Nokea
A patient is scheduled for hip replacement surgery in a month. Which statement made by the client demonstrates understanding for the preoperative instructions?
- A. I will stop taking my antihypertensive medications prior to my surgery.
- B. I will stop taking my aspirin prior to my surgery.
- C. I will have heat packs applied to my hip immediately after surgery.
- D. I will be able to walk independently when I wake up from surgery.
Correct Answer: B
Rationale: If a client is scheduled for joint replacement or other surgery, the client should be instructed to withhold aspirin prior to the surgery as per physician's instructions. The client should not be instructed to withhold antihypertensive medications to avoid a rebound hypertension. Cold packs, not heat packs, will be applied to reduce pain and edema after surgery. The client will require physical therapy after surgery and will not be able to walk until day 2 with assistance.
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A client having a cast applied for a fractured leg that extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. What type of cast is the client having applied?
- A. Short leg cast
- B. Long leg cast
- C. Walking cast
- D. Hip spica cast
Correct Answer: A
Rationale: A short leg cast extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position. A long leg cast extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed. A walking cast is a short or long leg cast reinforced for strength. A hip spica cast encloses the trunk and a lower extremity.
A client is scheduled for a joint replacement surgery. Which action would be most important for the nurse to take?
- A. Ensure adequate fluid intake before the surgery.
- B. Withhold intake of solid food before the surgery.
- C. Withhold administration of aspirin before the surgery.
- D. Ensure adequate sleep before the surgery.
Correct Answer: C
Rationale: If a client is scheduled for a joint replacement or other surgery, it is crucial for the nurse to withhold aspirin before surgery to reduce the risk of excessive bleeding. It is also essential to monitor the complete blood count, prothrombin time, bleeding, and clotting time to ensure that the client is able to control bleeding. The impact of fluid or solid food intake does not have as strong implications as the impact of aspirin intake before surgery. Having adequate sleep before surgery is helpful but is not the most important action.
A client has a cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb. The thumb is also casted. The nurse identifies this as which type of cast?
- A. Short arm cast
- B. Gauntlet cast
- C. Body cast
- D. Spica cast
Correct Answer: B
Rationale: A gauntlet cast is a short arm cast that extends from below the elbow to the palmar crease and is secured around the base of the thumb, with the thumb also being casted. A short arm cast extends from below the elbow to the palmar crease and is secured around the base of the thumb. A body cast is a larger form of a cylinder cast that encircles the trunk from about the nipple line to the iliac crests. A hip spica cast surrounds one or both legs and the trunk.
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 group of students is reviewing information about cast composition in preparation for a discussion on the advantages and disadvantages of each. The students demonstrate understanding of the topic when they cite what as an advantage of a plaster cast?
- A. Better molding to the client
- B. Quicker drying
- C. Longer lasting
- D. More breathable
Correct Answer: A
Rationale: Plaster casts require a longer time for drying but mold better to the client and are initially used until the swelling subsides. Fiberglass casts dry more quickly, are lighter in weight, longer lasting, and breathable.