. nausea e. paresthesia

a. unrelenting pain c. delayed capillary refill e. paresthesia

The splint must be ______ to prevent pressure, skin abrasion, and skin breakdown. a. well padded b. lubricated c. loosely fitted

a. well padded

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

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

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.) a. "You may cross your legs at the ankles only." b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitting in a chair." d. "Use a raised toilet seat and high-seated chair." e. "It is okay to briefly flex the hip to put on your clothes."

b. "Place pillows between your legs when you lay on your side." c. "Avoid bending forward when sitting in a chair." d. "Use a raised toilet seat and high-seated chair."

A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse? a. "This allows for the strength in the arm to remain consistent." b. "The joint above the fracture and below the fracture must be immobilized." c. "When a spica cast is ordered, the arm must be immobilized." d. "The method allows for the fastest healing time and the greatest mobility."

b. "The joint above the fracture and below the fracture must be immobilized."

Stability checks for external fixators should be checked every _______. a. 30 mins b. 2-4 hours c. 36-48 hours

b. 2-4 hours

Patient Education for Cast of Extremity Hardening plaster Max strength ______ for fiberglass. a. 5-15 mins b. 30 mins c. 24-72hrs

b. 30 mins

The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for? a. An open reduction b. A fasciotomy c. A total hip replacement d. A total knee replacement

b. A fasciotomy

Which action would be most important postoperatively for a client who has had a knee or hip replacement? a. Providing crutches to the client. b. Assisting in early ambulation. c. Using a continuous passive motion (CPM) machine. d. Encouraging expressions of anxiety.

b. Assisting in early ambulation.

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician? a. Blood pressure of 140/90 mm Hg b. Crackles in the lung bases c. Client complains of pain in the affected rib area when taking a deep breath d. Heart rate of 94 beats/minute

b. Crackles in the lung bases

Patient Education for Cast of Extremity Symptoms to report to provider: a. HA b. Disproportionate pain on movement c. Tingling d. BUN of 8.5 mg/dL e. S/s of infection

b. Disproportionate pain on movement c. Tingling e. S/s of infection

Casts are used to (select all that apply): a. Cure a disease b. Immobilize a reduced fracture c. Provide extra support for a healthy joint d. Made of newspaper or concrete e. Correct or prevent a deformity

b. Immobilize a reduced fracture e. Correct or prevent a deformity

_______: stabilization of the reduced fracture by the use of metal screws, plates, wires, nails, and pins a. Open reduction b. Internal fixation c. Arthroplasty d. Hemiarthroplasty

b. Internal fixation

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

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

______: Extends from the axillary fold to the proximal palmar crease. The elbow usually is immobilized at a right angle. a. Short-arm cast b. Long-arm cast c. Short-leg cast d. Long-leg cast

b. Long-arm cast

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority? a. Monitoring the client for skin breakdown b. Maintaining traction continuously to ensure its effectiveness c. Supporting the traction weights with a chair or table to prevent accidental slippage d. Restricting the client's fluid and fiber intake to reduce the movement required for bedpan use

b. Maintaining traction continuously to ensure its effectiveness

__________: excision of damaged joint fibrocartilage. a. Total joint arthroplasty or replacement b. Meniscectomy c. Bone graft d. Tendon transfer e. Fasciotomy

b. Meniscectomy

A client is having traction applied to a fractured left lower extremity prior to surgery. What outcomes does the nurse expect from the application of the traction for the client? Select all that apply. a. Surgery will not be required. b. Muscle spasms will be relieved. c. The bones of the left leg will be aligned. d. Immobilization of the left leg will be maintained. e. Less pain medication will be required.

b. Muscle spasms will be relieved. c. The bones of the left leg will be aligned. d. Immobilization of the left leg will be maintained.

An unresponsive client had a plaster cast applied to the right lower leg 8 hours ago. When moving the client, the nurse notices an indentation on the posterior lower portion of the cast. What is the best action by the nurse? a. Document the findings. b. Notify the physician. c. Remove the cast immediately.

b. Notify the physician.

