Musculoskeletal Trauma Prep U

A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate?

"Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury."

A 14-year-old client is treated in the emergency room for an acute knee sprain sustained during a soccer game. The nurse reviews discharge instructions with the client's parent. The nurse instructs the parent that the acute inflammatory stage will last how long?

24-48 hrs

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?

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

An elderly client's hip joint is immobilized prior to surgery to correct a femoral head fracture. What is the nurse's priority assessment?

Signs of neurovascular compromise

Which type of cast encloses the trunk and a lower extremity?

hip spica

The nurse caring for a client, who has been treated for a hip fracture, instructs the client not to cross their legs and to have someone assist with tying their shoes. Which additional instruction should the nurse provide to client?

Do not flex the hip over 90 degrees

The nurse teaching the client with a cast about home care includes which instruction?

Dry a wet fiberglass cast thoroughly to avoid skin problems

A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain?

Elevate the affected extremity and use cold applications.

A client with a traumatic amputation of the right lower leg is refusing to look at the leg. Which action by the nurse is most appropriate?

Provide feedback on the client's strengths and available resources.

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?

Teach the client how to prevent problems caused by immobility.

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

With the leg on the affected side abducted

Which device is designed specifically to initially support and immobilize a body part in a desired position until swelling subsides?

splint

A patient sustains a fracture of the arm. When does the nurse anticipate pendulum exercise should begin?

As soon as tolerated, after a reasonable period of immobilization

Which type of fracture is one in which the skin or mucous membrane wound extends to the fractured bone?

Compound

A client comes to the emergency department and reports localized pain and swelling in the lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. What will the nurse most likely suspect?

Contusion

A physician writes a prescription to discontinue skeletal traction on an orthopedic client. The nurse should anticipate what subsequent intervention?

application of a cast

Which cleansing solution is the most effective for use in completing pin site care?

chlorhexidine

A fracture is considered pathologic when it

occurs through an area of diseased bone.

When providing discharge teaching to a client with a fractured toe, the nurse should include which instruction?

Apply ice to the fracture site.

Which is a hallmark sign of compartment syndrome?

pain

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?

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

A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?

"Keep your right leg elevated above heart level."

A patient has stepped in a hole in the yard, causing an ankle injury. The ankle is edematous and painful to palpation. How long should the nurse inform the patient that the acute inflammatory stage will last?

24-48 hrs

A patient sustains an open fracture with extensive soft tissue damage. The nurse determines that this fracture would be classified as what grade?

3

A client is treated in the emergency department for acute muscle strain in the left leg caused by trying a new exercise. During discharge preparation, the nurse should provide which instruction?

Apply ice packs for the first 24 to 48 hours, then apply heat packs."

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?

Apply a tourniquet.

The nurse is assisting with the application of a cast. What will the nurse expect to be done first?

Cleaning the skin surface.

A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?

Elevating the stump for the first 24 hours SUBMIT ANSWER

n older female client who had a total hip replacement is to be discharged because her healing is almost complete. What would be most important for this client?

Exploring factors related to the client's home environment.

A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse would most likely prepare the client for?

Fasciotomy

The femur fracture that commonly leads to avascular necrosis or nonunion because of an abundant supply of blood vessels in the area is a fracture of the:

Femoral neck.

A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor may have contributed to this complication?

Inadequate immobilization

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture?

Incomplete

A client with a fractured femur is in balanced suspension traction. The client needs to be repositioned toward the head of the bed. During repositioning, what should the nurse do?

Maintain consistent traction tension while repositioning.

A client has undergone an external fixation. Which actions would be the priority for this client?

Maintaining pin care.

After a traumatic back injury, a client requires skeletal traction. Which intervention takes priority?

Maintaining traction continuously to ensure its effectiveness

The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery?

Never cross the affected leg when seated

Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?

Open reduction

Elderly clients who fall are most at risk for which injuries?

Pelvic fractures

Which nursing intervention is essential in caring for a client with compartment syndrome?

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

Which is an inaccurate principle of traction?

Skeletal traction is interrupted to turn and reposition the client.

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.

A client who has fallen and injured a hip cannot place weight on the leg and is in significant pain. After radiographs indicate intact but malpositioned bones, what would the physician diagnose?

dislocation

A client with a right leg fracture is returning to the orthopedist to have the cast removed. What would the physician prescribe as further treatment?

physical therapy

The nurse is caring for a patient postoperatively following orthopedic surgery. The nurse assesses an oxygen saturation of 89%, confusion, and a rash on the upper torso. What does the nurse suspect is occurring with this patient?

Fat emboli syndrome

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?

Fat embolism syndrome

Which assessment findings would the nurse expect to find in the postoperative client experiencing fat embolism syndrome?

HR- 116 RR- 32 pH- 7.5 CO2- 30 HCO3- 24 PaO2- 55 (<60) fever, hypoxia, Respiratory Alkalosis->Acidosis

The nurse is monitoring a patient who sustained an open fracture of the left hip. What type of shock should the nurse be aware can occur with this type of injury?

Hypovolemic

Which factor inhibits fracture healing?

Local malignancy

A nurse is caring for a client who is recovering in the hospital following orthopedic surgery. The nurse is performing frequent assessments for signs and symptoms of infection in the knowledge that the client faces a high risk of what infectious complication?

Osteomyelitis

The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed?

The skin may be covered with a yellowish crust that will shed in a few days.

Which may occur if a client experiences compartment syndrome in an upper extremity?

Volkmann's contracture- a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm

A client with a fractured distal left radius reports discomfort at the cast site, with pain specifically in the upper forearm. What would the nurse expect the physician to do?

Cut a cast window.