Nokea
A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?
- A. Arthrodesis
- B. Hemiarthroplasty
- C. Total arthroplasty
- D. Osteotomy
Correct Answer: C
Rationale: A total arthroplasty is a replacement of both articular surfaces within one joint. An arthrodesis is a fusion of a joint for stabilization and pain relief and is usually done on a wrist or knee. A hemiarthroplasty is the replacement of one of the articular surfaces in a joint, such as the femoral head but not the acetabulum. An osteotomy is the cutting and removal of a wedge of bone to change the bone's alignment, thereby improving function and relieving pain.
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A client has a fractured jaw sustained in an automobile accident and has had the fracture surgically reduced and immobilized with a wire loop. What should the nurse ensure is present at the client's bedside in case of vomiting?
- A. Wire cutters
- B. A tracheostomy tray
- C. Ice water with a straw
- D. An antiemetic medication
Correct Answer: A
Rationale: Ensure that wire cutters are easily accessible at the client's bedside. The nurse should be familiar with how to cut wire loops if the client vomits or chokes. A tracheostomy tray is not necessary when an airway can be obtained by cutting the wires so the client does not aspirate. If vomiting occurs, the client should have nothing by mouth. Antiemetic medication should be administered prior to the client vomiting and should not be kept at the bedside.
During the assessment of a client scheduled for orthopedic surgery, the nurse discovers that the client was previously treated for the disorder. In such a case, what additional data need to be collected?
- A. Occurrence of complications or problems during treatment
- B. Measures taken to minimize postoperative wound infection
- C. Perception of the client about the previous treatment
- D. Details of the medical team that handled the previous treatment
Correct Answer: A
Rationale: If the same disorder has been treated earlier, the nurse needs to determine and document any complications or problems that occurred during treatment. The nurse can determine whether the client understands the treatment or not based on the measures taken by the client to minimize postoperative wound infection. However, this factor can be assessed later because the nurse needs to explain the new treatment to the client. Although the client's perceptions of the previous treatment may be helpful, this data would not be as important. In addition, the nurse does not need to get details about the medical team that handled the previous treatment, unless specifically asked to do so.
The nurse is assigned to care for a client who has had a total knee arthroplasty yesterday. What type of pharmacologic therapy does the nurse anticipate administering to this client to prevent complications related to the surgery?
- A. Antidysrhythmic therapy
- B. Antianginal therapy
- C. Antineoplastic therapy
- D. Anticoagulation therapy
Correct Answer: D
Rationale: Anticoagulation therapy and early ambulation are very important for clients who have knee or hip replacement to prevent thrombus formation. The other therapies are not indicated for the knee or hip arthroplasty.
A client is having traction applied to a fractured left lower extremity prior to surgery. What outcome(s) does the nurse expect from the application of the traction for the client? Select all that apply.
- A. Surgery will not be required.
- B. Muscle spasms will be relieved.
- C. The bones of the left leg will be aligned.
- D. Immobilization of the left leg will be maintained.
- E. Less pain medication will be required.
Correct Answer: B,C,D
Rationale: Traction is used to relieve muscle spasm, align bones, and maintain immobilization when used properly. It will not replace surgery to correct the fracture. The client will still require pain medication prior to surgical correction.
A client is harbouring a fractured tibia is to be placed in skin traction. Which of the following is a type of skin traction that the nurse might expect to be used?
- A. Buck's traction
- B. Skeletal traction
- C. External fixation
- D. Cast application
Correct Answer: A
Rationale: Buck's traction is a type of skin traction commonly used for temporary immobilization and pain relief in fractures, such as a fractured tibia, until definitive treatment like surgery can be performed. Skeletal traction involves pins inserted into the bone, external fixation involves a frame outside the body, and cast application is not a form of traction.