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Questions and Answers

Where should the crutches be placed for standing assistance?

  • 3 inches to the front and side of the toes
  • 20 inches to the front and side of the toes
  • 15 inches to the front and side of the toes
  • 8 inches to the front and side of the toes (correct)
  • Which specimen item should be monitored frequently for a client in Buck's extension traction?

  • Neurovascular status (correct)
  • Mental state
  • Range of motion ability
  • Temperature
  • What type of traction is Buck's extension traction?

  • Traction involving the use of a cast
  • Circumferential traction involving the use of a belt around the body
  • Skin traction involving the use of traction attached to the skin and soft tissues (correct)
  • Skeletal traction involving the use of surgically inserted pins
  • Which intervention should the nurse plan to prevent complications from Buck's extension traction?

    <p>Inspect the skin on the right leg at least once every 8 hours</p> Signup and view all the answers

    How should a client with a left hip fracture be positioned in Buck's traction?

    <p>Left calf on pillow from knee to ankle</p> Signup and view all the answers

    What should be assessed primarily for a patient who is agitated and confused on the second post-operative day?

    <p>Alcohol use before surgery</p> Signup and view all the answers

    Which finding should the nurse be most concerned about in a patient post-hip replacement?

    <p>Temperature of 101.8 F (38.7 C)</p> Signup and view all the answers

    What do you notice about a client who is complaining of knee pain with swelling, redness, and warmth to the touch?

    <p>Possible joint inflammation or infection.</p> Signup and view all the answers

    Study Notes

    Crutch Use and Positioning

    • Crutches should be placed 8 inches in front and to the side of the toes for optimal stability.
    • Improper placement can lead to injury; crutches must not rest under the arms to prevent brachial plexus nerve injury.

    Buck's Extension Traction

    • Used for older clients with hip fractures to reduce muscle spasms and immobilize the fracture.
    • Frequent monitoring of neurovascular status is crucial, especially due to risk factors in older adults.
    • Skin integrity should be assessed at least every 8 hours to prevent breakdown.

    Post-Operative Care and Assessments

    • Early signs of infection post-surgery are critical; temperatures above 101.8°F indicate potential issues.
    • Pain during repositioning is generally normal; managing it with analgesics is essential.
    • Signs of fat embolism, including dyspnea and chest pain, should be monitored in post-fracture care.

    Client Education and Safety

    • Clients should be instructed not to use others' crutches and remove hazards like scatter rugs from home.
    • Clients should report any signs of fever or inflammation after procedures like knee arthroscopy.

    Ambulation Techniques

    • For descending stairs with crutches, the sequence is: crutches and the affected leg first, followed by the unaffected leg.
    • Instructing clients on the three-point gait is vital for safe ambulation.

    Traction Management

    • In Buck's traction, a slight elevation of the bed’s foot can help with countertraction.
    • Monitoring for weak pedal pulses is critical, indicating potential complications.

    Joint Protection Strategies

    • Recommendations for clients with rheumatoid arthritis include avoiding prolonged immobilization and using larger joints for activities.
    • Patients should be educated to slide objects instead of lifting and to rest when experiencing pain or fatigue.

    Discharge Instructions

    • After surgeries like total hip replacement, clients should use raised toilet seats to prevent hip flexion complications.
    • Clients should be aware that changes in knee shape following procedures are not normal and should be reported to healthcare providers.

    Recognition of Complications

    • Signs that may indicate complications include skin breakdown in clients with skin traction and the need for frequent assessments around pin sites in skeletal traction.
    • After a total knee replacement, clients should be wary of reclining excessively as it could lead to complications.

    Inflammatory Conditions

    • Clients with finger joint deformities should be informed about the autoimmune nature of their condition.
    • A swollen, warm knee may indicate infection, recent injury, or inflammation, necessitating further evaluation.

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