Week 13: ortho

Which of the following common problems of the upper extremities, results from entrapment of the median nerve at the wrist? a. Carpal tunnel syndrome b. Impingement syndrome c. Dupuytren's contracture d. Ganglion disease

A- carpal tunnel syndrome

A soccer player fell awkwardly, which resulted in a tear to the anterior cruciate ligament (ACL). The school nurse will anticipate the player to exhibit which clinical manifestations? Select all that apply. a. Edema of the knee b. Intense pain c. Large hematoma on the anterior knee surface d. Immovable knee joint e. Abscess formation

A. Edema (swelling) of the knee and B. Intense pain

The nurse is caring for a patient with osteoporosis who is being discharged on alendronate (Fosamax). Which statement would indicate effective teaching? A. "I should take the medication immediately before bed" B. "I should remain in an upright position for 30 minutes after taking the medication" C. "The medication is more effective if I take it with milk or dairy products" D. If I skip a dose, I can take two tablets the next time"

Answer: B -is a bisphosphonate, is a potent inhibitor of bone resorption that preserves bone mass and increases bone density. Bisphosphonates are administered on arising in the morning with a full glass of water on an empty stomach, and the patient must stay upright for 30 to 60 minutes. Esophagitis and esophageal ulcers have been reported with use of all of the bisphosphonates, staying upright helps to prevent this

The nurse is explaining the use of a splint for an ulnar fracture. Which information should be​ included? (Select all that​ apply.) A. At greater risk for compartment syndrome B. May be used as a temporary measure until a cast can be applied C. Easily removed if needed D. Can be adjusted if swelling occurs E. Allows some movement of the joint

Answer: B, C, D, E ​Rationale: A splint provides less support than a cast does but may be used as a temporary measure before a cast is applied​ (to stabilize bone until swelling has​ subsided) and can easily be adjusted to accommodate swelling and prevent compartment syndrome. Splints do allow some movement of the joint and so may also be used during the reparative phase of healing.

Which statement by the nurse describes a comminuted fracture to the​ client? A. The ends of the broken bones are forced​ together." B. The bone is breaking through the​ skin." C. The bone is broken into many​ pieces." D. A fragment of the bone is separated from the rest of the​ bone."

Answer: C​ Rationale: In a comminuted​ fracture, the bone is broken into many pieces. The bone fragments may cause further injury or complications. An open or compound fracture involves bone breaking through the skin. An avulsion fracture involves a fragment of bone being separated from the rest of the bone. In an impacted or buckle​ fracture, the ends of the broken bones are forced together.

The nurse is caring for a client who develops compartment syndrome from a severely fractured arm. The client asks the nurse how this can happen. The nurse's response is based on the understanding that: a. A bone fragment has injured the nerve supply in the area b. An injured artery causes impaired arterial perfusion through the compartment c. Bleeding and swelling cause increased pressure in an area that cannot expand d. The fascia expands with injury, causing pressure on underlying nerves and muscles

C. Bleeding and swelling cause increased pressure in an area that cannot expand. Compartment syndrome is caused by bleeding and swelling within a compartment, which is lined by fascia that does not expand. The bleeding and swelling place pressure on the nerves, muscles, and blood vessels in the compartment, triggering the symptoms.

A nurse is caring for a 5-year-old with a fracture of the tibia involving the growth plate. When providing information to the parents, the nurse should indicate that: A. The child will never be able to play contact sports. B. The fracture usually heals within 6 weeks without further complications. C. This is a serious injury that could cause long-term growth issues. D. Fractures involving the growth plate require pain medication.

C. This is a serious injury that could cause long-term growth issues.

A patient in the emergency department is diagnosed with a patellar dislocation. The initial patient teaching by the nurse will focus on the need for a.conscious sedation. b.a knee immobilizer. c.gentle knee flexion. d.cast application.

Correct Answer: A Rationale: The first goal of collaborative management is realignment of the knee to its original anatomic position, which will require anesthesia or conscious sedation. Immobilization of the joint will be done after realignment. Later, gentle ROM exercises may be started if the joint is stable. Casting is not usually required for dislocations.

A 5 year old has a fracture of the right upper arm. The x-ray showed that one side of the bone is bent while the other is broken. This known as a __________ fracture? A. Spiral B. Greenstick C. Oblique D. Transverse

The answer is B. This is a greenstick fracture. These types of fractures are more common in the pediatric population because their bones tend to be more flexible and the periosteum is stronger than an adult

A patient sustained a fracture to the femur. The patient has suddenly become confused, restless, and has a respiratory rate of 30 breaths per minute. Based on the location of fracture and the presenting symptoms, this patient may be experiencing what type of complication? A. Compartment Syndrome B. Osteomyelitis C. Fat embolism D. Hypovolemia

The answer is C. Patients who experience a fracture of the long bones (such as the femur) are at risk for a fat embolism. The patient will become confused and restless along with an abnormal respiratory status.

What are important red flags that would increase the suspicion of child abuse? SATA a. Bruises on the legs, particularly the knees b. Severity of the injury is more than what they came in for c. history of injury does not fit the childs development level d. caretaker shows too much concern or not enough concern

b, c, d

While horseback riding a patient fell from the hose sustaining a pelvic fracture. What complications should the nurse know to monitor for that are common to pelvic fractures? A. Paresthesia and ischemia B. Hemorrhage and shock C. Paralytic ileus and a lacerated urethra D. Thrombophlebitis and infection

b- due to femoral artery and vein being close to pelvis

What type of injury would you be most concerned about for radial nerve palsy? a. femoral fracture b. humerus fracture c. Scaphoid fracture d. 5th metacarpal fracture

b- humerus fracture has high incidence of radial nerve palsy, would need to test above and below place of injury for sensation

The nurse is caring for a client with a fractured fibula. Which assessment prompts immediate action by the nurse? a. Reported pain of 4 on a scale of 0 to 10 b. Numbness and tingling in the extremity c. Swollen extremity where the injury occurred d. Reports of being cold in bed

b. Numbness and tingling in extremity The client with numbness and tingling of the extremity may be displaying the first signs of acute compartment syndrome. This is an acute problem that requires immediate intervention because of possible decreased circulation. Moderate pain and swelling is an expected assessment after a fracture. These findings can be treated with comfort measures. Being cold can be treated with additional blankets or by increasing the temperature of the room.