Musculoskeletal Disorders

A client undergoes a total hip replacement. Which statement made by the client indicates to the nurse that the client requires further teaching?

"I don't know if I'll be able to get off that low toilet seat at home by myself."

A nurse is performing an admission assessment on a client admitted with a pelvic fracture. Which statement by the client requires the nurse to seek more information from a legal standpoint?

"Sometimes my spouse gets so angry with me."

A nurse is caring for a client who complains of lower back pain. Which instruction should the nurse give to the client to prevent back injury?

"Stand close to the object you're lifting."

A client recovering from hip replacement surgery questions the need for admission to a rehabilitation center because there are family members available at home to provide care. Which response by the nurse is best?

"The rehabilitation staff can evaluate your progress and help you recover without risking injury."

On the evening of surgery for total knee replacement, a client wants to get out of bed. What should the nurse do to safely assist the client?

Apply a knee immobilizer.

Four hours after a cast has been applied for a fractured ulna, the nurse assesses that the client's fingers are pale and cool and capillary refill is delayed for 4 seconds. How should the nurse interpret these findings?

Arterial blood supply to the fingers is decreased.

A client with a broken ulna reports having pain in the casted arm that is unrelieved by pain medication. The nurse assesses the arm and notes that the fingers are swollen and difficult to separate. What should the nurse do first?

Call the health care provider (HCP) to report swelling and pain.

A client is brought to the emergency department with a painful swollen ankle. What is the nurse's most appropriate action?

Elevate the ankle.

A client who has been diagnosed with osteoarthritis asks if they will eventually begin to notice deformities in their hands and fingers as the condition progresses. Which concept should the nurse include in the response?

Hand and finger deformities are associated with the development of rheumatoid arthritis.

A client is being discharged following an open reduction and internal fixation of the left ankle, and is to wear a non-weight-bearing cast for 2 weeks. What should the nurse teach the client to do when using crutches?

Maintain two to three finger widths between the axillary fold and underarm piece grip.

After a person experiences a closure of the epiphyses, which statement is true?

No further increase in bone length occurs.

The nurse is teaching a client with osteoporosis about optimal dietary choices to reduce the severity of the condition. What instruction should the nurse provide?

Prevent effects of immobility while in traction.

When caring for a client with acute osteomyelitis in the right tibia, which measure is most appropriate to implement when repositioning the client's leg?

Support the leg above and below the affected area when positioning.

The nurse is evaluating a client in skin traction. Which observation indicates the traction is applied for maximum effectiveness?

The ropes are in the wheel grooves of the pulleys.

The nurse is caring for a client with a fractured fibula who has skeletal traction and skeletal pins. What would the nurse instruct the unlicensed assistive personnel (UAP) to report immediately?

The traction weights are resting on the floor.

Two days after surgery to amputate their left lower leg, a client states that they have pain in the missing extremity. Which action by the nurse is most appropriate?

administer medication, as ordered, for the reported discomfort.

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

administering ordered analgesics and monitoring their effects

A nurse is caring for a client placed in traction to treat a fractured femur. Which nursing intervention has the highest priority?

assessing the extremity for neurovascular integrity

Following a total joint replacement, which complication has the greatest likelihood of occurring?

deep vein thrombosis (DVT)

The nurse should instruct a client who is using crutches to bear weight primarily on which part of the body?

hands

A client who has skeletal traction to stabilize a fractured femur has not had a bowel movement for 2 days. The nurse should:

increase the client's fluid intake to 3,000 mL/day.

A nurse notes that a client has kyphosis and generalized muscle atrophy. Which problem is a priority when the nurse develops a nursing plan of care?

ineffective coughing and deep breathing

A nurse is developing a teaching plan for a client diagnosed with osteoarthritis. To minimize injury to the osteoarthritic client, the nurse should instruct the client to

install safety devices in the home.

After a right total knee replacement, the client's right leg is placed in a continuous passive motion (CPM) machine. Nursing responsibilities when caring for a client with this apparatus should include:

maintaining proper positioning of the leg on the CPM machine.

When assessing an older adult as a candidate for crutch walking, the nurse should take into account that for some elderly people, crutch walking is an impractical goal primarily because of decreased:

motor coordination.

A diet plan is developed for a client with gouty arthritis. The nurse should advise the client to limit his intake of

organ meats.

The client with an open femoral fracture was discharged to home and reports having a fever, night sweats, chills, restlessness, and restrictive movement of the fractured leg. The nurse should interpret these findings as the client may be experiencing which complication?

osteomyelitis

The client sustained a tibia fracture and a cast was applied. The client is reporting increasing pain when flexing toes. Which symptoms does the nurse assess as associated with compartment syndrome? Select all that apply.

paresthesia pain pulselessness

The nurse is teaching a client with osteoporosis about taking alendronate sodium. The nurse emphasizes that the client is to take the medication:

with a full glass of water and remain upright for 30 minutes.

After surgery to treat a hip fracture, a client returns from the postanesthesia care unit to the medical-surgical unit. Postoperatively, how should the nurse position the client?

with the leg on the affected side abducted