Post Operative
3 nursing interventions for a post-op patient
-I/S, early ambulation, I/O, TCDB, elevation of affected extremity.
A nurse is assessing a 86 yo male after an ORIF of the right ankle. The nurse has documented pulses strong/ equal bilaterally, no reports of tingling, ROM present in all 5 toes of the right ankle and toes are warm to touch, pt reports 3/10 pain on a scale of 1-10. What did the nurse forget to assess of the 6 P's?
pallor.
A client had sustained an open compound fracture and the affected left leg has a cast on it. Upon nursing assessment the nurse finds hot spots and notices the WBC levels are increased. What is the nurses findings indicative of?
infection
Name 4 risk factors for developing osteoarthritis.
female, repetitive movements, increasing age >40, overweight/obesity, hormonal, family hx/ genetic, trauma
A nurse is conducting a health screen for osteoporosis, which client is at greatest risk for developing this disorder?
A. 30 year old woman who smokes tobacco
B. 46 year old woman who has asthma and vit-D deficiency
C. 50 year old man who drinks alcohol 3x a week
D. 65 year old woman who does not like to exercise, lays on the couch all day and smokes 2 packs of cigarettes a day.
D.
2 PCA drugs used and 4 aspects the nurse needs to assess with the patient prior to administration
Hydromorphone, Morphine
B/P, HR, SpO2, RR
Pt presented w/ edema of left lower extremity, diminished L posterior tibialis pulse, cap refill > 3 seconds, no sensation present to touch and temp on the L foot and positive Homan's sign. What complication can this be an indicator of ?
DVT
Name 3 signs and symptoms of a fracture.
crepitus, deformaties, edema, muscle spasms, ecchymosis, discoloration, diminshed ROM, swelling, pain, change in alignment
List 3 manifestations of osteoarthritis.
joint pain, stiffness, crepitus, joint enlargement, decreased ROM, flexion contractures
A nurse is providing teaching in collaboration with a dietitian about foods high in calcium to a newly diagnosed OA patient. list 3 foods that could be apart of this teaching.
milk, white beans, kale, broccoli, spinach, collard greens, almonds, oranges, tofu, sardines, yogurt, bok choy,
A nurse is assessing client c/o left ankle pain with limited ROM and swelling. Dr has dx the patient with a left ankle sprain. Name 2 nursing interventions for this client.
NSAID administration, RICE, pt education regarding assistive devices
3 aspects that need to be assessed for a neuro-vascular assessment.
6Ps, edema, cap refill
A nurse is assigning a client to an LVN. Which is appropriate client to assign:
A. 60 year old client who is 3 hours post op from a right hip ORIF.
B. 45 year old client who is one day post op who is complaining 6/10 pain and has PO Norco available.
C. 26 year old client who is post op left ankle surgery with cast and is complaining of increasing pain and tingling and numbness of toes.
D. 40 year old client who had surgery on hip 2 days ago and is being discharged today and needs discharge teaching.
B. this client is stable and LVN are able to give medications if they are PO.
What are 4 diagnostic tests to diagnose this disease?
x-ray, MRI, CT, nuclear bone scan, arthrogram, CT myelogram, EMG/ nerve conduction
80 y.o. woman has a dx of osteoporosis. She currently lives at home alone where there is a steep walkway leading up to her house and stairs located inside. list top 2 nursing diagnosis for a client with OA.
risk for falls risk for injury
knowledge deficit
3 nursing diagnosis regarding a post-op patient
impaired physical mobility, Risk for Injury, Risk for infection, knowledge deficit, acute pain.
A nurse is assessing a client w/ a full leg cast due to a femur fracture, which findings point to a fat-embolus.
A. reduced bowel sounds
B. swelling toes distal to injury site.
C. pain w/ passive ROM of foot distal to injury
D. AMS
D.
A nurse is planning care for client who has a right hip fracture. Which of the following immobilization devices should the nurse anticipate to be ordered?
A. Skeletal traction
B. Halo traction
C. Bucks traction
D. Bryant traction
C. This traction helps reduce pain and maintains length of bone. It is used as a skin traction.
A nurse is educating a patient on the new diagnosis of OA of the hip. What should the nurse include in the teaching? (select all that apply)
A. apply heat to the joint to alleviate pain
B. ice joints after activity
C. install elevated toilet seat
D. do high energy activities in the morning
E. take warm tub baths to alleviate pain
ABCD
we dont want them taking tub baths because they might slip in tub but also they may not be able to get out of the tub.
what is the key difference between osteoporosis and osteoarthritis. (hint think of patho)
in osteoporosis the bone has broken down and has become porosis also known as spongy and theres a decrease in bone density and bone mass. where osteoarthritis is the breakdown of cartilage in the joints and bone.