Mobility and Immobility PrepU
Upon reporting to work and receiving report, a nurse has been assigned to provide care for three clients. Each of the clients has called out to the nurses' station requesting assistance. Which client should the nurse see first?
A 32-year-old male, who had a plaster cast applied to his leg 2 hours ago, who complains that the cast feels as if it's getting tighter
A group of students are reviewing information about bone healing in children. The students demonstrate understanding of this information when they state:
A child's bones heal more quickly than those of an adult
A nurse is managing the care of a client with osteoarthritis. Appropriate treatment strategies for osteoarthritis include:
Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and initiation of an excuse program
A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast?
Assess fingers for warmth, pain, and function
A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?
Bone fracture
In a patient with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which of the following complications do the assessments help the nurse to monitor in the patient?
Compartment syndrome
Which assessment findings would cause the nurse to suspect compartment syndrome after casting of the leg?
Complaints of numbness and tingling in toes of affected leg
To help prevent osteoporosis, what should a nurse advise a young woman to do?
Consume at least 1000 mg of calcium daily
A 78-year-old client is in the emergency department following involvement in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of her upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma?
Immoblization
The nurse is evaluating the client's risk for having a pressure sore. Which is the best indicator of risk for the client's developing a pressure sore?
Mobility status
A nurse is performing discharge teaching for an elderly client diagnosed with osteoporosis. Which statement about home safety should the nurse include?
Most falls among the elderly occur in the home. These clients should remove throw rugs and install bathroom grab bars.
Which of the following terms refers to failure of fragments of a fractured bone to heal together?
Nonunion
The nurse is caring for a child with a broken wrist that has just been placed in a cast. The nurse would elevate the arm to:
Prevent edema
A nurse is giving instructions to a client who's going home with a cast on his leg. Which teaching point is most critical?
Reporting signs on impaired circulation
Which action would be most helpful in preventing pressure ulcer formation in an at-risk client?
Reposition every hour
Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?
Risk for injury related to altered mobility
Health promotion activities to reduce the incidence of osteoporosis include:
Teaching women to maintain adequate calcium intake
Which statement would be appropriate for a nurse documenting a stage 1 pressure ulcer found on a client who is immobilized?
The client's skin is intact with non-blanchable redness of a localized area over a bony prominence
The nurse is caring for a child in a type of traction in which weights are being used. What is true regarding the weights?
The weights must be hanging freely, not touching the bed or floor
Which of the following are general nursing measures for a patient with a fracture reduction?
Encourage participation in ADLs
The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit; heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing:
Fat embolism syndrome
A physician diagnoses primary osteoporosis in a client who has lost bone mass. In this metabolic disorder, the rate of bone resorption accelerates while bone formation slows. Primary osteoporosis is most common in:
Elderly postmenopausal women
The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions?
Encourage active and passive range-of-motion activities to prevent ineffectiveness tissue perfusion
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in the treatment of musculoskeletal conditions. It is important for the nurse to remind the client to:
Take NSAIDs with food