problems with coordination

• Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all that apply.


  -Keep the cast clean and dry.

  - Allow the cast 24 to 72 hours to dry.

  - Keep the cast and extremity elevated
• plaster cast teaching


  - A cool setting on the hair dryer can be used to dry a plaster cast (heat cannot be used on a plaster cast because the cast heats up and burns the skin).

  - not to stick anything under the cast because of the risk of breaking skin integrity.

  - The client is instructed to monitor the extremity for circulatory impairment, such as pain, swelling, discoloration, tingling, numbness, coolness, or diminished pulse.
• A client is being discharged to home after application of a plaster leg cast. Which statement indicates that the client understands proper care of the cast?

  I need to avoid getting the cast wet."
• The nurse is assessing the casted extremity of a client. Which sign is indicative of infection?


  Presence of a "hot spot" on the cast
• fracture pain


  Most pain associated with fractures can be minimized with rest, elevation, application of cold, and administration of analgesics. Pain that is not relieved by these measures should be reported to the health care provider because pain unrelieved by medications and other measures may indicate neurovascular compromise.
• 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 elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain?

  Impaired tissue perfusion
• The nurse is admitting a client with multiple trauma injuries to the nursing unit. The client has a leg fracture and had a plaster cast applied. Which position would be best for the casted leg?

  Elevated on pillows continuously for 24 to 48 hours
• A client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. The nurse responds knowing that which would most likely result from this improper crutch measurement?

  Injury to the brachial plexus nerves
• crutch measurement


  Crutches are measured so that the tops are 2 to 3 fingerwidths from the axillae. This ensures that the client's axillae are not resting on the crutch or bearing the weight of the crutch, which could result in injury to the nerves of the brachial plexus.
• The nurse has given the client instructions about crutch safety. Which statement indicates that the client understands the instructions? Select all that apply.


  - I should not use someone else's crutches."

  - "I need to remove any scatter rugs at home."

  - "I need to have spare crutches and tips available."See an expert-written answer!We have an expert-written solution to this problem!
• The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus?

  Clear mentation
• sign fat embolus is resolving

  An altered mental state is an early indication of fat emboli; therefore, clear mentation is a good indicator that a fat embolus is resolving.
• The nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome?


  Numbness and tingling in the fingers
• The earliest symptom of compartment syndrome is paresthesia (numbness and tingling in the fingers). Other symptoms include pain unrelieved by opioids, pain that increases with limb elevation, and pallor and coolness to the distal limb. Cyanosis is a late sign. Pain that is out of proportion to the severity of the fracture,


  The earliest symptom of compartment syndrome is paresthesia (numbness and tingling in the fingers). Other symptoms include pain unrelieved by opioids, pain that increases with limb elevation, and pallor and coolness to the distal limb. Cyanosis is a late sign. Pain that is out of proportion to the severity of the fracture,
• compartment syndrome 5 P's

  unrelieved pain, paresthesia, pallor, paralysis, pulselessness (fasciotomy)
• A client with diabetes mellitus has had a right below-knee amputation. Given the client's history of diabetes mellitus, which complication is the client at most risk for after surgery?

  Separation of the wound edges
• A client is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor?

  Bending or lifting
• The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client?


  Uric acid level of 9.0 mg/dL (0.54 mmol/L

  In addition to the presence of clinical manifestations, gout is diagnosed by the presence of persistent hyperuricemia, with a uric acid level higher than 8 mg/dL
• A client with a hip fracture asks the nurse about Buck's (extension) traction that is being applied before surgery and what is involved. The nurse should provide which information to the client?


  Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels
• how many types of traction are there

  2 types skeletal and skin (buck's traction)
• The nurse is assigned to care for a client in traction. The nurse creates a plan of care for the client and should include which action in the plan?

  Check the weights to ensure that they are off of the floor.
• Buck's Traction (skin traction)


  To achieve proper traction, weights need to be free-hanging, with knots kept away from the pulleys. Weights should not be kept resting on a firm surface. The head of the bed is usually kept low to provide countertraction
• The nurse is caring for an older adult who has been placed in Buck's extension traction after a hip fracture. On assessment of the client, the nurse notes that the client is disoriented. What is the best nursing action based on this information?


