Nokea
The nurse is caring for a client with an external fixator that requires pin care twice a day. The nurse observes that there is a new purulent drainage around one of the pins. What intervention should the nurse anticipate doing?
- A. Scrubbing the drainage from around the pin site
- B. Obtaining a culture
- C. Applying iodine-based solution
- D. Apply ointment to the pin site.
Correct Answer: B
Rationale: A culture should be obtained if purulent drainage is present. Drainage should be gently removed, not scrubbed. Iodine-based products interfere with tissue healing and are not recommended for cleaning pin sites. Ointment should not be applied to the pin site unless specifically ordered.
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The nurse is caring for a patient with a fractured right femur who is not a candidate to repair the femur immediately. What intervention should the nurse anticipate the physician will order to relieve muscle spasm and pain until surgery is performed?
- A. Skeletal traction
- B. Skin traction
- C. Open reduction
- D. External fixator
Correct Answer: B
Rationale: If surgery for a fracture cannot be performed right away, Buck's traction or other skin traction may be applied to relieve muscle spasm and pain until surgery is performed. The other distractors all require surgical intervention.
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.
A client is seen in the orthopedic clinic for complaints of severe pain in the left hip. After a series of diagnostic tests, the client is diagnosed with severe degenerative joint disease of the left hip and suggested to have the hip reconstructed. What procedure will the nurse schedule the client for?
- A. Left hip arthroplasty
- B. Left hip arthroscopy
- C. Open reduction and internal fixation of the left hip.
- D. Closed reduction of the left hip.
Correct Answer: A
Rationale: Clients with arthritis, trauma, hip fracture, or a congenital deformity may have an arthroplasty, or reconstruction of the joint. This procedure uses an artificial joint that restores previously lost function and relieves pain. An arthroscopy is not used to reconstruct a diseased hip. A closed reduction is not an invasive surgical procedure and would not be used to reconstruct the hip. An open reduction and internal fixation is not the treatment for reconstruction of the hip related to a diseased hip.
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 brought to the emergency department by a softball team member who states the client and another player ran into each other, and the client is having severe pain in the right shoulder. What symptoms of a fractured clavicle does the nurse recognize?
- A. Client complains of tingling and numbness in the right shoulder.
- B. Right shoulder is elevated above the left.
- C. Client complains of pain in the unaffected shoulder.
- D. Right shoulder slopes downward and droops inward.
Correct Answer: D
Rationale: The client with a fractured clavicle has restricted motion, and the affected shoulder appears to slope downward and droop inward. The client will have pain, not typically tingling and numbness in the right shoulder. Pain is not felt in the unaffected shoulder.