ortho 3

Which statement by the client who has received home care instruction following an arthroscopy of the knee indicates a need for further teaching?

"I can apply heat to my knee if it becomes uncomfortable."

A client has just had an application of a nonplaster cast. What are some of the synthetic materials used for nonplaster casts? Select all that apply.

4.Fiberglass 5.Polyester-cotton knit

The nurse is providing care to a client with this type of cast. (Refer to figure.) The nurse documents that the client has which type of cast?

A hip spica cast

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse has elevated the limb, applied an ice bag, and administered an analgesic, which was ineffective in relieving the pain. The nurse interprets that this pain may be caused by which condition?

Impaired tissue perfusion

A client with possible rib fracture has never had a chest x-ray. The nurse should tell the client which statement about the procedure?

"It is necessary to remove jewelry and any other metal objects."

The nurse has a prescription to get the client out of bed to a chair on the first postoperative day after total knee replacement. The nurse plans to do which to protect the knee joint?

Apply a knee immobilizer before getting the client up, and elevate the client's surgical leg while sitting.

A client in skeletal leg traction with an overbed frame is not allowed to turn from side to side. Which action by the nurse should be most useful in trying to provide good skin care to the client?

Asking the client to pull up on a trapeze to lift the hips off the bed

A client with a fractured femur is placed in skeletal traction. The nurse should do which to monitor for nerve injury?

Check the neurovascular status of the affected extremity.

The nurse is teaching a client about foods in the diet that could minimize the risk of osteoporosis. The nurse should encourage the client to increase intake of which food?

Cheese

this morning a client sustained a right proximal fibula and tibia fracture that was casted in a long leg plaster cast. During evening rounds, the nurse notes that the right lower extremity capillary refill is greater than 3 seconds and the toes are edematous and dusky. The client states that the pain medication is not working anymore and that the right foot feels like it is asleep. The nurse analyzes the data and determines that the client's signs/symptoms are indicative of which complication?

Compartment syndrome

A client has had skeletal traction applied to the right leg and has an overhead trapeze available for use. The nurse should monitor which area as a high-risk area for pressure and breakdown?

Left heel

The nurse is caring for the client who has skeletal traction applied to the left leg. The client complains of severe left leg pain. The nurse checks the client's alignment in bed and notes that proper alignment is maintained. Which action should the nurse take next?

Notify the registered nurse.

A client is complaining of skin irritation from the edges of a cast applied the previous day. The nurse should plan for which intervention?

Petaling the cast edges with adhesive tape

The nurse is checking the casted extremity of a client. The nurse should check for which sign indicative of infection?

Presence of a "hot spot" on the cast

A client has sustained multiple fractures in the left leg and is in skeletal traction. The nurse has obtained an overhead trapeze for the client's use to aid in bed mobility. The nurse should monitor for which high-risk area for pressure and breakdown?

Right heel

A client with type 1 diabetes mellitus has had a left above-the-knee amputation. The nurse carefully inspects the residual limb for which complication because of the history of diabetes?

Separation of wound edges

A client has been placed in Buck's extension traction. Which technique provided by the nurse will provide countertraction?

Slightly elevating the foot of the bed

The nurse is one of several people who witness a vehicle hit a pedestrian at a fairly low speed on a small street. The individual is dazed and tries to get up, and the leg appears fractured. The nurse should plan to perform which action?

Stay with the person and encourage the person to remain still.

A primary health care provider has given a prescription for dietary iron supplements to the client with osteoporosis who has an iron deficiency anemia. The nurse suggests that the client do which to enhance compliance with therapy?

Take the medication following a meal.

A client has been taught to use a walker to aid in mobility following internal fixation of a hip fracture. The nurse determines that the client is using the walker incorrectly if which action is noted?

The client advances the walker with reciprocal motion.

The nurse is evaluating a client in skeletal traction. When evaluating the pin sites, the nurse would be most concerned with which finding?

Thick, yellow drainage from the pin sites

The nurse is collecting data from a client who is being seen in the health care clinic. The client is complaining of unrelieved back pain that has persisted over the past 3 months. The nurse determines that which harmful effect can occur as a result of uncontrolled muscle pain?

Weakness

The nurse is preparing to collect data from a client who has sustained a pelvic fracture following a motor vehicle crash. The nurse reviews the primary health care provider's (PHCP) prescriptions and notes that the PHCP has prescribed a pelvic (skin) sling. The nurse prepares to place the client in which device? Refer to figure.

c

A client who is scheduled for surgery and who is to be placed in skeletal traction says to the nurse, "I'm not sure if I want to have this skeletal traction or if the skin traction would be best to stabilize my fracture." Based on the client's statement, the nurse should make which response to the client?

"You have concerns about skeletal versus skin traction for your type of fracture?"

The nurse is caring for a client who had a total knee replacement and was put on a continuous passive motion (CPM) machine in the postanesthesia care unit (PACU). What are some of the actions the nurse needs to monitor to operate this machine? Select all that apply.

1.Ensure that the machine is well padded. 2.Assess the client's response to the machine. 5.Turn off the machine while the client is having a meal in bed. 6.Make sure that the joint being moved is properly positioned on the machine

The nurse is caring for a client diagnosed with Paget's disease. The nurse plans care knowing that this condition usually affects which bones? Select all that apply.

1.Femur 2.Skull 3.Tibia 6.Vertebrae

The nurse is preparing a list of cast care instructions for a client who just had a plaster cast applied to his right forearm. Which instructions should the nurse include on the list? Select all that apply.

1.Keep the cast and extremity elevated. 2.The cast needs to be kept clean and dry. 3.Allow the wet cast 24 to 72 hours to dry.

