Musculo

The unlicensed assistive personnel (UAP) reports a client with a fractured femur has "fatty globules" floating in the urinal. What intervention should the nurse implement first? 1. Assess the client for dyspnea and altered mental status. Obtain an arterial blood gas and order a portable chest x-ray. Call the HCP for a ventilation/perfusion scan. Instruct the UAP keep the client on strict bedrest.

1. Assess the client for dyspnea and altered mental status.

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

A fasciotomy

A client who was treated for a long bone fracture suddenly has a respiratory rate of 28 breaths/ min with an oxygen saturation of 86% on room air. The client is confused and restless. Which collaborative intervention is appropriate? A. Applying oxygen and continuing to assess respiratory status B. Intubating the client immediately C. Immediately immobilizing the pelvic area D. Administering corticosteroids as ordered

A. Applying oxygen and continuing to assess respiratory status

A client had a cast applied to a fractured​ limb, and the healthcare provider has ordered frequent neurovascular checks. Which assessment should the nurse​ perform? (Select all that​ apply.) A. Paresthesia B. Pain C. Position D. Color E. Temperature

A. Paresthesia B. Pain D. Color E. Temperature

Which interventions should the nurse implement for the client diagnosed with an open fracture of the left ankle? Select all that apply. 1. Apply an immobilizer snugly to prevent edema. Apply an ice pack for 10 minutes and remove for 20 minutes. Place the extremity in the dependent position to allow drainage. Obtain an x-ray of the ankle after applying the immobilizer. Administer tetanus toxoid, 0.5 mL intramuscularly, in the deltoid.

Administer tetanus toxoid, 0.5 mL intramuscularly, in the deltoid. Apply an ice pack for 10 minutes and remove for 20 minutes.

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement? The longer the joint is displaced, the more difficult it is to get it back in place. The client's pain will increase until the joint is realigned. Dislocation can become permanent if the process of bone remodeling begins. Avascular necrosis may develop at the site if it is not promptly resolved.

Avascular necrosis may develop at the site if it is not promptly resolved.

There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head? avascular necrosis fat embolism pulmonary embolism shock

avascular necrosis

A variety of complications can occur after a leg amputation. Which is not a possibility in the immediate postoperative period? osteomyelitis hematoma hemorrhage infection

osteomyelitis

The nurse instructs the client with a right BKA to lie on the stomach for at least 30 minutes a day. The client asks the nurse, "Why do I need to lie on my stomach?" Which statement is the most appropriate statement by the nurse? 1. "This position will help your lungs expand better." "Lying on your stomach will help prevent contractures." "Many times this will help decrease pain in the limb." "The position will take pressure off your backside."

"Lying on your stomach will help prevent contractures."

A CLIENT HAS SUSTAINED A CLOSED FRACTURE AND HAS JUST HAD A CAST APPLIED TO THE AFFECTED ARM. THE CLIENT IS COMPLAINING OF INTENSE PAIN. THE NURSE ELEVATES THE LIMB, APPLIES AN ICE BAG, AND ADMINISTERS AN ANALGESIC, WITH LITTLE RELIEF. WHICH PROBLEM MAY BE CAUSING THIS PAIN? A. INFECTION UNDER THE CAST B. THE ANXIETY OF THE CLIENT C. IMPAIRED TISSUE PERFUSION D. THE RECENT OCCURRENCE

C. IMPAIRED TISSUE PERFUSION

THE NURSE IS EVALUATING A CLIENT IN SKELETAL TRACTION. WHEN EVALUATING THE PIN SITES, THE NURSE WOULD BE MOST CONCERNED WITH WHICH FINDING? A. REDNESS AROUND THE PIN SITES B. PAIN ON PALPATION AT THE PIN SITE C. THICK, YELLOW DRAINAGE FROM THE PIN THE SITES D. CLEAR, WATERY DRAINAGE FROM THE PIN SITES

C. THICK, YELLOW DRAINAGE FROM THE PIN THE SITES

Two days after application of a cast to treat a fractured femur, the client reports severe, deep, and constant pain in the leg. What will the nurse suspect? Compartment syndrome. Phlebitis. Infection. Chronic venous insufficiency.

Compartment syndrome.

The recovery room nurse is caring for a client who has just had a left BKA. Which intervention should the nurse implement? 1. Assess the client's surgical dressing every two (2) hours. Do not allow the client to see the residual limb. Keep a large tourniquet at the client's bedside. Perform passive range-of-motion exercises to the right leg.

Do not allow the client to see the residual limb.

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient? Spontaneous pneumothorax Cardiac tamponade Pneumonia Fat emboli

Fat emboli

A nurse is performing a shift assessment on an elderly client who is recovering after surgery for a hip fracture. The client reports chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the client is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this client is likely demonstrating symptoms of what complication? Avascular necrosis of bone Compartment syndrome Fat embolism syndrome Complex regional pain syndrome

Fat embolism syndrome

The client is three (3) hours postoperative left AKA. The client tells the nurse, "My left foot is killing me. Please do something." Which intervention should the nurse implement? 1. Explain to the client his left leg has been amputated. Medicate the client with a narcotic analgesic immediately. Instruct the client on how to perform biofeedback exercises. Place the client's residual limb in the dependent position.

