Lecture 1: Fractures Flashcards
A patient with a fractured femur is being assessed. Which symptom requires the nurse to suspect compartment syndrome?
a. Bruising at the fracture site
b. pain unrelieved by medication
c. increased capillary refill time
d. numbness and tingling in the uninjured limb
b. pain unrelieved by medication
pain unrelieved by analgesics is a hallmark sign of compartment syndrome, often accompanied by pain with passive stretch of the affect area
What is the primary purpose of applying a plaster cast immediately after a closed reduction?
a. to allow full mobility of the joints
b. to provide immobilization and alignment of the bone
c. to enable early weight bearing on the limb
d. to enhance circulation to the affected area
b. to provide immobilization and alignment of the bone
after a closed reduction, a plaster cast is applied to stabilize the fracture and maintain proper alignment during healing
A nurse is educating a patient about cast care. Which statement indicates a need for further teaching?
a. “I can apply ice to reduce swelling around the cast”
b. “I should avoid getting my cast wet”
c. “I can insert a pencil to scratch an itch inside the cast”
d. “I should elevate my leg above heart level for the first 24 hours”
c. “I can insert a pencil to scratch an itch inside the cast”
Inserting objects into a cast can cause skin injury and introduce bacteria, increasing the risk of infection
What intervention is inappropriate for managing compartment syndrome?
a. lowering the affected limb below heart level
b. removing restrictive dressings or casts
c. applying cold compresses to the limb
d. monitoring urine output for dark discolouration
c. applying cold compresses to the limb
cold compresses cause vasoconstriction, which can worsen compartment syndrome by further reducing blood flow
Which fracture type is most commonly associated with bending forces in children?
a. greenstick fracture
b. spiral fracture
c. comminuted fracture
d. oblique fracture
a. greenstick fracture
greenstick fractures are incomplete fractures typically caused by bending forces, commonly seen in children due to softer bones
A patient with a pelvic fracture is at high risk for which life threatening complication?
a. osteomyelitis
b. hypovolemic shock
c. fat embolism
d. compartment syndrome
b. hypovolemic shock
pelvic fractures can cause significant blood loss, leading to hypovolemic shock
Which diagnostic finding confirms callus formation in the fracture healing process?
a. palpable crepitation
b. visible callus on x-ray
c. increased capillary refill time
d. elevated white blood cell count
b. visible callus on x ray
callus formation can be identifies as an organized network of bone visible on x ray around two weeks after injury
A patient with skeletal traction asks why weights are attached to the pins. What is the best response
a. “ It reduces the risk of infection”
b. “it immobilizes the joint above the fracture”
c. “it maintains proper bone alignment during healing”
d. “it prevents muscle atrophy
c. “it maintains proper bone alignment during healing
skeletal traction ensures alignment of fractured bones by using a pulling force
Which patient is at highest risk for developing a pathological fracture?
a. 25 year old with a femur fracture from a car accident
b. a 70 year old with osteoporosis
c. 40 year old with a spiral fracture from jogging
d. 50 year old with a comminuted fracture from a fall
b. a 70 year old with osteoporosis
Osteoporosis weakens bones, making them more prone to pathological fractures
A nurse is caring for a patient with external fixation. Which finding requires immediate intervention?
a. small amounts of clear drainage around pins
b. redness and swelling at pin sites
c. patient reported pain relieved by analgesics
d. secure and tight pins
b. redness and swelling at pin sites
redness and swelling suggest infection, requiring prompt intervention to prevent complications
During the acute assessment of a patient with a fracture, the nurse identifies muscle spasms and guarding. What is the priority action?
a. Administer muscle relaxants as prescribed
b. Perform a neurovascular assessment
c. Elevate the limb above heart level
d. Apply a heating pad to the area
b. Perform a neurovascular assessment
Muscle spasms and guarding may indicate complications like compartment syndrome, requiring immediate neurovascular assessment.
