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The nurse is preparing a client to have his cast cut off after having it for 6 weeks to treat a fractured tibia. What should the nurse inform the client prior to the cast being removed?
- A. The leg will look as it did prior to the cast being applied.
- B. The leg will look moist and will have small bumps that will go away in a few days.
- C. The skin may be covered with a yellowish crust that will shed in a few days.
- D. The leg strength is enforced by the wearing of the cast.
Correct Answer: C
Rationale: Once the cast is off, the skin appears mottled and may be covered with a yellowish crust composed of accumulated body oil and dead skin. The client usually sheds this residue in a few days. The leg will not look as it did prior to the cast but will regain the same shape and status as the other leg. There should be no bumps underneath the cast. The leg may be weak and stiff for some time after the cast is removed, not stronger.
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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.
The nurse is caring for a client who has had a fracture reduction using a cast. What would be most important for the nurse to assess?
- A. Cardiac and respiratory status
- B. Renal and hepatic function
- C. Sleep status
- D. Sensation and mobility status
Correct Answer: D
Rationale: After cast application, the nurse should assess circulation, sensation, and mobility in exposed fingers and toes every 1 to 2 hours. Assessment of cardiac, respiratory, hepatic, and renal status would be priorities if the client experienced multiple fractures or had an open reduction. The client's sleep status would be a low priority.
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.
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.
The nurse is caring for a client who had an amputation of the left leg above the knee. What position can the nurse place the client in several times per day to promote stump extension and prevent contractures?
- A. Supine
- B. Left lateral
- C. Prone
- D. Right lateral
Correct Answer: C
Rationale: Place the client with leg amputation in the prone position several times a day. This position promotes stump extension and prevents contractures. The other positions do neither of these things.