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? a. Scrubbing the drainage from around the pin site b. Obtaining a culture c. Applying iodine-based solution d. Apply ointment to the pin site.

b. Obtaining a culture

Patient Education for Cast of Extremity Symptoms to report to provider: a. HA b. Persistent pain/swelling c. Discoloration d. N/V e. Burning

b. Persistent pain/swelling c. Discoloration e. Burning

Braces are used to (select all that apply): a. Correct or prevent a deformity b. Provide support c. Prevent additional injury d. Control movement e. Made of fiberglass or plaster

b. Provide support c. Prevent additional injury d. Control movement

A client arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the client to describe the pain? a. A dull, deep, boring ache b. Sharp and piercing c. Sore and aching d. Similar to "muscle cramps"

b. Sharp and piercing

Rigid external immobilizing device molded to contours of body part a. truss b. cast c. catheter

b. cast

To prevent _______ the nurse instructs the patient to tense or contract muscles without moving the underlying bone. a. compartment syndrome b. disuse syndrome c. osteomyelitis

b. disuse syndrome

A dry cast feels (select all that apply): a. damp b. dried c. appears dull and gray d. hard and firm e. white and shiny

b. dried d. hard and firm e. white and shiny

Compartment syndrome symptoms (select all that apply): a. tightness under the cast with very painful "hot spot" b. dusky c. pale coloring d. drainage w unpleasant odor e. cool to touch

b. dusky c. pale coloring e. cool to touch

After external fixators are applied, the extremity is _____ to reduce swelling. a. iced b. elevated c. depressed

b. elevated

Assessments of immobilization devices are performed ______ after day one. a. every hour b. every 1 to 4 hours c. every shift

b. every 1 to 4 hours

The cast should not be covered while it is drying because the: a. cast will dry too quickly and crumble b. heat generated by the chemical reaction cannot escape c. cast will take too long to dry; causing infection

b. heat generated by the chemical reaction cannot escape

________ exercises are key to the prevention of disuse syndrome. a. isotonic b. isometric c. isokinetic

b. isometric

Tightness under the cast with very painful "hot spot" Drainage w/ unpleasant odor a. compartment syndrome b. pressure ulcers c. disuse syndrome

b. pressure ulcers

A dry plaster cast feels (select all that apply): a. crumbly b. resonant to percussion c. smells musty d. sounds dull on percussion e. odorless

b. resonant to percussion e. odorless

Gardner-Wells is an example of a: a. skin traction b. skeletal traction c. truss

b. skeletal traction

Patient Education for Cast of Extremity Elevate extremity above the heart _____ after cast is applied. a. 5-15 mins b. 30 mins c. 24-48 hrs

c. 24-48 hrs

Patient Education for Cast of Extremity Hardening plaster Max strength may be up to _____ for plaster. a. 5-15 mins b. 30 mins c. 24-72hrs

c. 24-72hrs

Patients with Total Hip Arthroplasty (THA) Do not flex hip more than: a. 30 degrees b. 45 degrees c. 90 degrees

c. 90 degrees

_______: repair of joint problems through the operating arthroscope (an instrument that allows the surgeon to operate within a joint without a large incision) or through open joint surgery. a. Open reduction b. Internal fixation c. Arthroplasty d. Hemiarthroplasty

c. Arthroplasty

_________: placement of bone tissue (autologous or homologous grafts) to promote healing, to stabilize, or to replace diseased bone a. Total joint arthroplasty or replacement b. Meniscectomy c. Bone graft d. Tendon transfer e. Fasciotomy

c. Bone graft

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? a. Crutchfield tongs b. Thomas splint c. Buck's

c. Buck's

The nurse assesses a client after total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse? a. Apply Buck's traction. b. Externally rotate the extremity. c. Notify the health care provider. d. Bend the knee and rotate the knee internally.

c. Notify the health care provider. Explanation: If any clinical manifestations of dislocation of the prosthesis occur (acute groin pain in the affected hip or shortening of the affected extremity) the surgeon must be immediately notified.

