Nokea
The nurse is providing home care instructions to a patient who has multiple forearm fractures and a long-arm cast on the right arm. Which of the following information should the nurse include in the teaching plan?
- A. Keep the hand immobile to prevent soft tissue swelling.
- B. Keep the right shoulder elevated on a pillow or cushion.
- C. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for the first 48 hours after the injury.
- D. Call the health care provider for increased swelling or numbness.
Correct Answer: D
Rationale: Increased swelling or numbness may indicate increased pressure at the injury, and the health care provider should be notified immediately to avoid damage to nerves and vessels. The patient should be encouraged to move the joints above and below the cast to avoid stiffness. There is no need to elevate the shoulder. The forearm should be elevated to reduce swelling. NSAIDs can be used to manage pain and swelling.
You may also like to solve these questions
Which of the following nursing actions should the nurse include in the plan of care for a patient who has had a total knee arthroplasty?
- A. Avoid extension of the knee beyond 120 degrees.
- B. Use a compression bandage to keep the knee flexed.
- C. Start progressive knee exercises to obtain 90-degree flexion.
- D. Teach about the need to avoid weight bearing for 4 weeks.
Correct Answer: C
Rationale: After knee arthroplasty, active or passive flexion exercises are used to obtain a 90-degree flexion of the knee. The goal for extension of the knee will be 180 degrees. A compression bandage is used to hold the knee in an extended position after surgery. Full weight bearing is expected before discharge.
The nurse is caring for a patient who has a long-arm plaster cast applied for immobilization of a fractured left radius. Which of the following actions should the nurse implement until the cast has completely dried?
- A. Keep the left arm in a dependent position.
- B. Handle the cast with the palms of the hands.
- C. Place gauze around the cast edge to pad any roughness.
- D. Cover the cast with a small blanket to absorb the dampness.
Correct Answer: B
Rationale: Until a plaster cast has dried, placing pressure on the cast should be avoided to prevent creating areas inside the cast that could place pressure on the arm. The left arm should be elevated to prevent swelling. The edges of the cast may be petalled once the cast is dry but padding the edges before that may cause the cast to be misshapen. The cast should not be covered until it is dry because heat builds up during drying.
The nurse is caring for a patient who is on bed rest after having a complex pelvic fracture. Which of the following assessment findings is most important to report to the health care provider?
- A. The patient states that the pelvis feels unstable.
- B. Abdominal distention is present and bowel tones are absent.
- C. There are ecchymoses on the abdomen and hips.
- D. The patient complains of pelvic pain with palpation.
Correct Answer: B
Rationale: The abdominal distention and absent bowel tones may be due to complications of pelvic fractures such as paralytic ileus or hemorrhage or trauma to the bladder, urethra, or colon. Pelvic instability, abdominal pain with palpation, and abdominal bruising would be expected with this type of injury.
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 has a comminuted fracture of the right femur and has Buck's traction in place while waiting for surgery. Which of the following actions should the nurse implement to assess for pressure areas on the patient's back and sacral area and to provide skin care?
- A. Loosen the traction and have the patient turn onto the unaffected side.
- B. Place a pillow between the patient's legs and turn gently to each side.
- C. Turn the patient partially to each side with the assistance of another nurse.
- D. Have the patient lift the buttocks by bending and pushing with the left leg.
Correct Answer: D
Rationale: The patient can lift the buttocks off the bed by using the left leg without changing the right-leg alignment. Turning the patient will tend to move the leg out of alignment. Disconnecting the traction will interrupt the weight needed to immobilize and align the fracture.