A nurse is caring for a client who has a prescription for balanced skeletal traction with a Thomas splint for the treatment of a fractured femur. Which of the following interventions should the nurse implement to prevent pressure points from developing around the edges of the splint?
Remove the weights for a few minutes each hour.
Apply lotion to the skin under the edges of the splint.
Apply a foot plate to the bed.
Reposition the client to keep him from staying in the same position in bed.
The Correct Answer is D
A. Removing the weights periodically helps relieve pressure on the skin but dosen't prevent pressure points from developing.
B. Applying lotion may not effectively prevent pressure points and could potentially lead to skin irritation.
C. Applying a foot plate to the bed is not directly related to preventing pressure points around the edges of the splint.
D. Repositioning the client is important for overall comfort as well as preventing complications by altering pressure points.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Hypovolemic shock is characterized by a significant loss of blood volume. While it can occur due to severe trauma, the symptoms of shortness of breath and chest pain are more indicative of a potential respiratory issue, making Fat Embolism Syndrome (FES) a higher concern in this case.
B. Correct. Given the client's recent multiple long bone fractures and the symptoms of shortness of breath and chest pain, the nurse should be concerned about the possibility of fat embolism syndrome (FES). FES can occur as a result of long bone fractures, particularly those involving the femur, pelvis, or tibia. Fat emboli can enter thebloodstream and potentially obstruct blood vessels, leading to symptoms such as shortness of breath, chest pain, and altered mental status.
C. Venous thromboembolism (VTE) is a condition involving the formation of blood clots in the veins, which can lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). While this is a consideration for clients with immobilization due to fractures, it is not the primary concern in this case based on the presenting symptoms.
D. Compartment syndrome is a condition characterized by increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage. While it can occur after fractures, it typically presents with symptoms like severe pain, swelling, and tense muscles, rather than shortness of breath and chest pain.
Correct Answer is A
Explanation
A. Holding the wrist at a 90-degree flexion is known as Phalen's maneuver, which is a test for carpal tunnel syndrome. This position puts pressure on the median nerve, potentially reproducing the client's symptoms.
B. Flexing the right arm at the elbow is not a specific test for carpal tunnel syndrome.
C. Holding the right arm straight is not a specific test for carpal tunnel syndrome.
D. Extending the right arm upward is not a specific test for carpal tunnel syndrome.
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