Chapter 61: Caring for Clients Requiring Orthopedic Treatment

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 nurse is caring for a client who has had a total hip replacement. The nurse is reviewing health education prior to discharge. Which of the client's statements would indicate to the nurse that the client requires further teaching?

"I will need my husband to assist me in getting off the low toilet seat at home."

A client with a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide in relationship to the client's cast care?

"Keep your right leg elevated above heart level."

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."

Which statement by a staff nurse on the orthopedic floor indicates the need for further staff education?

"The client is receiving physical therapy twice per day, so the client doesn't need a continuous passive motion device."

A client with an arm cast reports pain. What nursing interventions should the nurse provide in order to reduce the incidence of complications? Select all that apply.

Assess the fingers for color and temperature. Assess for a pressure sore Determine the exact site of the pain.

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 nurse is caring for a client after stabilization of a radial fracture. Which actions by the nurse would be appropriate for the client following arm casting? Select all that apply.

Handle the cast with the palms of hands Circulate room air with a portable fan Petal and smooth the edges of the 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.

The nursing care plan for a client in traction specifies regular assessments for venous thromboembolism (VTE). When assessing a client's lower limbs, what sign or symptom is suggestive of deep vein thrombosis (DVT)?

Increased warmth of the calf

Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply.

Placing a trapeze on the bed Ensuring that the weights are hanging freely Assessing the client's alignment in the bed Frequently assessing pain level

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.

A nurse is giving instructions to a client who's going home with a leg cast. Which teaching point is most critical?

Reporting signs of impaired circulation

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.

Which statement is accurate regarding care of a plaster cast?

The cast can be dented while it is damp.

Which statement about traction pin care is incorrect?

The pin should be cleaned from the distal point inward toward the insertion site.

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 long arm cast continues to complain of unrelieved throbbing pain even after receiving opioid pain medication. Which is the priority action by the nurse?

assess for complications

A client with a lengthy history of degenerative joint disease is being seen by an orthopedic surgeon. What joints are most commonly replaced? Select all that apply.

hip knee

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 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