Which statement by a patient with a plaster cast indicates the need for further teaching?
a. “I will use the palm of my hands to handle the cast while it dries.”
b. “I can cover the cast with plastic to shower.”
c. “I should elevate the casted limb to reduce swelling.”
d. “I can apply lotion to the edges of the cast to reduce irritation.”
d. “I can apply lotion to the edges of the cast to reduce irritation.”
Lotion can increase moisture and lead to skin maceration. Padding and petaling are safer options for reducing irritation.
What is the primary goal of open reduction and internal fixation (ORIF)?
a. Prevent bone infection
b. Restore bone alignment and stability
c. Promote early ambulation
d. Minimize muscle atrophy
b. Restore bone alignment and stability
ORIF stabilizes the bone using surgical interventions like screws, plates, or rods to promote proper healing.
A patient has been diagnosed with a comminuted fracture. What does this mean?
a. The fracture line spirals along the bone shaft.
b. The bone has broken into three or more fragments.
c. The fracture occurs at an angle to the bone shaft.
d. The fracture line extends across the bone at a right angle.
b. The bone has broken into three or more fragments.
Comminuted fractures involve multiple bone fragments, often floating, requiring careful management.
Which finding is a late sign of compartment syndrome?
a. Severe, unrelieved pain
b. Pallor of the affected limb
c. Pulselessness in the distal extremity
d. Paresthesia of the limb
c. Pulselessness in the distal extremity
Pulselessness is a late sign indicating severe vascular compromise and requires immediate intervention.
A patient is on bed rest with skeletal traction. Which intervention is most important to prevent complications?
a. Increasing fluid intake to prevent renal calculi
b. Applying cold compresses to reduce swelling
c. Removing weights to facilitate repositioning
d. Allowing flexion of the affected limb for comfort
a. Increasing fluid intake to prevent renal calculi
Adequate hydration prevents kidney stones, a common complication of immobility and bone demineralization.
What complication is most associated with long-term external fixation devices?
a. Malunion of the fracture
b. Avascular necrosis
c. Infection at pin sites
d. Hypovolemic shock
c. Infection at pin sites
The percutaneous pins used in external fixation are a potential entry point for infection, requiring regular assessment and care.
A patient with a greenstick fracture asks why their injury is different. How should the nurse respond?
a. “Your fracture completely severed the bone.”
b. “Your fracture has caused multiple bone fragments.”
c. “Your fracture only partially cracked the bone.”
d. “Your fracture has twisted along the bone shaft.”
c. “Your fracture only partially cracked the bone.”
A greenstick fracture is incomplete, where one side of the bone bends while the other side breaks.
A nurse is monitoring a patient for fat embolism syndrome (FES). Which symptom is an early indicator?
a. Decreased urine output
b. Chest petechiae
c. Confusion or altered mental status
d. Diminished peripheral pulses
c. Confusion or altered mental status
Neurological changes, including confusion, are often the first signs of FES due to hypoxia from fat emboli.
Which intervention is appropriate when managing post-operative amputation care?
a. Elevating the stump on a pillow at all times
b. Applying cold compresses to reduce swelling
c. Encouraging prone positioning to prevent contractures
d. Allowing weight-bearing immediately after surgery
c. Encouraging prone positioning to prevent contractures
Prone positioning stretches the hip flexors and helps prevent contractures in post-amputation patients.
A nurse is teaching a patient with osteoporosis about preventing fractures. Which advice is most important?
a. “Use a cane for walking outdoors.”
b. “Ensure adequate calcium and vitamin D intake.”
c. “Avoid strenuous exercises or activities.”
d. “Drink plenty of fluids to prevent kidney stones.”
b. “Ensure adequate calcium and vitamin D intake.”
Adequate calcium and vitamin D strengthen bones, reducing the risk of fractures associated with osteoporosis.
A nurse is evaluating a patient with a femoral fracture in traction. Which observation requires immediate action?
a. Traction weights are freely hanging.
b. The patient reports mild discomfort at the pin site.
c. The affected limb is warm and pink.
d. The patient reports difficulty moving their toes.
d. The patient reports difficulty moving their toes.
