Podcast
Questions and Answers
Where should the crutches be placed for standing assistance?
Where should the crutches be placed for standing assistance?
Which specimen item should be monitored frequently for a client in Buck's extension traction?
Which specimen item should be monitored frequently for a client in Buck's extension traction?
What type of traction is Buck's extension traction?
What type of traction is Buck's extension traction?
Which intervention should the nurse plan to prevent complications from Buck's extension traction?
Which intervention should the nurse plan to prevent complications from Buck's extension traction?
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How should a client with a left hip fracture be positioned in Buck's traction?
How should a client with a left hip fracture be positioned in Buck's traction?
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What should be assessed primarily for a patient who is agitated and confused on the second post-operative day?
What should be assessed primarily for a patient who is agitated and confused on the second post-operative day?
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Which finding should the nurse be most concerned about in a patient post-hip replacement?
Which finding should the nurse be most concerned about in a patient post-hip replacement?
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What do you notice about a client who is complaining of knee pain with swelling, redness, and warmth to the touch?
What do you notice about a client who is complaining of knee pain with swelling, redness, and warmth to the touch?
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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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