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 C
Explanation
Choice A reason: "Diet and exercise are good for you and good for your heart." This response is true, but it does not address the client's concern or provide any specific information about cardiac rehabilitation.
Choice B reason: "It's not unusual to feel that way at first, but once you learn the routine, you'll enjoy it." This response is empathetic, but it does not explain the benefits or goals of cardiac rehabilitation.
Choice C reason: "Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely." This response is accurate and informativE. It acknowledges the client's condition and provides realistic expectations about cardiac rehabilitation.
Choice D reason: "Your doctor is the expert here, and I'm sure he would only recommend what is best for you." This response is respectful, but it does not answer the client's question or encourage their participation in cardiac rehabilitation.
Correct Answer is ["A","E"]
Explanation
The correct answers are:
a) Transport a urine culture sample to the laboratory. Correct
This is a client care intervention that the PN can assign to the UAP. Transporting a urine culture sample to the laboratory is a routine and non-invasive task that does not require clinical judgment or skill. The UAP should follow the standard precautions and protocols for handling and labeling the specimen.
b) Obtain a post-voided residual (PVR) volume.
This is not a client care intervention that the PN can assign to the UAP. Obtaining a post-voided residual (PVR) volume is a procedure that requires clinical judgment and skill, as it involves using a bladder scanner or catheterizing the client to measure the amount of urine left in the bladder after voiding.
The UAP is not trained or authorized to perform this task, and it should be done by the PN or another licensed nurse.
c) Teach the client with fluid restrictions how to measure urine output.
This is not a client care intervention that the PN can assign to the UAP. Teaching the client with fluid restrictions how to measure urine output is an educational activity that requires clinical judgment and skill, as it involves assessing the client's learning needs, providing clear and accurate instructions, and evaluating the client's understanding and compliance. The UAP is not trained or authorized to perform this task, and it should be done by the PN or another licensed nurse.
d) Irrigate an indwelling urinary catheter for a client with bladder suspension.
This is not a client care intervention that the PN can assign to the UAP. Irrigating an indwelling urinary catheter for a client with bladder suspension is a procedure that requires clinical judgment and skill, as it involves inserting sterile fluid into the bladder through the catheter to flush out any clots, debris, or bacteria. The UAP is not trained or authorized to perform this task, and it should be done by the PN or another licensed nurse.
e) Empty bedside drainage unit for a client with indwelling urinary catheter. Correct
This is a client care intervention that the PN can assign to the UAP. Emptying bedside drainage unit for a client with indwelling urinary catheter is a routine and non-invasive task that does not require clinical judgment or skill. The UAP should follow the standard precautions and protocols for emptying, measuring, and recording the urine output.
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