Difficulty moving toes indicates possible neurovascular compromise, requiring immediate assessment and intervention.
Which dietary choice is most beneficial for a patient recovering from a fracture?
a. Grilled chicken, broccoli, and milk
b. Bacon, eggs, and toast
c. Spaghetti with marinara sauce and garlic bread
d. Cereal with almond milk
a. Grilled chicken, broccoli, and milk
This meal provides high levels of protein, calcium, and vitamin D, essential for bone healing.
A patient with compartment syndrome has dark amber urine. What complication does this indicate?
a. Fat embolism
b. Myoglobinuria
c. Osteomyelitis
d. Renal calculi
b. Myoglobinuria
Dark amber urine suggests myoglobinuria, a result of muscle breakdown that can impair kidney function.
Which intervention is contraindicated for a patient with compartment syndrome?
a. Removing restrictive dressings
b. Elevating the limb above heart level
c. Notifying the physician immediately
d. Performing a fasciotomy
b. Elevating the limb above heart level
Elevation reduces arterial perfusion and worsens ischemia in compartment syndrome. The limb should be kept at heart level.
A patient with an open tibial fracture is admitted to the hospital. What is the priority nursing intervention?
a. Administer pain medication as prescribed
b. Apply a sterile dressing to the wound
c. Monitor the patient’s capillary refill time
d. Elevate the affected limb
b. Apply a sterile dressing to the wound
Explanation: An open fracture exposes bone and tissue to the environment, increasing the risk of infection. Applying a sterile dressing is crucial to prevent contamination.
a. Administer pain medication as prescribed: Important, but infection prevention takes precedence.
c. Monitor the patient’s capillary refill time: Necessary but not the immediate priority.
d. Elevate the affected limb: Can help with swelling but should only be done after addressing infection risk.
What finding in a patient with skeletal traction requires immediate intervention?
a. Clear drainage from the pin site
b. Traction weights resting on the floor
c. The patient reports discomfort while moving
d. Slight redness at the pin insertion site
b. Traction weights resting on the floor
Explanation: Traction weights must hang freely to maintain proper alignment. Weights on the floor compromise the traction’s effectiveness.
a. Clear drainage from the pin site: Normal finding.
c. The patient reports discomfort while moving: Common but not an emergency.
d. Slight redness at the pin insertion site: Could indicate irritation but is not immediately alarming.
A nurse is assessing a patient in a cast. Which finding indicates a possible complication?
a. Warm toes with brisk capillary refill
b. Pain relieved by analgesics
c. Swelling causing tightness in the cast
d. Ability to wiggle toes freely
c. Swelling causing tightness in the cast
Explanation: Tightness can indicate compromised circulation or the onset of compartment syndrome.
a. Warm toes with brisk capillary refill: Normal finding.
b. Pain relieved by analgesics: Expected after injury.
d. Ability to wiggle toes freely: Indicates intact neurovascular status.
A patient is diagnosed with a spiral fracture of the femur. What mechanism of injury is most likely?
a. Compression injury
b. Twisting force
c. Direct impact
d. Repeated stress
b. Twisting force
Explanation: Spiral fractures are caused by twisting forces applied to the bone.
a. Compression injury: Associated with crushed bone or vertebral fractures.
c. Direct impact: Often causes transverse or comminuted fractures.
d. Repeated stress: Leads to stress fractures.
A patient in skeletal traction reports severe pain despite medication. What should the nurse do first?
a. Increase the prescribed pain medication dose
b. Assess the alignment of the traction apparatus
c. Notify the healthcare provider
d. Apply cold compresses to the affected area
b. Assess the alignment of the traction apparatus
Explanation: Misalignment can cause increased pain by exerting pressure or improper pull.
a. Increase the prescribed pain medication dose: Pain management is important, but the cause must be identified first.
c. Notify the healthcare provider: Necessary if alignment issues persist.
d. Apply cold compresses to the affected area: Not appropriate as a first step.
