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The nurse is caring for a patient with Buck's traction who had an intracapsular fracture of the left femur. Which of the following actions should the nurse take to evaluate the effectiveness of Buck's traction?
- A. Assess for hip contractures.
- B. Monitor for hip dislocation.
- C. Check the peripheral pulses.
- D. Ask about left hip pain level.
Correct Answer: D
Rationale: Buck's traction keeps the leg immobilized and reduces painful muscle spasm. Hip contractures and dislocation are unlikely to occur in this situation. The peripheral pulses will be assessed, but this does not help in evaluating the effectiveness of Buck's traction.
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The nurse is caring for a patient who is 1 day postoperative below-the-knee amputation who indicates pain in the amputated limb. Which of the following actions is best for the nurse to take?
- A. Explain the reasons for the phantom limb pain.
- B. Administer prescribed analgesics to relieve the pain.
- C. Loosen the compression bandage to decrease incisional pressure.
- D. Remind the patient that this phantom pain will diminish over time.
Correct Answer: B
Rationale: Phantom limb pain is treated like any other type of postoperative pain would be treated. Explanations of the reason for the pain may be given, but the nurse should still medicate the patient. The compression bandage is left in place except during physical therapy or bathing. Although the pain may decrease over time, it still requires treatment now.
The nurse is caring for a patient who arrives in the emergency department with ankle swelling and severe pain after twisting the ankle playing soccer. Which of the following prescribed collaborative interventions will the nurse implement first?
- A. Wrap the ankle and apply an ice pack.
- B. Administer naproxen 500 mg PO.
- C. Give acetaminophen with codeine.
- D. Take the patient to the radiology department for x-rays.
Correct Answer: A
Rationale: Immediate care after a sprain or strain injury includes the application of cold and compression to the injury to minimize swelling. The other actions should be taken after the ankle is wrapped with a compression bandage and ice is applied.
In which order will the nurse take these actions when caring for a patient with left leg fractures after a motor vehicle accident?
- A. Obtain x-rays.
- B. Check pedal pulses.
- C. Assess lung sounds.
- D. Take blood pressure.
- E. Apply splint to the leg.
- F. Administer tetanus prophylaxis.
Correct Answer: C,D,B,E,A,F
Rationale: The initial actions should be to ensure that airway, breathing, and circulation are intact. This should be followed by checking the neurovascular status of the leg (before and after splint application). Application of a splint to immobilize the leg should be done before sending the patient for x-rays. The tetanus prophylaxis is the least urgent of the actions.
The nurse is preparing a patient for discharge from the emergency department with a sprained wrist. Which of the following information should the nurse include?
- A. Keep the wrist loosely wrapped with gauze.
- B. Apply a heating pad to reduce muscle spasms.
- C. Use pillows to elevate the arm above the heart.
- D. Gently move the wrist through the range of motion.
Correct Answer: C
Rationale: Elevation of the arm will reduce the amount of swelling and pain. Compression bandages are used to decrease swelling. For the first 24-48 hours, cold packs are used to reduce swelling. The wrist should be rested and kept immobile to prevent further swelling or injury.
The nurse is caring for a patient who is a baseball pitcher and had an arthroscopic repair of a rotator cuff injury performed in same-day surgery. Which of the following information should be included in the patient's postoperative teaching plan?
- A. You have an appointment with a physical therapist for tomorrow.
- B. You can still play baseball but you will not be able to return to pitching.
- C. The doctor will use the drop-arm test to determine the success of surgery.
- D. Leave the shoulder immobilizer on for the first few days to minimize pain.
Correct Answer: A
Rationale: Physical therapy after a rotator cuff repair begins on the first postoperative day to prevent 'frozen shoulder.' A shoulder immobilizer is used immediately after the surgery, but leaving the arm immobilized for several days would lead to loss of range of motion (ROM). The drop-arm test is used to test for rotator cuff injury, but not after surgery. The patient may be able to return to pitching after rehabilitation.