  Place a clock and calendar in the client's room.
• The nurse is creating a plan of care for a client in skin traction. The nurse should monitor for which priority finding in this client?

  Signs of skin breakdown
• Skin traction (Buck's traction)


  Skin traction is achieved by Ace wraps, boots, or slings that apply a direct force on the client's skin. Traction is maintained with 5 to 8 lb (2.3 to 3.6 kg) of weight, and this type of traction can cause skin breakdown.
• The nurse develops a plan of care for a client with a spica cast that covers a lower extremity and documents that the client is at risk for constipation. When planning for bowel elimination needs, the nurse should include which in the plan of care?

  Use a fracture pan for bowel elimination.
• The nurse is preparing to teach a client how to safely use crutches. Before initiating the teaching, the nurse performs an assessment on the client. The priority nursing assessment should include which information?


  The client's vital signs, muscle strength, and previous activity level
• The nurse is providing instructions to a client regarding ambulation after the application of a fiberglass cast to the lower leg. The nurse determines that the client understands the instructions if the client states that weight bearing on the casted leg can begin at which time period?

  Within 20 to 30 minutes of application
• The nurse is caring for a client in skeletal leg traction with an overbed frame. Which nursing intervention will best assist the client with self-positioning in bed?


  Place a trapeze on the bed frame to provide a means for the client to lift the hips off the bed.See an expert-written answer!We have an expert-written solution to this problem!
• 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 is the priority nursing action?


  Call the health care provider.

  
  

  Severe pain in a client in skeletal traction may indicate a need for realignment, or the traction weights applied to the limb may be too heavy.
• The home care nurse visits a client who has a cast applied to the left lower leg. On assessment of the client, the nurse notes the presence of skin irritation from the edges of the cast. Which nursing intervention is most appropriate?

  Petal the cast edges with appropriate material.
• A client who has been taking high doses of acetylsalicylic acid to relieve pain from osteoarthritis now has more generalized joint pain and an elevated temperature. The nurse should assess for which complication to determine whether the client has other signs of aspirin toxicity?

  Ringing in the ears
• The nurse is developing a plan of care for a client in Buck's traction. The plan of care should include assessing the client for which finding indicating a complication associated with the use of this type of traction?


  Weak pedal pulses

  
  

  Weak pedal pulses are a sign of vascular compromise, which can be caused by pressure on the tissues of the leg by the elastic bandage used to secure the traction system
• The nurse is caring for a client with a radius fractured across the shaft and bone splintered into fragments. Information about which type of fracture should be included by the nurse in the client's education?

  Comminuted fracture
• The home care nurse is providing instructions to a client regarding the use of crutches. The client asks the nurse to demonstrate the method for going down the stairs with the crutches. How should the nurse accurately demonstrate this technique?


  Crutches and the affected leg down, followed by the unaffected leg
• The home care nurse has instructed a client how to perform the three-point gait with the use of crutches. The nurse observes the client using this gait to ensure correct performance of the maneuvers. Which observation, if made by the nurse, would indicate that the client understands how to perform this type of gait?


  The client moves both crutches forward, along with the affected leg, and then moves the unaffected leg forward.
• RICE


  Soft tissue injuries such as sprains are treated with RICE (rest, ice, compression, and elevation) for the first 24 to 48 hours after the injury, depending on health care provider prescription. Ice is applied intermittently for 20 to 30 minutes at a time. Heat is not used for the first 24 hours because this could cause venous congestion, thereby increasing edema and pain.
• A male client arrives in the hospital emergency department and tells the nurse that he twisted his ankle while jogging. The client is seen by the health care provider and is diagnosed with a sprained ankle. The nurse provides instructions to the client regarding home care for the injury. Which statement, if made by the client, would indicate an understanding of appropriate care measures for the next 24 hours?


  "I should elevate my foot above the level of the heart."
• The nurse is teaching a client with a right arm cast how to prevent stiff or frozen shoulder. What should the nurse instruct the client to do?


  Lift the shoulder of the casted arm over the head periodically throughout the day.
• The nurse is preparing to perform pin site care for a client in skeletal traction. On assessment of the pin site, the nurse notes the presence of serous drainage. Which nursing action would be appropriate?

  Document the findings