Lewis Chapter 64: Nursing Management: Musculoskeletal Problems

7. A 39-year-old patient whose work involves frequent lifting has a history of chronic back pain. After the nurse has taught the patient about correct body mechanics, which patient statement indicates that the teaching has been effective?

"I will begin doing exercises to strengthen the muscles of my back."

5. A 23-year-old patient with a history of muscular dystrophy is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

.Assist the patient with ambulation.

6. An appropriate nursing intervention for a patient who has acute low back pain and muscle spasms is to teach the patient to

.keep the head elevated slightly and flex the knees when resting in bed.

20. Which action will the nurse take first when a patient is seen in the outpatient clinic with neck pain?

Ask about numbness or tingling of the hands and arms.

2. Which information will the nurse include when teaching a patient with acute low back pain (select all that apply)? a. Sleep in a prone position with the legs extended. b. Keep the knees straight when leaning forward to pick something up. c. Avoid activities that require twisting of the back or prolonged sitting. d. Symptoms of acute low back pain frequently improve in a few weeks. e. Ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) can be used to relieve pain.

Avoid activities that require twisting of the back or prolonged sitting. Symptoms of acute low back pain frequently improve in a few weeks. Ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) can be used to relieve pain.

2. A 50-year-old patient is being discharged after a week of IV antibiotic therapy for acute osteomyelitis in the right leg. Which information will be included in the discharge teaching?

How to monitor and care for the long-term IV catheter

4. The nurse instructs a patient who has osteosarcoma of the tibia about a scheduled above-the-knee amputation. Which statement by a patient indicates that additional patient teaching is needed?

I did not have this bone cancer until my leg broke a week ago."

1. A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention will be included in the initial plan of care?

Immobilization of the left leg

18. Which nursing action included in the care of a patient after laminectomy can the nurse delegate to experienced unlicensed assistive personnel (UAP)?

Log roll the patient from side to side every 2 hours.

1. Which actions will the nurse include in the plan of care when caring for a patient with metastatic bone cancer of the left femur (select all that apply)? a. Monitor serum calcium level. b. teach about the need for strict bed rest. c. Avoid use of sustained-release opioids for pain. d. Support the left leg when repositioning the patient. e. Support family as they discuss the prognosis of patient

Monitor serum calcium level. Support the left leg when repositioning the patient. Support family as they discuss the prognosis of patient

12. Which menu choice by a patient with osteoporosis indicates that the nurse's teaching about appropriate diet has been effective?

Oatmeal with skim milk and fruit yogurt

21. A nurse who works on the orthopedic unit has just received the change-of-shift report. Which patient should the nurse assess first?

Patient who has not voided 10 hours after having a laminectomy

14. Which action should the nurse take before administering gentamicin (Garamycin) to a patient who has acute osteomyelitis?

Review the patient's creatinine level.

19. Which action will the nurse take when caring for a patient with osteomalacia?

Teach about the use of vitamin D supplements.

15. Which assessment finding for a patient who has had a surgical reduction of an open fracture of the right radius is most important to report to the health care provider?

Temperature 101.4° F (38.6°

10. An assessment finding for a 55-year-old patient that alerts the nurse to the presence of osteoporosis is

a measurable loss of height.

17. When administering alendronate (Fosamax) to a patient with osteoporosis, the nurse will

assist the patient to sit up at the bedside.

11. A 54-year-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia following densitometry testing. In teaching the woman about her osteoporosis, the nurse explains that

calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

16. Following laminectomy with a spinal fusion to treat a herniated disc, a patient reports numbness and tingling of the right lower leg. The first action that the nurse should take is to

check the chart for preoperative assessment data.

3. A 67-year-old patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur. The nurse chooses a nursing diagnosis of ineffective health maintenance when the nurse finds that the patient

is unable to plantar flex the foot on the affected side

9. The nurse will determine that more teaching is needed if a patient with discomfort from a bunion says, "I will

only wear sandals, no closed-toe shoes."

13. The nurse evaluating effectiveness of prescribed calcitonin (Cibacalcin) and ibandronate (Boniva) for a patient with Paget's disease will consider the patient's

pain level.

8. The nurse should reposition the patient who has just had a laminectomy and diskectomy by

placing a pillow between the patient's legs and turning the entire body as a unit.