A nurse is educating a patient about cast care. Which statement requires correction?
a. “I can apply ice over my cast to reduce swelling.”
b. “I will call my provider if I experience increased pain.”
c. “I can stick a ruler into my cast to relieve itching.”
d. “I will elevate my casted arm above my heart for the first 24 hours.”
c. “I can stick a ruler into my cast to relieve itching.”
Explanation: Inserting objects into the cast can cause skin injury and infection.
a. “I can apply ice over my cast to reduce swelling.”: Correct practice.
b. “I will call my provider if I experience increased pain.”: Appropriate action.
d. “I will elevate my casted arm above my heart for the first 24 hours.”: Correct advice.
Which dietary choice is most beneficial for a patient with a healing fracture?
a. Grilled salmon, kale, and milk
b. Bacon, eggs, and toast
c. Pasta with marinara sauce and garlic bread
d. Fried chicken and french fries
a. Grilled salmon, kale, and milk
Explanation: This meal provides calcium, vitamin D, and protein, essential for bone healing.
b. Bacon, eggs, and toast: Lacks calcium and vitamin D.
c. Pasta with marinara sauce and garlic bread: Insufficient protein and nutrients.
d. Fried chicken and french fries: High in fats, low in nutrients.
A nurse suspects compartment syndrome in a patient. Which assessment finding supports this diagnosis?
a. Pale and cool extremity
b. Pain relieved by analgesics
c. Presence of strong peripheral pulses
d. Normal sensation in the affected limb
a. Pale and cool extremity
Explanation: Pallor and coolness indicate poor circulation, a key sign of compartment syndrome.
b. Pain relieved by analgesics: Pain is unrelieved in compartment syndrome.
c. Presence of strong peripheral pulses: Pulses may be absent or weak.
d. Normal sensation in the affected limb: Paresthesia is common in compartment syndrome.
What is the most appropriate intervention for a patient with a femoral fracture to prevent fat embolism syndrome (FES)?
a. Administer anticoagulants as prescribed
b. Encourage early ambulation
c. Immobilize the fracture as soon as possible
d. Perform frequent neurovascular checks
c. Immobilize the fracture as soon as possible
Explanation: Early immobilization reduces the release of fat droplets into circulation.
a. Administer anticoagulants as prescribed: Does not prevent FES.
b. Encourage early ambulation: May worsen the condition if the fracture is not immobilized.
d. Perform frequent neurovascular checks: Important but does not prevent FES.
A patient with a tibial fracture is placed in a cast. What assessment finding requires immediate intervention?
a. Pain relieved by elevation
b. Warm toes with brisk capillary refill
c. Numbness and tingling in the affected leg
d. Slight swelling near the cast edges
c. Numbness and tingling in the affected leg
Explanation: Numbness and tingling (paresthesia) are early signs of neurovascular compromise and require immediate intervention to prevent further complications like compartment syndrome.
a. Pain relieved by elevation: This indicates swelling is resolving.
b. Warm toes with brisk capillary refill: Normal circulation is intact.
d. Slight swelling near the cast edges: Expected due to the inflammatory response.
A patient with a comminuted fracture asks why surgery is necessary. What is the nurse’s best response?
a. “Surgery ensures infection control.”
b. “The fracture needs surgical alignment for proper healing.”
c. “This type of fracture always requires surgery.”
d. “Surgery helps reduce your pain.”
b. “The fracture needs surgical alignment for proper healing.”
Explanation: Comminuted fractures involve multiple fragments, requiring surgical intervention for alignment and stabilization.
a. “Surgery ensures infection control”: Infection prevention is important but not the primary reason.
c. “This type of fracture always requires surgery”: Not all comminuted fractures require surgery.
d. “Surgery helps reduce your pain”: Pain management is a benefit but not the main reason.
