musculoskeletal part2
clients who are taking NSAIDs should be monitored for
gastrointestinal GI intolerance
a patient present to the emergency department immediately after an injury an x ray has been ordered for a suspected dislocation before confirmation bu X ray which fining support the potential diagnosis? select all
history of forceful injury severe pain aggravated by motion muscle spasm abnormal appearance of joint
the nurse suspects compartment syndrome in a patient with aq side arm cast and traction when observing which findings select all that apply
intense pain in hand and fingers edema of fingers weak radial pulse tingling and numbness
adverse effects for client with osteoporosis who take bishosphonate dugs include
kidney failure
when the clinic nurse starts to take cast off the grade 2 sprain the patient ask why it is being removed since he still has no pain which explanation is best ?
long term immobilization can cause permanet disability
a patient has come to the ambulatory care clinic with a spring the nurse correctly differentiates a grade 2 sprain from a grade 3 spring with the assessment of which finding?
minor loss of function
a client is being evaluated for carpal tunnel syndrome the nurse is observed asking the client to place the back of her hands together and flex them at the same time which assessment is the nurse performing
phalen meneuver
the two most immediate post op problems after amputation are
phantom limb pain
the nurse is performing morning care for a patient who sustained a fractured pelvis and bilateral femur fractures yesterday in a motorcycle collision the patient complains of the shortness of breath assessment reveal audible wheezes and oxgen saturation of 78%what action should the nurse take frist
raise the patient to high fowler position
A provider communicates a treatment plan to a client who has osteoarthritis. The plan includes the use of an intra-articular injection of cortisone. When the client asks about the purpose of this injection, the nurse should explain that the goal of this treatment is to
suppress local inflammation.
a nurse is reinforcing discharge teaching to a client who had a wound debridement for osteomyelitis which of the following information should the nurse reinforce ?
Antibiotic therapy should continue for 3 months.
a nurse is planning care for a client who is is postoperative following an arthroscopy of the knee which actions should the nurse take select all that apply
Asses color and temperature of the extremity place pillow under the extremity administer analgesic meds asses pules and sensation in the foot
A nurse is caring for a client who has a full arm cast and reports pain of 8 on a scale from 0 to 10 that is unrelieved by pain medication. Which of the following actions should the nurse plan to take first?
Check the circulation of the affected extremity.
a nurse is caring for a client who has a full arm cast and reports pain of 8 on a scale from 0 to 10 that is unrelieved by pain medication. which action should the nurse take?
Check the circulation of the affected extremity.
which major advantage is specific to external fixation devices ?
Greater freedom of movement
A client is complaining of skin irritation from the edges of a cast applied the previous day. The nurse should plan for which intervention?
Petaling the cast edges with adhesive tape
The nurse is evaluating the pin sites of a client in skeletal traction. The nurse would be least concerned with which finding?
Serous drainage
A nurse is collecting data from a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to find?
Swelling of all joints
the patient with oseoporosis calls the nurse in the doctors office to report that she should have taken but has forgotten to take her weekly bisphoshonate alendronate fosamax that was due 2 dasys ago how should the nurse advise theb patient
Take two tablets now with a snack."
a nurse caring for a client who is 72 hr postoperative following a above the knee amputation and reports phantom limb pain which action should the nurse take
adminsister a dose of gabapentin to the client
a nurse is caring for a client who has acute osteomyelitis what is the priority therapeutic invention for this client
antibiotic therapy
A nurse is reinforcing teaching to a client who had a wound debridement for osteomyelitis. Which of the following information should the nurse include in the teaching?
antibiotic therapy should continue for 3 months
select the most appropriate nusring assessment for the nursing diagnosis of the ineffective tissue perfusion , secondary to fractured hip.
asses digital pules
medications used treat osteoporosis include ?
bisphosphonate
a nurse in the emergency department is planning care for a client who has right hip fracture which of the. flowing immobilization devices should the nurse anticipate in the plan of care?
bucks traction
an 80 year old man falls and suffers a compound fracture of the femur which immediate action is most appropriate?
carefully splint the leg as it is
A nurse is caring for a client who has a cast in place for a fractured tibia. Of the following, which nursing action is the priority immediately after the provider has applied the cast?
