1 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. Nursing Management: Musculoskeletal Trauma & Orthopedic Surgery Chapter 63

2 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 1. X-rays indicate that a patient has a severely sprained ankle from a sports injury. When providing discharge instructions from the urgent care center, the nurse teaches the patient to 1. alternate cold and heat for 30 minutes each until symptoms are relieved. 2. use continuous cold for the first 24 hours and then continuous heat until the symptoms are relieved. 3. apply continuous heat to the ankle for the first 24 hours and then continuous cold until the symptoms are relieved. 4. apply cold for 20 to 30 minutes with breaks of 10 to 15 minutes during the first 2 days and then apply heat intermittently for 20 to 30 minutes.

3 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 2.A plaster splint is applied with an elastic bandage to the leg of a patient hospitalized with a fractured tibia in preparation for open reduction and internal fixation of the fracture. The patient complains of increasing pain in the affected leg and foot that is not relieved by loosening of the elastic bandage. The most appropriate action by the nurse is to 1.elevate the leg on two pillows. 2.perform neurovascular assessment of the foot. 3.notify the health care provider. 4.apply ice over the fracture site.

4 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 3.The nurse determines that discharge teaching for the patient with a total hip replacement (posterior approach) has been effective when the patient says, 1.“I should keep my leg elevated above the level of my heart when I am sitting in a chair.” 2.“It is necessary for me to use an elevated toilet seat at home.” 3. “I need to perform as many activities of daily living for myself as I can to gain strength.” 4.“Exercises for my leg include swinging my leg out and then across the other leg.”

5 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 4.The nurse teaches a 58-year-old patient who had an above-the- knee amputation how to care for the residual limb. Which of the following statements by the patient indicates that teaching was effective? 1.“I should use only mild soap and water to clean the limb.” 2.“I can apply lotion to the residual limb to keep the skin from cracking.” 3. “Tincture of iodine or alcohol could be used to toughen the limb.” 4.“I can elevate the residual limb on a pillow to prevent swelling when I am sitting or lying down.”