A client with a compound fracture of the left ankle is being discharged with a below-the-knee cast. Which
instruction should the practical nurse (PN) provide to the client prior to discharge?
Apply a cold pack to any "hot spots" on the cast.
Keep the left leg in a dependent position.
Expect some increase in pain.
Never scratch under the cast.
The Correct Answer is D
When providing instructions to a client with a below-the-knee cast for a compound fracture of the left ankle, it is important to prioritize their safety and proper care of the cast. The instruction to never scratch under the cast is crucial for preventing complications and maintaining the integrity of the cast.
Let's evaluate the other options:
a) Apply a cold pack to any "hot spots" on the cast.
Applying a cold pack to any "hot spots" on the cast may help alleviate discomfort or itching, but it is not the highest priority instruction. Preventing scratching under the cast is more important to avoid skin damage or infection.
b) Keep the left leg in a dependent position.
Keeping the left leg in a dependent position (hanging down) is not the appropriate instruction for a client with a below-the-knee cast. It is generally recommended to elevate the injured limb to reduce swelling and promote proper blood flow. Elevating the leg would involve keeping it raised above the level of the heart.
c) Expect some increase in pain.
While it is possible for the client to experience some increase in pain after the application of a cast, this instruction alone is not comprehensive or specific enough for proper discharge education. Providing information about pain management strategies or when to seek medical atention for excessive pain would be more appropriate.
In summary, when discharging a client with a compound fracture of the left ankle and a below-the-knee cast, the practical nurse (PN) should provide the instruction to never scratch under the cast. This helps prevent complications and maintain the integrity of the cast, promoting proper healing of the fracture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A black tag is not an appropriate priority tag for this client because it indicates that the client is dead or has injuries that are incompatible with life and survival is unlikely even with treatment.
Choice B reason: A red tag is an appropriate priority tag for this client because it indicates that the client has life-threatening injuries that require immediate attention and treatment to survivE.
Choice C reason: A green tag is not an appropriate priority tag for this client because it indicates that the client has minor injuries that do not require immediate attention and treatment and can wait until the more urgent cases are handleD.
Choice D reason: A yellow tag is not an appropriate priority tag for this client because it indicates that the client has serious injuries that require attention and treatment within a short time, but can wait until the more critical cases are handleD.
Correct Answer is B
Explanation
Choice A reason: Limiting fluid intake to prevent incontinence is not the highest priority intervention for this client because it can cause dehydration, urinary tract infections, or kidney stones, which can worsen the client's condition and quality of lifE. The client should be encouraged to drink adequate fluids and empty their bladder regularly.
Choice B reason: Providing regular perineal care to prevent skin breakdown is the highest priority intervention for this client because it can prevent infection, irritation, and ulceration of the skin around the genital and anal areas, which can cause pain, discomfort, and complications. The client should be kept clean and dry, and use barrier creams or pads as needeD.
Choice C reason: Administering hypotonic IV fluids is not an intervention for this client because it can cause fluid overload, hyponatremia, or cerebral edema, which can endanger the client's health and safety. The client does not need IV fluids unless they are dehydrated or have other indications.
Choice D reason: Teaching Kegel exercises to strengthen the pelvic floor is not an intervention for this client because it can be ineffective or harmful for clients with reflex incontinence, which is caused by loss of voluntary control over bladder contractions due to spinal cord injury. The client may benefit from other interventions such as bladder training, medication, or surgery.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today