Chapter 61

Which statement is accurate regarding care of a plaster cast?

The cast can be dented while it is damp.

A client is reporting pain in her casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. The nurse should identify the warning signs of what complication?

Compartment syndrome

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

Open reduction

A nurse is planning the care of a client who will require a prolonged course of skeletal traction. When planning this client's care, the nurse should prioritize interventions related to what risk nursing diagnosis?

Risk for Impaired Skin Integrity

A patient arrives in the emergency department with a suspected bone fracture of the right arm. How does the nurse expect the patient to describe the pain?

Sharp and piercing

A nurse is caring for a client who has had a plaster arm cast applied. Immediately postapplication, the nurse should provide what teaching to the client?

The cast will only have full strength when dry.

The nurse is helping to set up Buck's traction on an orthopedic client. How often should the nurse assess circulation to the affected leg?

Within 30 minutes, then every 1 to 2 hours

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

A nurse is caring for a client who is in skeletal traction. To prevent the complication of skin breakdown in a client with skeletal traction, what action should be included in the plan of care?

Assess the pin insertion site every 8 hours

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 nurse is planning the care of a client who has undergone orthopedic surgery. What main goal should guide the nurse's choice of interventions?

Improving the client's level of function

A nurse is caring for a patient who is postoperative day 1 right hip replacement. How should the nurse position the patient?

Keep the client's hips in abduction at all times.

The nurse is caring for a patient who had a total hip replacement. What lethal postoperative complication should the nurse closely monitor for?

Pulmonary embolism

A client was brought to the emergency department after a fall. The client is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize?

"Make sure you don't bring your knees close together."

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."

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

Splint

The orthopedic surgeon has prescribed balanced skeletal traction for a client. What advantage is conferred by balanced traction?

Balanced traction allows for greater client movement and independence than other forms of traction.

A nurse is reviewing a client's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?

Bending down to put on socks

The nurse is caring for a client who underwent a total hip replacement yesterday. What should the nurse do to prevent dislocation of the new prosthesis?

Protect the affected leg from internal rotation.

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."

A nurse is providing discharge education to a client who is going home with a cast on his leg. What topic should the nurse emphasize in the teaching session?

Reporting signs of impaired circulation

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 nurse is assessing the neurovascular status of a client who has had a leg cast recently applied. The nurse is unable to palpate the client's dorsalis pedis or posterior tibial pulse and the client's foot is pale. What is the nurse's most appropriate action?

Promptly inform the primary provider.

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

Application of a cast