Chapter 40 PrepU - Musculoskeletal Care Modalities
A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?
A splint is applied when more swelling is expected at the site of injury
A client has a cast applied to the leg for treatment of a tibia fracture and also has a wound on the leg that requires dressing changes due to drainage. For what should the nurse prepare the client?
Cutting a cast window
Which is an inappropriate use of traction?
Decrease space between opposing structures
A hip spica cast:
Encloses the trunk and a lower extremity
To reduce the incidence of complications in a client in traction, which intervention should be included in the care plan?
Increase fiber intake
The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is:
Risk for ineffective therapeutic regimen management
Which is an inaccurate principle of traction?
Skeletal traction is interrupted to turn and reposition the client
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
A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?
Total arthroplasty
The nurse is checking the traction apparatus for a client in skin traction. Which finding would require the nurse to intervene?
Weights hanging and touching the floor
A group of students are reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite which of the following as an advantage of a plaster cast?
Better molding to the client
Following a total knee replacement, the surgeon orders a continuous passive motion (CPM) device. The client asks about the purpose of this treatment. What is the best response by the nurse?
CPM increases range of motion of the joint
A patient has a cast removed after bone healing takes place. What should the nurse instruct the patient to do after removal?
Control swelling with elastic bandages, as directed Gradually resume activities and exercise Apply an emollient lotion to soften the skin
Which would be contraindicated as a component of self-care activities for the client with a cast?
Cover the cast with plastic to insulate it
A client sustained a stable fracture of the cervical spine and is having skeletal traction applied. What type of traction does the nurse educate the client about?
Crutchfield tongs
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
A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?
Gauntlet cast
Which intervention would the nurse implement with the client in a plaster cast?
Handle wet cast with palms of hands Trim, reshape, and smooth edges of cast
A patient in pelvic traction needs circulatory status assessed. How should the nurse assess for a positive Homans' sign?
Have the patient extend each leg and dorsiflex each foot to determine if pain or tenderness is present in the lower leg
A client has just undergone a leg amputation. What will the nurse closely monitor the client for during the immediate postoperative period?
Hematoma
The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?
Metal pins will go through my skin to the bone
The nurse assesses a client after total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse?
Notify the health care provider
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
Obtaining a culture
A patient has a long leg cast applied. Where does the nurse understand a common pressure problem may occur?
Peroneal nerve
Which instruction should the nurse include when teaching the client following hip replacement surgery?
Place pillows between your legs when you lay on your side Avoid bending forwards when sitting in a chair Use a raised toilet seat and high-seated chair
A client presents at the emergency department with a compound fracture of the right femur. Skeletal traction is applied to align the bones. What type of traction would be used?
Steinmann traction
Which statement is accurate regarding care of a plaster cast?
The cast can be dented while it is damp
Which is not a guideline for avoiding hip dislocation after replacement surgery.
The hip may be flexed to put o clothing such as pants, stockings, socks, or shoes
Arthrodesis is:
fusion of a joint (most often the wrist of knee) for stabilization and pain relief
