Musculoskeletal Med surg

-Checking the urine for hematuria -Palpating peripheral pulses in both lower extremities -Testing the stool for occult blood

The nurse is caring for a patient with a pelvic fracture. What nursing assessment for a pelvic fracture should be included? (Select all that apply.)

Peroneal

The nurse is conducting a musculoskeletal assessment of a client in a nursing home. The client is unable to dorsiflex the right foot or extend the toes. The nurse evaluates this finding as an injury to which nerve?

"We need an adequate amount of exposure to sunshine."

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement?

Pale, cyanotic, or mottled color Cool temperature of the extremity More than 3-second capillary refill

The nurse is performing an assessment for a patient who may have peripheral neurovascular dysfunction. What signs does the patient present with that indicate circulation is impaired? (Select all that apply.)

Humerus

The orthopedic nurse should assess for signs and symptoms of Volkmann contracture if a client has fractured which of the following bones?

Elevate the affected area.

The primary nursing intervention that will control swelling while treating a musculoskeletal injury is:

Hemorrhage

Which factor may contribute to compartment syndrome?

-Pneumonia -Skin breakdown -Sepsis -Delirium

A 75-year-old client had surgery for a left hip fracture yesterday. When completing the plan of care, the nurse should include assessment for which complications? Select all that apply.

Support the affected extremity with external supports such as splints.

A nurse is caring for a client with a bone tumor. The nurse is providing education to help the client reduce the risk for pathologic fractures. What should the nurse teach the client?

Stress on the weakened bone must be avoided.

A nurse is collaborating with the physical therapist to plan the care of a client with osteomyelitis. What principle should guide the management of activity and mobility in this client?

Regular bone density testing A high-calcium diet Use of falls prevention precautions Weight-bearing exercise

A nurse is planning the care of an older adult client who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage what actions? Select all that apply.

Type and crossmatch

A nurse is reviewing a client's laboratory results. Which laboratory study is most relevant to treating a client who has sustained a pelvic fracture?

-Petechiae on the chest -Substernal chest pain -Hypoxia

A nurse suspects a client has a fat embolism after a femur fracture. What are the significant client signs and symptoms to support the suspicion of the nurse? Select all that apply.

-Pain -Erythema -Fever

A patient is diagnosed with osteomyelitis of the right leg. What signs and symptoms does the nurse recognize that are associated with this diagnosis? (Select all that apply.)

Covering the area with a clean dressing if the fracture is open Immobilizing the affected site Splinting the injured limb

A patient sustains an open fracture of the left arm after an accident at the roller skating rink. What does emergency management of this fracture involve? (Select all that apply.)

There is a deficiency of activated vitamin D (calcitriol). Calcium and phosphate are not moved to the bones. The bone mass is structurally weaker, and bone deformities occur.

Identify descriptors of the pathophysiologic process seen in osteomalacia. Select all that apply.

Elastic compression bandages

The health care provider is preparing to bivalve the client's cast. Which supplies should the nurse assemble?

Shortened, adducted, and externally rotated

What assessment findings of the leg are consistent with a fracture of the femoral neck?

Osteomalacia

Which condition is a metabolic bone disease characterized by inadequate mineralization of bone?

-NSAIDs -activity modification and joint rest -arthroscopic surgery

A client has been diagnosed with a rotator cuff tear. What are the options for treating this condition? Select all that apply.

Electrical stimulation

A client has delayed bone healing in a fractured right humerus. What should the nurse prepare the client for that promotes bone growth?

Administer oxygen.

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first?

-"I cannot seem to catch my breath." -"I have a pins-and-needles sensation in my toes." -Dorsiplantar weak and unequal bilaterally -T 101.2 degrees F; HR 110; RR 28; pulse oximetry 90%

A client with a fractured femur is admitted to the nursing unit. Which assessment finding requires follow up by the nurse? Select all that apply.

Ensure that a large tourniquet is in the room.

A client with a right below-the-knee amputation is being transferred from the postanesthesia care unit to a medical-surgical unit. What is the highest priority nursing intervention by the receiving nurse?