Which statement indicates a patient understands cast care instructions?
a. “I will keep my cast covered with plastic at all times.”
b. “I should elevate my casted leg only when it feels swollen.”
c. “I will use a hairdryer to help dry my cast if it gets wet.”
d. “I should move my fingers and toes frequently to promote circulation.”
. “I should move my fingers and toes frequently to promote circulation.”
Explanation: Moving fingers and toes helps prevent stiffness and improves circulation.
a. “I will keep my cast covered with plastic at all times”: Incorrect for plaster casts as they need airflow to dry.
b. “I should elevate my casted leg only when it feels swollen”: Elevation should be done routinely, especially during the first 24-48 hours.
c. “I will use a hairdryer to help dry my cast if it gets wet”: Heat can weaken the cast material.
A nurse is assessing a patient with an external fixation device. Which finding is concerning?
a. Clear drainage at the pin sites
b. Redness and warmth at the pin sites
c. Loose fixation pins
d. The patient reports mild pain
c. Loose fixation pins
Explanation: Loose pins compromise the device’s stability and increase the risk of infection.
a. Clear drainage at the pin sites: Normal, especially initially.
b. Redness and warmth at the pin sites: Early infection signs but not as critical as loose pins.
d. The patient reports mild pain: Expected and manageable.
Which intervention is contraindicated in a patient with suspected compartment syndrome?
a. Elevating the limb to heart level
b. Applying ice packs to the affected area
c. Removing restrictive dressings
d. Monitoring the patient’s urine output
b. Applying ice packs to the affected area
Explanation: Ice packs cause vasoconstriction, worsening ischemia in compartment syndrome.
a. Elevating the limb to heart level: Maintains circulation.
c. Removing restrictive dressings: Alleviates pressure.
d. Monitoring the patient’s urine output: Detects complications like myoglobinuria.
A patient with osteoporosis is admitted after a pathological fracture. What is the most appropriate nursing intervention?
a. Encourage high-impact exercises to improve bone density
b. Administer calcium and vitamin D supplements
c. Limit weight-bearing activities to prevent further fractures
d. Place the patient on strict bed rest
b. Administer calcium and vitamin D supplements
Explanation: Calcium and vitamin D support bone health and reduce fracture risk.
a. Encourage high-impact exercises: These can cause fractures.
c. Limit weight-bearing activities: Weight-bearing, when safe, improves bone strength.
d. Place the patient on strict bed rest: Bed rest increases bone loss.
A patient with a femoral fracture suddenly develops confusion and difficulty breathing. What complication should the nurse suspect?
a. Pulmonary embolism
b. Fat embolism syndrome
c. Compartment syndrome
d. Osteomyelitis
Answer: b. Fat embolism syndrome
Explanation: Confusion and respiratory distress are hallmark signs of fat embolism syndrome.
a. Pulmonary embolism: Similar symptoms but less likely in the early stages of fracture.
c. Compartment syndrome: Primarily affects limb circulation.
d. Osteomyelitis: Presents with fever and localized signs of infection.
What is the priority nursing intervention for a patient undergoing a closed reduction of a dislocated joint?
a. Administer prescribed pain medication
b. Apply traction to the affected joint
c. Monitor neurovascular status frequently
d. Ensure the patient remains immobile
c. Monitor neurovascular status frequently
Explanation: Neurovascular compromise can occur after reduction.
a. Administer prescribed pain medication: Important but secondary.
b. Apply traction to the affected joint: Part of the procedure, not a nursing intervention.
d. Ensure the patient remains immobile: Done post-procedure.
A patient with an amputation is concerned about “phantom limb pain.” How should the nurse respond?
a. “This type of pain is only temporary.”
b. “We will manage your pain with medications and therapies.”
c. “You should ignore the pain, as it’s not real.”
d. “This is a sign of poor surgical outcomes.”
b. “We will manage your pain with medications and therapies.”
Explanation: Phantom pain is real and requires a multi-modal pain management approach.
a. “This type of pain is only temporary”: It may persist.
c. “You should ignore the pain, as it’s not real”: Invalidating the patient’s experience is unhelpful.
d. “This is a sign of poor surgical outcomes”: Incorrect and discouraging.
