musculoskeletal prep u
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 -Unrelieved pain can be an indicator of a complication, such as compartment syndrome.
After undergoing surgery the previous day for a total knee replacement, a client states, "I am not ready to ambulate yet." What should the nurse do?
Discuss the complications that the client may experience if there is lack of cooperation with the care plan
What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast?
Educate the client on cast care and complications
A client is reporting pain following orthopedic surgery. Which intervention will help relieve pain?
Elevate the affected extremity and use cold applications.
A 68-year-old female client who had a total hip replacement is to be discharged because her healing is almost complete. Which of the following would be most important for this client?
Exploring factors related to the client's home environment
The client with a fractured femur is upset and agitated that skeletal traction will be necessary for 6 to 8 weeks. The client states, "How can I stay like this for weeks? I can't even move!" Based on these statements, the nurse would identify which of the following as the most appropriate nursing diagnosis?
Ineffective Coping related to prolonged immobility
Which is a benefit of a continuous passive motion (CPM) device when applied after knee surgery?
It promotes healing by increasing circulation and movement of the knee joint
A nurse is caring for a client who recently underwent a total hip replacement. What is the best action by the nurse for client care?
Limit hip flexion of the client's hip when the client sits up
A client has undergone an external fixation. Which actions would be the priority for this client?
Maintaining pin care
A client's fracture was reduced by surgically exposing the bone and realigning it. What type of treatment does the nurse identity this as?
Open reduction
Which orthopedic surgery is done to correct and align a fracture after surgical dissection and exposure of the fracture?
Open reduction
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
Which nursing assessment finding indicates the client with traction has not met expected outcomes?
Right calf warm and swollen
A client is about to have a cast applied to the left arm. What will nurse alert the client to as the cast is applied?
Sensation of warmth or heat with application
Which statement is accurate regarding care of a plaster cast?
The cast can be dented while it is damp.
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
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 client who is undergoing skeletal traction reports pressure on bony areas. Which action would be most appropriate to provide comfort for the client?
Changing the client's position within prescribed limits
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
Which action would be most important postoperatively for a client who has had a knee or hip replacement?
Assisting in early ambulation.
The client displays manifestations of compartment syndrome. What treatment will the nurse expect the client to be scheduled for?
A fasciotomy
The nurse is assigned to care for a client who has had an open reduction and internal fixation of a fractured right femur 2 days ago. The nurse is listening to the client's lungs and, when moving the gown, observes petechial hemorrhages on the skin of the chest. What is the first action by the nurse?
Call the physician to inform them of the findings
An older female client who had a total hip replacement is to be discharged because her healing is almost complete. What would be most important for this client
Exploring factors related to the client's home environment
The nurse is caring for a client who lives alone and had a total knee replacement. An appropriate nursing diagnosis for the client is:
Risk for ineffective therapeutic regimen management
A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first?
"My toes are stiff." -Compartment syndrome is characterized by neurovascular compromise. Stiffness of the toes may be a preliminary finding that the client is having trouble with motor function.
A client diagnosed with a right ulnar fracture asks why the cast needs to go all the way up the arm. What is the best response by the nurse?
"The joint above the fracture and below the fracture must be immobilized."
A client is seen in the emergency department for an injury acquired from falling off of a bicycle and fracturing the arm. The client also has a long laceration that has been sutured in the same area. The client asks the nurse why a splint is applied and not a cast. What is the best explanation by the nurse?
"We will need to monitor the status of the laceration to be sure it does not get infected."
The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?
Crackles in the lung bases -Crackles in the lung bases can be an indicator that the client has developed pneumonia from shallow respirations. The blood pressure is high but may be due to pain. It is expected that the client will have pain in the rib area when taking deep breaths. A heart rate of 94 beats/minuteis within normal range
The client returns to the nursing unit following an open reduction with internal fixation of the right hip. Nursing assessment findings include temperature 100.8 degrees Farenheit, heart rate 112 beats per minute, respiratory rate 28 breaths per minute, and blood pressure 86/58. There is no urine in the Foley catheter collection bag. The nurse interprets these findings as indicating which complication?
Hypovolemic shock
The nurse assesses a clientafter total right hip arthroplasty and observes a shortening of the extremity. The client reports severe pain in the right side of the groin. What is the priority action of the nurse?
Notify the health care provider
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
Obtaining a culture -A culture should be obtained if purulent drainage is present. Drainage should be gently removed, not scrubbed. Iodine-based products interfere with tissue healing and are not recommended for cleaning pin sites. Ointment should not be applied to the pin site unless specifically ordered.
A client is brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
Right shoulder slopes downward and droops inward
The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed?
The skin may be covered with a yellowish crust that will shed in a few days.
The nurse teaches the client which intervention to avoid hip dislocation after replacement surgery?
Never cross the affected leg when seated
A client's cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem?
Apply lotions and take warm baths or soaks.
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