The nurse is caring for a client diagnosed with Paget's disease. What abnormal laboratory values would the nurse specifically monitor in a client with Paget's disease? Select all that apply.

2.Elevated serum calcium 5.Elevated serum alkaline phosphatase (ALP) 6.Elevated 24-hour urinary hydroxyproline level

A client with a 4-day-old lumbar vertebral fracture is experiencing muscle spasms. The nurse avoids using which intervention in an effort to relieve the spasm?

Cold

A client is complaining of low back pain with radiation down the left posterior thigh. The nurse continues to collect data from the client to see if the pain is worsened or aggravated with which action?

Bending or lifting

The nurse is caring for a client with a tibial fracture who was just diagnosed with acute compartment syndrome (ACS). Which procedure does the nurse anticipate the surgeon will perform?

Fasciotomy

The nurse witnesses a client sustain a fall and suspects that the client's leg may be fractured. Which action is the priority?

Immobilize the leg before moving the client

The nurse is caring for a client with a diagnosis of osteoarthritis. Which actions would be least helpful for the client?

Increasingly vigorous and high-impact exercise

The nurse has provided instructions regarding specific leg exercises for the client immobilized in right skeletal lower leg traction. The nurse determines that the client needs further teaching if the nurse observes the client doing which activity?

Performing active range of motion (ROM) to the right ankle and knee

Which intervention should be contraindicated in the postprocedure care of the client following a bone biopsy of the left arm?

Place the left arm in a dependent position for 24 hours.

A client with a hip fracture asks the nurse why Buck's extension traction is being applied before surgery. The nurse's response is based on the understanding that Buck's extension traction has which primary function?

Provides comfort by reducing muscle spasms and provides fracture immobilization

The nurse is teaching a male client with osteomalacia about this disorder. Which comment by the client indicates a need for further teaching?

This condition is primarily due to my lack of calcium and testosterone

A client who is learning to use a cane is afraid it will slip with ambulation, causing a fall. What should the nurse tell the client to provide greater reassurance?

The cane has a flared tip with concentric rings to provide stability.

A client has just had a cast removed and the underlying skin is yellow-brown and crusted. The nurse determines that further instructions are needed about skin care if the client makes which statement?

"I need to scrub the skin vigorously with soap and water."

The nurse is discharging a client who had conventional open back surgery. Which comment by the client indicates a need for further teaching?

"I'll be careful not to lift anything heavier than 20 pounds."

The nurse has reinforced instructions to the client returning home after arthroscopy of the knee. The nurse determines that the client understands the instructions if the client makes which statement?

"I'll report fever or site inflammation to the primary health care provider."

The nurse has reinforced instructions with the client with a nonplaster (fiberglass) leg cast about cast care at home. The nurse determines that the client needs further teaching if the client makes which statement?

"If the cast gets wet, I can dry it with a hair dryer turned to the warmest setting."

The nurse is caring for a client recently diagnosed with Parkinson disease (PD). The nurse is assessing the client and knows that PD is characterized by what cardinal signs/symptoms? Select all that apply.

1.Tremor 3.Muscle rigidity 4.Postural instability 6.Bradykinesia or akinesia (slow movement/no movement

The nurse is caring for a client admitted with fat embolism syndrome (FES). Which are some of the early manifestations of this syndrome? Select all that apply.

2.Dyspnea 4.Hypoxemia 5.Tachypnea

The nurse is teaching a client how to walk with a cane. Which information should the nurse include? Select all that apply.

3.The cane should create no more than 30 degrees of flexion of the elbow. 4.The top of the cane should be parallel to the greater trochanter of the femur. 5.A straight leg cane is used if the client only needs minimal support for an affected leg.

The nurse is caring for a client with a fractured tibia and fibula. Eight hours after a long leg cast was applied, the client began to report an increase in pain level even after administration of the prescribed dose of opioid analgesic. Which is the initial nursing action?

Check the neurovascular status of the toes on the casted leg.

A client has several fractures of the lower leg and has been placed in an external fixation device. The client is upset about the appearance of the leg, which is very edematous. The nurse determines that the client is experiencing which problem?

Concerns about body image

A client with a left arm fracture exhibits loss of sensation in the left fingers, pallor, slow refill, and diminished left radial pulse. The licensed practical nurse (LPN) should take which action?

Notify the registered nurse.

The nurse is caring for a client who sustained multiple fractures in a motor vehicle accident 12 hours ago. The client develops severe dyspnea, tachycardia, and mental confusion, and the nurse suspects fat embolism. Which is the nurse's initial action?

Place the client in a Fowler's position.

The nurse is preparing to reinforce instructions to a client regarding how to safely use crutches. Before initiating the teaching, the nurse collects data on the client. Which priority data should be included?

The client's vital signs, muscle strength, and previous activity level

The nurse is planning to reinforce instructions to the client about proper use of a thoracolumbosacral orthosis (TLSO) after spinal fusion with instrumentation. The nurse plans to include which teaching points in discussion with the client?

The device is applied before getting out of bed in the morning.

The nurse is reinforcing discharge instructions for a client who underwent left total knee replacement (TKR) with insertion of a metal prosthesis. Which statement by the client indicates the need for further teaching?

"I don't need to be worried if the shape of my knee changes."

A nursing instructor asks a nursing student about the risk factors associated with osteoporosis. The instructor determines that the student needs further teaching if the student states that which is an associated risk factor?

High-calcium diet consumption

The nurse is caring for a client diagnosed with Paget's disease. The nurse plans care knowing that this condition usually affects which bones? Select all that apply.

1.Femur 2.Skull 3.Tibia 6.Vertebrae