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Care of Patients with Musculoskeletal Trauma

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Care of Patients with Musculoskeletal Trauma.Chapter 51: Care of Patients with Musculoskeletal Trauma Ignatavicius: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A nurse assesses a clien... t with a fracture who is being treated with skeletal traction. Which assessment should alert the nurse to urgently contact the health provider? a. Blood pressure increases to 130/86 mm Hg b. Traction weights are resting on the floor c. Oozing of clear fluid is noted at the pin site d. Capillary refill is less than 3 seconds ANS: B The immediate action of the nurse should be to reapply the weights to give traction to the fracture. The health care provider must be notified that the weights were lying on the floor, and the client should be realigned in bed. The client’s blood pressure is slightly elevated; this could be related to pain and muscle spasms resulting from lack of pressure to reduce the fracture. Oozing of clear fluid is normal, as is the capillary refill time. DIF: Applying/Application REF: 1060 KEY: Fracture| traction MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 2. A nurse coordinates care for a client with a wet plaster cast. Which statement should the nurse include when delegating care for this client to an unlicensed assistive personnel (UAP)? a. “Assess distal pulses for potential compartment syndrome.” b. “Turn the client every 3 to 4 hours to promote cast drying.” c. “Use a cloth-covered pillow to elevate the client’s leg.” d. “Handle the cast with your fingertips to prevent indentations.” ANS: C When delegating care to a UAP for a client with a wet plaster cast, the UAP should be directed to ensure that the extremity is elevated on a cloth pillow instead of a plastic pillow to promote drying. The client should be assessed for impaired arterial circulation, a complication of compartment syndrome; however, the nurse should not delegate assessments to a UAP. The client should be turned every 1 to 2 hours to allow air to circulate and dry all parts of the cast. Providers should handle the cast with the palms of the hands to prevent indentations. DIF: Applying/Application REF: 1059 KEY: Fracture| cast| delegation| unlicensed assistive personnel (UAP) MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 3. A nurse obtains the health history of a client with a fractured femur. Which factor identified in the client’s history should the nurse recognize as an aspect that may impede healing of the fracture? a. Sedentary lifestyleb. A 30–pack-year smoking history c. Prescribed oral contraceptives d. Paget’s disease ANS: D Paget’s disease and bone cancer can cause pathologic fractures such as a fractured femur that do not achieve total healing. The other factors do not impede healing but may cause other health risks. [Show More]

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