Medicate the client with a narcotic analgesic immediately.

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for? Atelectasis Hypovolemia Pulmonary embolism Urinary tract infection

Pulmonary embolism

Which nursing intervention is essential in caring for a client with compartment syndrome? Keeping the affected extremity below the level of the heart Wrapping the affected extremity with a compression dressing to help decrease the swelling Removing all external sources of pressure, such as clothing and jewelry Starting an I.V. line in the affected extremity in anticipation of venogram studies

Removing all external sources of pressure, such as clothing and jewelry

The nurse is preparing the plan of care for the client with a closed fracture of the right arm. Which problem is most appropriate for the nurse to identify? 1. Risk for ineffective coping related to the inability to perform ADLs. Risk for compartment syndrome-related injured muscle tissue. Risk for infection related to exposed bone and tissue. Risk for complications related to compromised neurovascular status.

Risk for complications related to compromised neurovascular status.

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

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

Which may occur if a client experiences compartment syndrome in an upper extremity? Whiplash injury Volkmann's contracture Callus Subluxation

Volkmann's contracture

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching? "I'll need to keep several pillows between my legs at night." "I need to remember not to cross my legs. It's such a habit." "The occupational therapist is showing me how to use a sock puller to help me get dressed." "I don't know if I'll be able to get off that low toilet seat at home by myself."

"I don't know if I'll be able to get off that low toilet seat at home by myself."

A client had an above-the-knee amputation of the left leg related to complications from peripheral vascular disease. The nurse enters the client's room and observes the dressing and bed covers saturated with blood. What is the first action by the nurse? Notify the health care provider. Apply a tourniquet. Use skin clips to close the wound. Reinforce the dressing.

Apply a tourniquet.

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority? Assessing the extremity for neurovascular integrity Keeping the client from sliding to the foot of the bed Keeping the ropes over the center of the pulley Ensuring that the weights hang free at all times

Assessing the extremity for neurovascular integrity

The 62-year-old client diagnosed with type 2 diabetes who has a gangrenous right toe is being admitted for a below-the-knee amputation. Which nursing intervention should the nurse implement? 1. Assess the client's nutritional status .2. Refer the client to an occupational therapist. 3. Determine if the client is allergic to IVP dye. 4. Start a 22-gauge Angiocath in the right arm.

1. Assess the client's nutritional status

The client is taken to the emergency department with an injury to the left arm. Which intervention should the nurse implement first? 1. Assess the nailbeds for capillary refill time. 2. Remove the client's clothing from the arm. 3. Call radiology for a STAT x-ray of the extremity. 4. Prepare the client for the application of a cast.

1. Assess the nailbeds for capillary refill time.

The 32-year-old male client with a traumatic left AKA is being discharged from the rehabilitation department. Which discharge instructions should be included in the teaching? Select all that apply. 1. Report any pain not relieved with analgesics. 2. Eat a well-balanced diet and increase protein intake. 3. Be sure to attend all outpatient rehabilitation appointments. 4. Encourage the client to attend a support group for amputations. 5. Stay at home as much as possible for the first couple of months.

1. Report any pain not relieved with analgesics. 2. Eat a well-balanced diet and increase protein intake. 3. Be sure to attend all outpatient rehabilitation appointments. 4. Encourage the client to attend a support group for amputations.

The nurse is caring for a client with a right below-the-knee amputation. There is a large amount of bright red blood on the client's residual limb dressing. Which intervention should the nurse implement first? 1. Notify the client's surgeon immediately. 2. Assess the client's blood pressure and pulse. 3. Reinforce the dressing with additional dressing. 4. Check the client's last hemoglobin and hematocrit levels.

2. Assess the client's blood pressure and pulse.

The client admitted with a diagnosis of a fractured hip who is in Buck's traction is complaining of severe pain. Which intervention should the nurse implement? 1. Adjust the patient-controlled analgesia (PCA) machine for a lower dose. 2. Ensure the weights of the Buck's traction are off the floor and hang freely. 3. Raise the head of the bed to 45 degrees and the foot to 15 degrees. 4. Turn the client on the affected leg using pillows to support the other leg.

2. Ensure the weights of the Buck's traction are off the floor and hang freely.

A patient with a femoral fracture suddenly complains that he cannot catch his breath. His pulse is 106 bpm, and respiration is 30 breaths per minute. You notice a measles like rash on his neck and chest. You should suspect which of the following? a. Shock b. Fat embolism c. Avascular necrosis d. Compartment syndrome

b. Fat embolism

Which of the following is the main advantage of surgery over traction for older patients with hip fractures? a. Traction is more expensive because a longer hospitalization is required b. Surgery allows earlier mobilization, which results in fewer complications. c. After a few days, surgical treatment is generally less painful than traction d. Bones of older people heal better with surgery than with traction.

b. Surgery allows earlier mobilization, which results in fewer complications.

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician perform? joint manipulation and immobilization analgesia and immobilization heat and immobilization ice and immobilization

joint manipulation and immobilization