A patient has a transverse fracture of the femur. Which characteristic is associated with this type of fracture?
a. The fracture line extends in a spiral along the bone shaft.
b. The fracture line is straight across the bone at a right angle.
c. The bone breaks into multiple fragments.
d. The fracture occurs due to repeated stress on the bone.
b. The fracture line is straight across the bone at a right angle.
Explanation: A transverse fracture occurs when the fracture line runs perpendicular to the bone’s longitudinal axis.
a. The fracture line extends in a spiral along the bone shaft: This describes a spiral fracture.
c. The bone breaks into multiple fragments: This describes a comminuted fracture.
d. The fracture occurs due to repeated stress on the bone: This describes a stress fracture.
A patient with a plaster cast reports feeling warmth and a burning sensation under the cast. What is the nurse’s priority action?
a. Reassure the patient that this is normal.
b. Elevate the casted limb above heart level.
c. Assess the cast and perform a neurovascular check.
d. Apply a cold compress to the cast.
c. Assess the cast and perform a neurovascular check.
Explanation: Warmth and burning may indicate complications like pressure ulcers or compartment syndrome. A thorough assessment is needed.
a. Reassure the patient that this is normal: This dismisses a potentially serious complication.
b. Elevate the casted limb above heart level: Helpful for swelling but not a priority in this situation.
d. Apply a cold compress to the cast: This is not appropriate for plaster casts.
A patient with a femur fracture is at risk for fat embolism syndrome (FES). What symptom should the nurse prioritize?
a. Cyanosis of the toes
b. Petechiae on the chest and upper arms
c. Localized pain at the fracture site
d. Increased capillary refill time
b. Petechiae on the chest and upper arms
Explanation:Petechiae are a classic sign of FES, often accompanied by respiratory distress and confusion.
a. Cyanosis of the toes: This could indicate peripheral vascular compromise but is not specific to FES.
c. Localized pain at the fracture site: This is expected with a fracture.
d. Increased capillary refill time: Indicates poor circulation but is not a hallmark of FES.
What is the most common complication of open fractures?
a. Compartment syndrome
b. Osteomyelitis
c. Avascular necrosis
d. Malunion
b. Osteomyelitis
Explanation: Open fractures expose the bone to the environment, increasing the risk of infection, including osteomyelitis.
a. Compartment syndrome: More common with closed fractures or tight dressings.
c. Avascular necrosis: Occurs due to disrupted blood supply but is less common.
d. Malunion: A long-term complication if the bone does not heal correctly
A nurse is caring for a patient with skeletal traction. Which intervention is most appropriate?
a. Remove weights for repositioning.
b. Ensure the traction weights are hanging freely.
c. Place a pillow under the affected limb.
d. Use a heating pad for muscle relaxation.
b. Ensure the traction weights are hanging freely.
Explanation: Freely hanging weights maintain proper alignment and traction effectiveness.
a. Remove weights for repositioning: This can disrupt alignment and healing.
c. Place a pillow under the affected limb: May interfere with traction.
d. Use a heating pad for muscle relaxation: Heat is not appropriate in this context.
A patient in skeletal traction reports pain at the pin site. What is the nurse’s best action?
a. Remove the weights to relieve pressure.
b. Clean the pin site using aseptic technique.
c. Apply an ice pack to the pin site.
d. Administer additional pain medication.
b. Clean the pin site using aseptic technique.
Explanation: Pain at the pin site may indicate infection; cleaning prevents further complications.
a. Remove the weights to relieve pressure: This disrupts the treatment.
c. Apply an ice pack to the pin site: Not recommended for skeletal traction.
d. Administer additional pain medication: Addresses symptoms but not the cause.
A patient with a cast develops swollen fingers and reports pain despite taking medication. What is the nurse’s priority?
a. Apply ice packs to the fingers.
b. Elevate the hand above the heart.
c. Notify the healthcare provider immediately.
d. Loosen the cast edges.
c. Notify the healthcare provider immediately.