checking capillary refill
a nurse is completing a neuromuscular check of a client lower extremity after surgery to reduce a fracture which parameters should the nurse include as a part of evaluating the neuromuscular status of injured leg select all that apply
color temperature sensation skin integrity
after a fracture of the forearm or tibia, complaints of sharp deep unrelenting pain in the hand or foot unrelieved by analgesics or evaluation of the extremity indicate. which compilation?
compartment syndrome
which client would be at greatest risk for fat emboli following a fracture ?
a 21 year old man with fractured femur
the nurse should watch for signs of potential complication in a young adult patient with a fractured femur with internal fixation and a long leg cast such leg cast such as
pulmonary fat embolism
the nurse is caring for a patient who just returned from surgical decompression of the carpal tunnel which finding requires the nurse immediate acton ?
the capilary refill time is 6 seconds
A client has a first-degree ankle sprain. Which of the following interventions should the nurse reinforce immediately after the injury?
-Elevate ankle above the heart
The nurse is assuming immediate postoperative care of a 23 y.o. pt who had carpal tunnel repair. ON receiving the pt, what is the priority nursing assessment?
Color, warmth, and capillary refill
he nurse is caring for the client who has had skeletal traction applied to the left leg. The client is complaining of severe left leg pain. Which action should the nurse take first?
Check the client's alignment in bed.
a client is being discharged afrer application of a plaster leg cast the nurse determines that the client understands proper care of the cast if the client makes which statement?
I need to avoid getting the cast wet."
The nurse is caring for a patient with osteoporosis who is being discharged on alendronate (Fosamax). Which statement would indicate effective teaching?
I should remain in an upright position for 30 minutes after taking the medication"
The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured. Which action is the priority?
Immobilize the leg before moving the client.
the nurse is one of several people who witness a vehicle hit a pedestrian at fairly low speed on a small street the individual is dazed and tries to get up and the leg appears fractured the nurse would plan to perform which action
Stay with the person & encourage the person to remain still
a nurse is assessing a client who has a casted compound fracture of the femur which finding is a manifestation of a fat embolus
altered mental status
an older adult has fallen and sprained his ankle in a local park which action should the responder perform first?
elevate the foot
after sustaining a rotator cuff tear a patient arm is placed in a sling the patient is instructed to rest and to take ibuprofen motrin for pain which patient statement indicates a need a need for further teaching?
i need to rest in bed for next 2 days
which statement indicates that the patient needs further instruction about application of ice to a sprain?
i will keep ice on this knee for the rest of the day
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 has elevated the limb, applied an ice bag and administered an analgesic which was ineffective in relieving the pain the nurse interprets that this pain may be cauesd by which condition?
impaired tissue perfusion
a nurse is reinforcing dietary about calcium rich foods to a client who has osteoporosis which food should the nurse include in the instructions ?
kale
client who are taking NSAIDs should be monitored for ?
kidneys
a difference in the postoperative care a patient with a knee replacement compared with a patient with a hip replacement
less chance of developing deep vein thrombosis
a client who has had rheumatoid arthrits for 3 years report increasing pain and stiffness in her hands especially in the morning oh physical examination the nurse in the clinic should expect which finding
low grade fever
a patient in traction for a fracture of the tibia complains of incresed swelling at the fracture site the nurse assesses a temp of 102degrees f with chills and increased swelling which complication do these finding suggest?
osteomyelitis
a nurse is reviewing the heath record of a client whois to undergo total joint arthroplasty. the nurse should recognize which of the flowing finding as a contraindication to this procedure ?
pneumonia 2 weeks ago
a nurse is caring patient who has rheumatoid arthritis who is taking asprin bufferin 650 mg every 4 hours which diagnostic test should the nusre monitor to evaluate the effectiveness of this medication ?
Erythrocyte sedimentation rate (ESR)
the nurse is caring for client with a fresh application of a plaster leg cast the nurse would plan to prevent the development of compartment syndrom by which action ?
Elevating the limb and applying ice to the affected leg
A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?
White blood cell (WBC) count
a provider communicate a treatment plan to client who has osteoarthritis. the plan includes the use of an intra articular injection of cortisone. when the client asks about the purpose of this injection the nurse should explain that the goal of this treatment is to
suppress local inflammation.
a client is being evaluated for carpal tunnal syndrome. the nurse is observed asking the client to place the back of her hands together and flex them at the same time which assessment is the nurse performing ?
the Phalen's test.
a nurse is caring for a client with gout which laboratory value should the nurse monitor fir in the client
uric acid