Nokea
A nurse is emptying an orthopedic surgery patient's closed suction drainage at the end of a shift. The nurse notes that the volume is within expected parameters but that the drainage has a foul odor. What is the nurse's best action?
- A. Aspirate a small amount of drainage for culturing.
- B. Advance the drain 1 to 1.5 cm.
- C. Irrigate the drain with normal saline.
- D. Inform the surgeon of this finding.
Correct Answer: D
Rationale: The nurse should promptly notify the surgeon of excessive or foul-smelling drainage. It would be inappropriate to advance the drain, irrigate the drain, or aspirate more drainage.
You may also like to solve these questions
A patient has recently been admitted to the orthopedic unit following total hip arthroplasty. The patient has a closed suction device in place and the nurse has determined that there were 320 mL of output in the first 24 hours. How should the nurse best respond to this assessment finding?
- A. Inform the primary care provider promptly.
- B. Document this as an expected assessment finding.
- C. Limit the patient's fluid intake to 2 liters for the next 24 hours.
- D. Administer a loop diuretic as ordered.
Correct Answer: B
Rationale: Drainage of 200 to 500 mL in the first 24 hours is expected. Consequently, the nurse does not need to inform the physician. Fluid restriction and medication administration are not indicated.
A patient is being prepared for a total hip arthroplasty, and the nurse is providing relevant education. The patient is concerned about being on bed rest for several days after the surgery. The nurse should explain what expectation for activity following hip replacement?
- A. Actually, patients are only on bed rest for 2 to 3 days before they begin walking with assistance.
- B. The physical therapist will likely help you get up using a walker the day after your surgery.
- C. Our goal will actually be to have you walking normally within 5 days of your surgery.
- D. For the first two weeks after the surgery, you can use a wheelchair to meet your mobility needs.
Correct Answer: B
Rationale: Patients post-THA begin ambulation with the assistance of a walker or crutches within a day after surgery. Wheelchairs are not normally utilized. Baseline levels of mobility are not normally achieved until several weeks after surgery.
A patient was brought to the emergency department after a fall. The patient is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize?
- A. Make sure you don't bring your knees close together.
- B. Try to lie as still as possible for the first few days.
- C. Try to avoid bending your knees until next week.
- D. Keep your legs higher than your chest whenever you can.
Correct Answer: A
Rationale: After receiving a hip prosthesis, the affected leg should be kept abducted. Mobility should be encouraged within safe limits. There is no need to avoid knee flexion and the patient's legs do not need to be higher than the level of the chest.
A nurse is caring for a patient who is postoperative day 1 right hip replacement. How should the nurse position the patient?
- A. Keep the patient's hips in abduction at all times.
- B. Keep hips flexed at no less than 90 degrees.
- C. Elevate the head of the bed to high Fowler's.
- D. Seat the patient in a low chair as soon as possible.
Correct Answer: A
Rationale: The hips should be kept in abduction by an abductor pillow. Hips should not be flexed more than 90 degrees, and the head of bed should not be elevated more than 60 degrees. The patient's hips should be higher than the knees; as such, high seat chairs should be used.
A 91-year-old patient is slated for orthopedic surgery and the nurse is integrated gerontologic considerations into the patient's plan of care. What intervention is most justified in the care of this patient?
- A. Administration of prophylactic antibiotics
- B. Total parenteral nutrition (TPN)
- C. Use of a pressure-relieving mattress
- D. Use of a Foley catheter until discharge
Correct Answer: C
Rationale: Older adults have a heightened risk of skin breakdown; use of a pressure-reducing mattress addresses this risk. Older adults do not necessarily need TPN and the Foley catheter should be discontinued as soon as possible to prevent urinary tract infections. Prophylactic antibiotics are not a standard infection prevention measure.