Explanation: Swelling and unrelieved pain may indicate compartment syndrome, requiring immediate intervention.
a. Apply ice packs to the fingers: May delay treatment.
b. Elevate the hand above the heart: Useful for swelling but not sufficient alone.
d. Loosen the cast edges: Should only be done under medical guidance.
A patient with an amputation is concerned about phantom limb pain. What should the nurse prioritize in their response?
a. “Phantom pain is only temporary.”
b. “It’s important to manage this pain effectively.”
c. “This pain is psychological and will resolve soon.”
d. “Focus on the remaining limb to improve function.”
b. “It’s important to manage this pain effectively.”
Explanation: Phantom pain is real and requires a multidisciplinary approach to manage effectively.
a. “Phantom pain is only temporary.”: It can persist long-term.
c. “This pain is psychological and will resolve soon.”: Incorrect and dismissive.
d. “Focus on the remaining limb to improve function.”: Does not address the patient’s concern.
A patient with a closed tibial fracture is scheduled for a reduction. What preoperative nursing action is most important?
a. Explain the procedure to the patient in detail.
b. Monitor neurovascular status of the affected limb.
c. Administer prescribed antibiotics.
d. Teach the patient how to use crutches.
b. Monitor neurovascular status of the affected limb.
Explanation: Neurovascular assessment is critical to identify potential complications, such as impaired circulation or nerve damage, before reduction.
a. Explain the procedure to the patient in detail: This is typically done by the provider.
c. Administer prescribed antibiotics: Not necessary for a closed fracture unless there’s a risk of infection.
d. Teach the patient how to use crutches: Important, but not the priority preoperatively.
A nurse is caring for a patient 24 hours post-amputation. The patient reports pain described as “burning and shooting” in the amputated limb. What is the best nursing intervention?
a. Administer prescribed opioids for pain relief.
b. Explain that the sensation is psychological.
c. Apply a cold compress to the residual limb.
d. Offer distraction techniques, such as watching TV.
a. Administer prescribed opioids for pain relief.
Explanation: Opioids are effective for managing phantom limb pain. Other modalities can be used in conjunction but are not primary.
b. Explain that the sensation is psychological: This is incorrect; phantom pain is real and physical.
c. Apply a cold compress to the residual limb: Not effective for phantom pain.
d. Offer distraction techniques, such as watching TV: May help but should not replace effective pain management.
A patient with an external fixation device for a femoral fracture reports clear drainage at the pin site. What is the nurse’s best action?
a. Notify the healthcare provider immediately.
b. Clean the pin sites with an antiseptic solution.
c. Apply an antibiotic ointment to the pin sites.
d. Increase the frequency of neurovascular checks.
b. Clean the pin sites with an antiseptic solution.
Explanation: Clear drainage is normal initially; cleaning the pin site helps prevent infection.
a. Notify the healthcare provider immediately: Not necessary for clear drainage.
c. Apply an antibiotic ointment to the pin sites: Not typically recommended unless ordered by a provider.
d. Increase the frequency of neurovascular checks: Important but not specific to the drainage.
A nurse is teaching a patient with a leg cast about complications to report. Which statement indicates correct understanding?
a. “I should call the clinic if my toes are cool and pale.”
b. “Swelling and tingling in my toes is normal.”
c. “I can ignore mild pain in my foot as long as it improves.”
d. “If my leg feels warm, I just need to elevate it.”
a. “I should call the clinic if my toes are cool and pale.”
Explanation: Cool, pale toes indicate compromised circulation and require immediate attention.
b. “Swelling and tingling in my toes is normal”: Swelling is expected, but tingling indicates neurovascular compromise.
c. “I can ignore mild pain in my foot as long as it improves”: Persistent or worsening pain should be reported.
d. “If my leg feels warm, I just need to elevate it”: Warmth could indicate infection or inflammation, which requires further evaluation.