________: Extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. a. Short-arm cast b. Long-arm cast c. Short-leg cast d. Long-leg cast

c. Short-leg cast

Indentations in a wet cast can result in: a. an unpleasant appearance b. air pockets in the cast c. areas of pressure on the skin

c. areas of pressure on the skin

A physical assessment should be done: a. before cast applied b. after cast applied c. before and after cast applied

c. before and after cast applied

External fixators are pins, screws, or tongs inserted through one or more ______ to stabilize fragments during healing. a. skin layers b. muscles c. bones

c. bones

Deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity (e.g. muscle atrophy, loss of muscle strength). a. compartment syndrome b. pressure ulcers c. disuse syndrome

c. disuse syndrome

If the skin wounds are extensive, an alternative method _______ may be chosen to immobilize the body part. a. fiberglass cast b. splint c. external fixator

c. external fixator

Used to treat severe joint pain and disability and repair and management of joint fractures or joint necrosis a. joint-implanted traction b. joint patch c. joint replacements

c. joint replacements

Improper pin care of external fixators can lead to: a. disuse syndrome b. compartment syndrome c. osteomyelitis

c. osteomyelitis

The wet plaster cast should be handled by only the ______ so that indentations in the cast may be prevented. a. arms b. wrists c. palms

c. palms

_______ :smoothing the rough edges of the cast a. burnishment b. intubation c. petaling

c. petaling

Maintaining a dry cast is important to: a. prevent discoloration of cast b. prevent shrinkage of cast c. prevent skin breakdown, infection, or irritation

c. prevent skin breakdown, infection, or irritation

The joints _______ to the area immobilized are included in the cast. a. anterior and distal b. ventral and caudal c. proximal and distal

c. proximal and distal

A wet plaster cast feels (select all that apply): a. crumbly b. resonant to percussion c. smells musty d. sounds dull on percussion e. odorless

c. smells musty d. sounds dull on percussion

_______ are often used for simple and stable fractures, sprains, tendon injuries, and other soft tissue injuries. a. braces b. casts c. splints

c. splints

A pulling force used to maintain body alignment, maintain fracture alignment, and relieve pain and muscle spasm a. brace b. splint c. traction

c. traction

Needs of Patients with Hip or Knee Replacement Surgery Infection may occur in the immediate postoperative period (______) or as a delayed infection (4-24 months). a. within 3 months b. within 6 months c. within 12 months

c. within 3 months

A ______ is used to remove the cast.

cast saw

______ is most serious potential complication of immobilization devices.

compartment syndrome

_______: Extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed. a. Short-arm cast b. Long-arm cast c. Short-leg cast d. Long-leg cast

d. Long-leg cast

The nurse is caring for a client who has had a fracture reduction using a cast. What is most important for the nurse to assess? a. Cardiac status b. Renal function c. Sleep status d. Neurovascular status

d. Neurovascular status

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture? a. Arthrodesis b. Joint arthroplasty c. Total joint arthroplasty d. Open reduction

d. Open reduction

A nurse is giving instructions to a client who's going home with a leg cast. Which teaching point is most critical? a. Using crutches properly b. Exercising joints above and below the cast, as ordered c. Avoiding walking on a leg cast without the health care provider's permission d. Reporting signs of impaired circulation

d. Reporting signs of impaired circulation

Which is an inaccurate principle of traction? a. The weights are not removed unless intermittent treatment is prescribed. b. The weights must hang freely. c. The client must be in good alignment in the center of the bed. d. Skeletal traction is interrupted to turn and reposition the client.

d. Skeletal traction is interrupted to turn and reposition the client.

Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides? a. Brace b. Continuous passive motion (CPM) device c. Trapeze d. Splint

d. Splint

A client's left leg is in skeletal traction with a Thomas leg splint and Pearson attachment. Which intervention should the nurse include in this client's care plan? a. Apply the traction straps snugly. b. Assess the client's level of consciousness. c. Remove the traction at least every 8 hours. d. Teach the client how to prevent problems caused by immobility.

d. Teach the client how to prevent problems caused by immobility.

_________: Insertion of tendon to improve function a. Total joint arthroplasty or replacement b. Meniscectomy c. Bone graft d. Tendon transfer e. Fasciotomy

d. Tendon transfer

If the thumb is included in a cast, it is known as a a. thumb spica b. intrapollex truss c. gauntlet cast d. a and c only

d. a and c only

________: incision and diversion of the muscle fascia to relieve muscle constriction, as in compartment syndrome, or to reduce fascia contracture a. Total joint arthroplasty or replacement b. Meniscectomy c. Bone graft d. Tendon transfer e. Fasciotomy

e. Fasciotomy

Hallmark of compartment syndrome is:

pain with passive ROM

What are the (2) types of tractions?

skin and skeletal