-Prepare to remove the cast. -Provide support to the injured extremity.

A client with a short arm cast is suspected to have compartment syndrome. What actions should the nurse include in the plan of care? Select all that apply.

-Assess the fingers for color and temperature. -Assess for a pressure sore -Determine the exact site of the pain.

A client with an arm cast reports pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? Select all that apply.

Hypothyroidism

A group of students are reviewing information about osteoporosis in preparation for a class discussion. The students demonstrate a need for additional review when they state which of the following as a risk factor?

An elevated serum alkaline phosphatase level and a normal serum calcium level

A nurse is caring for a client with Paget disease and is reviewing the client's most recent laboratory values. Which of the following values is most characteristic of Paget disease?

Promoting weight-bearing exercises

An older adult client with a diagnosis of left-sided stroke is admitted to the facility. To prevent the development of disuse osteoporosis, which objective is most appropriate?

Trauma, such as penetrating wounds or compound fractures Vascular insufficiency in clients with diabetes or peripheral vascular disease Surgical contamination, such as pin sites of skeletal traction

The client has just been diagnosed with osteomyelitis. What are possible causes of osteomyelitis? Select all that apply.

decreased endurance joint stiffness decreased range of motion

The nurse is admitting an older adult to a skilled nursing facility. What assessment parameters will the nurse expect to find with the musculoskeletal assessment? Select all that apply.

Calcium Vitamin D

The nurse is assessing a client for dietary factors that may influence her risk for osteoporosis. The nurse should question the client about her intake of what nutrients? Select all that apply.

"Are you wearing any jewelry?" "Have you removed your hearing aid?" "Do you have a pacemaker?"

The nurse is preparing the client with a right neck mass for magnetic resonance imaging (MRI). Which question should the nurse ask? Select all that apply.

Educate the client on cast care and complications

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast?

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

Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply.

-Absence of feeling -Capillary refill of 4 to 5 seconds -Cool skin -Pain -Weakness in motion

Which assessment findings indicate to the nurse that a client may have peripheral neurovascular dysfunction? Select all that apply.

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

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)

-Perform pin care as ordered. -Supervise the client during transfers. -Perform neurovascular assessment. -Inspect pin sites for signs of infection.

Which intervention should the nurse implement with the client who has an external fixator? Select all that apply.

Nonunion

Which of the following describes failure of the ends of a fractured bone to unite in normal alignment?

Compression

Which of the following type of fracture is associated with osteoporosis?

-Realignment of the fracture -Reduction of deformity -Minimization of muscle spasms

A client is placed in traction for a femur facture. The nurse would document which expected outcomes of traction? Select all that apply.

-"Immobilization of the fracture will promote healing by maximizing contact of bone fragments." -"Fractured bones require a good blood supply and adequate nutrition for healing." -"Weight bearing stimulates healing of the long bones of the leg, if the fracture is stabilized."

A client who has fractured the radial head asks the nurse about factors that will promote bone healing. Which statement should the nurse include when responding to the client? Select all that apply.

Explain the risks of flexion contracture to the client.

The nurse is providing care for a client who has had a below-the-knee amputation. The nurse enters the client's room and finds the client resting in bed with his residual limb supported on pillow. What is the nurse's most appropriate action?

-Deep vein thrombosis -Compartment syndrome -Fat embolism

A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until his femur can be rodded in surgery. For what early complications should the nurse monitor this client? Select all that apply.

Encouraging the client to turn from side to side and to assume a prone position

A nurse is caring for a client who had a right below-the-knee amputation (BKA). The nurse recognizes the importance of implementing measures that focus on preventing flexion contracture of the hip and maintaining proper positioning. What nursing action will best achieve these goals?

-The physician orders the amount of extension and flexion produced by the machine. -The physician orders the frequency of use of the machine. -The amount of flexion for clients with hip replacements should never exceed 30 degrees in the CPM machine.

A continuous passive motion (CPM) machine is used to promote healing and flexibility in the knee and hip joint and increase circulation to the operative area. What is true about the use of CPM? Select all that apply.