Chapter 62: Caring for Clients with Traumatic Musculoskeletal Injuries

Which client(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply.

*The client with elevated pressure within the muscles *The client with hemorrhage in the site of injury *The client with a plaster cast applied immediately after injury

A rehabilitation nurse is working with a client who has had a below-the-knee amputation. In order to determine the client's ability to be an active participant in self-care, the nurse should prioritize assessment of what variable?

The client's attitude

An elite high school football player has been diagnosed with a shoulder dislocation. The client has been treated and is eager to resume his role on his team, stating that he is not experiencing pain. What should the nurse emphasize during health education?

The importance of adhering to the prescribed treatment and rehabilitation regimen

A client has been diagnosed with a muscle strain. What does the physician mean by the term "strain"?

stretched or pulled beyond its capacity

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."

Which nursing intervention is appropriate for monitoring the client for the development of Volkmann's contracture?

Assess the radial pulse.

The nurse is assessing a client's knee. The area has a grating sensation. What would this be documented as?

Crepitus

Which factor inhibits fracture healing?

History of diabetes

A school nurse is assessing a student who was kicked in the shin during a soccer game. The area of the injury has become swollen and discolored. The triage nurse should organize care for a:

contusion.

The type of fracture described as having one side of the bone broken and the other side bent would be:

greenstick

An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?

Avascular necrosis may develop at the site if it is not promptly resolved.

A client who has undergone a lower limb amputation is preparing to be discharged home. What outcome is necessary prior to discharge?

Client can demonstrate safe use of assistive devices.

The nurse is caring for a 24-year-old female client with a right tibial fracture treated with a cast 2 hours ago. The client now reports unrelenting pain, rated as 7/10, despite taking oxycodone, and decreased sensation in the right foot. A nursing assessment reveals the right foot is cooler and paler than the left foot, with delayed capillary refill and a weak pulse. Complete the following sentence by choosing from the lists of options. Based on the nursing assessment, the priority action the nurse should take is to _____________and prepare the client for_______________

Complete the following sentence by choosing from the lists of options. Based on the nursing assessment, the priority action the nurse should take is to notify the orthopedic health care provider immediately and prepare the client for bivaling of the cast

The client with a fractured left humerus reports dyspnea and chest pain. Pulse oximetry is 88%. Temperature is 100.2 degrees Fahrenheit (38.5 degrees Centigrade); heart rate is 110 beats per minute; respiratory rate is 32 breaths per minute. The nurse suspects the client is experiencing:

Fat embolism syndrome

A nurse is preparing to discharge a client from the emergency department after receiving treatment for an ankle sprain. While providing discharge education, the nurse should encourage what action?

Keep an elastic compression bandage on the ankle.

A client undergoes open reduction with internal fixation to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

Keeping a pillow between the client's legs at all times

What nursing intervention should the nurse prioritize to facilitate healing in a client who has suffered a hip fracture?

Place a pillow between the client's legs when turning.

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 general nursing measure is used for a client with a fracture reduction?

Which general nursing measure is used for a client with a fracture reduction?

A nurse is caring for a client with an intracapsular hip fracture. Identify the area where this client's fracture occurred.

X one ball point of the bone

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 has been in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of the upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma?

immobilization

With fractures of the femoral neck, the leg is

shortened, adducted, and externally rotated.

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?

Between 24 and 48 hours

A nurse is caring for a client who has suffered a hip fracture and who will require an extended hospital stay. The nurse should ensure that the client does what action to prevent common complications associated with a hip fracture?

Increase fluid intake and perform prescribed foot exercises.

A client experienced an open fracture to the left femur during a horse-riding accident. For which complication is this client at highest risk?

Infection