Osteo Flashcards
A patient with osteomyelitis undergoes surgical debridement with implantation of antibiotic beads. When the patient asks why the beads are used, the nurse answers (select all that apply)
a. “Oral or IV antibiotics are not effective in most cases of bone infection.”
b. “The beads are an adjunct to debridement and antibiotics for deep infections.”
c. “The beads are used to deliver antibiotics directly to the site of the infection.”
d. “This is the safest method to deliver long-term antibiotic therapy for bone infection.”
e. “Ischemia and bone death related to osteomyelitis are impenetrable to IV antibiotics.”
b. “The beads are an adjunct to debridement and antibiotics for deep infections.”
c. “The beads are used to deliver antibiotics directly to the site of the infection.”
A patient diagnosed with osteosarcoma of the humerus demonstrates understanding of his treatment options when he states
a. “I accept that I have to lose my arm with surgery.”
b. “The chemotherapy before surgery will shrink the tumor.”
c. “This tumor is related to the melanoma I had 3 years ago.”
d. “I’m glad they can take out the cancer with such a small scar.”
b. “The chemotherapy before surgery will shrink the tumor.”
Which individuals would be at high risk for low back pain (select all that apply)?
a. A 63-year-old man who is a long-distance truck driver
b. A 36-year-old construction worker who is 6 ft 2 in and weighs 260 lb
c. A 44-year-old female chef with prior compression fracture of the spine
d. A 30-year-old nurse who works on an orthopedic unit and smokes
e. A 28-year-old female yoga instructor who is 5 ft 6 in and weighs 130 lb
a. A 63-year-old man who is a long-distance truck driver
b. A 36-year-old construction worker who is 6 ft 2 in and weighs 260 lb
c. A 44-year-old female chef with prior compression fracture of the spine
d. A 30-year-old nurse who works on an orthopedic unit and smokes
A patient with suspected disc herniation is experiencing acute pain and muscle spasms. The nurse’s responsibility is to
a. encourage total bed rest for several days.
b. teach principles of back strengthening exercises.
c. stress the importance of straight-leg raises to decrease pain.
d. promote use of cold and hot compresses and pain medication.
d. promote use of cold and hot compresses and pain medication.
In caring for a patient after a spinal fusion, the nurse would immediately report which of the following to the surgeon?
a. The patient experiences a single episode of emesis.
b. The patient is unable to move the lower extremities.
c. The patient is nauseated and has not voided in 4 hours.
d. The patient complains of pain at the bone graft donor site.
b. The patient is unable to move the lower extremities.
A patient who has had surgical correction of bilateral hallux valgus is being discharged from the same-day surgery unit. The nurse will instruct the patient to
a. expect continued pain in the feet.
b. rest frequently with the feet elevated.
c. soak the feet in warm water several times a day.
d. expect the feet to be numb for the next few days.
b. rest frequently with the feet elevated.
What is important to include in the teaching plan for a patient with osteopenia?
a. Lose weight.
b. Stop smoking.
c. Eat a high-protein diet.
d. Start swimming for exercise.
b. Stop smoking.
A patient 1 day postoperative after abdominal surgery has incisional pain, 99.5° F temperature, slight erythema at the incision margins, and 30 mL serosanguineous drainage in the Jackson-Pratt drain. Based on this assessment, what conclusion would the nurse make?
a. The abdominal incision shows signs of an infection.
b. The patient is having a normal inflammatory response.
c. The abdominal incision shows signs of impending dehiscence.
d. The patient’s physician must be notified about her condition.
b
The nurse assessing a patient with a chronic leg wound finds local signs of erythema and the patient complains of pain at the wound site. What would the nurse anticipate being ordered to assess the patient’s systemic response?
a. Serum protein analysis
b. WBC count and differential
c. Punch biopsy of center of wound
d. Culture and sensitivity of the wound
b
A patient in the unit has a 103.7° F temperature. Which intervention would be most effective in restoring normal body temperature?
a. Use a cooling blanket while the patient is febrile.
b. Administer antipyretics on an around-the-clock schedule.
c. Provide increased fluids and have the UAP give sponge baths.
d. Give prescribed antibiotics and provide warm blankets for comfort.
b
A nurse is caring for a patient who has a pressure ulcer that is treated with debridement, irrigations, and moist gauze dressings. How should the nurse anticipate healing to occur?
a. Tertiary intention
b. Secondary intention
c. Regeneration of cells
d. Remodeling of tissues
b
A nurse is caring for a patient with diabetes who is scheduled for amputation of his necrotic left great toe. The patient’s WBC count is 15.0 × 106/µL, and he has coolness of the lower extremities, weighs 75 lb more than his ideal body weight, and smokes two packs of cigarettes per day. Which priority nursing diagnosis addresses the primary factor affecting the patient’s ability to heal?
a. Imbalanced nutrition: obesity related to high-fat foods
b. Impaired tissue integrity related to decreased blood flow secondary to diabetes and smoking
c. Ineffective peripheral tissue perfusion related to narrowed blood vessels secondary to diabetes and smoking
d. Ineffective individual coping related to indifference and denial of the long-term effects of diabetes and smoking
b
Which one of the orders should a nurse question in the plan of care for an elderly immobile stroke patient with a stage III pressure ulcer?
a. Pack the ulcer with foam dressing.
b. Turn and position the patient every hour.
c. Clean the ulcer every shift with Dakin’s solution.
d. Assess for pain and medicate before dressing change.
c
An 85-year-old patient is assessed to have a score of 16 on the Braden Scale. Based on this information, how should the nurse plan for this patient’s care?
a. Implement a 1-hr turning schedule with skin assessment.
b. Place DuoDerm on the patient’s sacrum to prevent breakdown.
c. Elevate the head of bed to 90 degrees when the patient is supine.
d. Continue with weekly skin assessments with no special precautions.
a
- A 65-year-old stroke patient with limited mobility has a purple area of suspected deep tissue injury on the left greater trochanter. Which nursing diagnoses are most appropriate (select all that apply)?
a. Acute pain related to tissue damage and inflammation
b. Impaired skin integrity related to immobility and decreased sensation
c. Impaired tissue integrity related to inadequate circulation secondary to pressure
d. Risk for infection related to loss of tissue integrity and undernutrition secondary to stroke
e. Ineffective peripheral tissue perfusion related to arteriosclerosis and loss of blood supply to affected area
b,c
