Upgrade to remove ads
Only $2.99/month

Musculoskeletal KAPLAN B

Terms in this set (15)

The LVN cares for a client diagnosed with a left femur fracture
The client has balanced suspension traction applied to the left leg
What is a priority action for the LVN to take
Maintain continuous line of pull of the traction and weight

Rationale:
Purpose of traction is increase alignment, immobilize joint, and reduce the fracture; counter traction provided by clients body; traction should be in straight line; weights should hang freely
The LVN cares for a client after a total knee arthroplasty
The client asks the nurse why the continuous passive motion machine is necessary
What is the most appropriate response by the nurse
The continual movement will prevent scar tissue formation and promote healing

Rationale:
Keeps prosthetic joint in motion;
decreases scar tissue formation; scar tissue increases pain and inhibits healing
The LVN cares for a client diagnosed with early rheumatoid arthritis
What will the LVN expect to observe
Early morning stiffness

Rationale:
Rheumatoid arthritis is an inflammatory process; autoimmune and systemic; chronic, progressive and affect synovial joints; morning stiffness is common
The LVN reinforces teaching for a client diagnosed with rheumatoid
What statement should e included in the reinforced teaching
I should take a warm shower before I begin to do any exercise

Rationale:
Rheumatoid arthritis is autoimmune disease;
inflammation of the joints is major clinical manifestation; warm packs, warm showers will decrease pain and stiffness prior to activity
The LVN reinforces instructions for a client who is to use crutches after a right leg fracture
What statement should e included in the reinforced instructions
Place the crutch tips 6 inches in front of your body when standing

Rationale:
Crutch tips should be placed 6 inches in front and 6 inches to the side during ambulation
The LVN reinforces teaching for a client after a total left hip replacement
What statements indicate understanding of the teaching SATA
-I will avoid crossing my legs when I sit in a chair
-I should not behind over and tie my shoes


Rationale:
-Crossing legs increases risk of prosthesis dislocation; should not have significant hip flexion
-Extreme flexion increases the risk of hip dislocation
The LVN cares for a client diagnosed with a right hip fracture
The client has Bucks traction applied to the right lower leg
The client asks about the purpose of Bucks traction
What is the most appropriate response by the LVN
This type of traction will decrease the muscle spasm seen after a fracture

Rationale:
Traction will help reduce muscle spasms, maintain alignment, and assist in reduction of the fracture
A client is scheduled for a MRI of the knee
What is a priority question for the LVN to ask
Do you have any body piercings

Rationale:
Magnetic field may move metal objects;
MRI contraindicated in clients with aneurysm clips, pacemakers, shrapnel, or electronic devices
The LVN cares for a client diagnosed with an open fracture of the right femur
The LVN is aware that the client is at high risk to develop with complication
Infection


Rationale:
At risk for osteomyelitis; skin integrity disrupted; contamination of fracture area may promote infection; contaminants are removed or debrided; skin grafting may be done; wound may be irrigated; antibiotics administered
The LVN reinforces teaching for a client who takes alendronate
Which statement by the client indicates understanding of the instructions
I need to take the alendronate on an empty stomach

Rationale:
Alendronate is bisphosphonate; increase total bone mass and bone mass density;
take with full glass of water and 30 min before food or other medications
The LVN reinforces teaching about osteoporosis prevention at a local senior citizen clinic
Which clients are at highest risk to develop osteoporosis SATA
-Client who has taken prednisone for 5 years
-Client who has smoked 1 pack of cigarettes a day for 10 days


Rationale:
-Long term corticosteroid use decreases bone density and increase risk of osteoporosis
-Smoking is risk factor for osteoporosis
The LVN cares for a client diagnosed with a compound fracture of the right femur
The client has balanced suspension traction in place
Which observation should be reported immediately to the RN
Clients is restless and confused

Rationale:
Client is at risk for fat embolism; more common with long bone fractures; fat globules released into circulation; may migrate to brain or lungs;
restlessness, confusion, headache seen with decreased oxygenation
The LVN cares for a client diagnosed with a left tibial fracture
A cast was applied to the left leg 12 hours ago
Which observation should be reported to the RN immediately
Pain unrelieved by hydrocodone

Rationale:
Client at risk for compartment syndrome
Cast application too restrictive;
decreases blood supply to extremity;
symptoms include lack of pain relief after opioid analgesics administered
Numbness and tingling and pallor of extremity;
decreased or absent pulses; loss of motor function
LVN cares for a client diagnosed with osteoarthritis
What will the LVN expect the client to report
Joint pain after activity

Rationale:
Osteoarthritis;
non inflammatory disorder of joints;
cartilage damage and collagen changes cause erosion of articular bone surfaces; possible complete deterioration of joints; later stages pain present at rest and interrupt sleep
The LVN cares for a client who had a left above the knee amputation 12 hours ago
What is a priority action for the LVN to take
Position the client in a prone position for 1 hour every 4 hours

Rationale:
Should lie in prone position for 30 minutes 3-4 times a day
Will maintain extension of hip; should not sit in chair for more than 1 hour or elevate residual limb on pillow
THIS SET IS OFTEN IN FOLDERS WITH...