A nurse is caring for a client who has an acute ankle sprain. Which of the following actions should the nurse take? (Select all that apply.)
Place a compression bandage on the ankle.
Apply heat to the ankle.
Encourage rest.
Elevate the ankle.
Perform passive range-of-motion exercises to the ankle.
Correct Answer : A,C,D,E
A. Place a compression bandage on the ankle.
- This helps reduce swelling and provides support to the injured area.
B. Apply heat to the ankle
- This action is not recommended for acute sprains as it can increase swelling. Cold packs or ice should be used initially to reduce inflammation.
C. Encourage rest.
- Rest is important to allow the ankle to heal properly and prevent further injury.
D. Elevate the ankle.
- Elevating the ankle helps reduce swelling by allowing fluid to drain away from the injured area.
E. Perform passive range-of-motion exercises to the ankle.
- Gentle range-of-motion exercises can help prevent stiffness in the ankle joint. However, it's important to perform these exercises within the limits of comfort and not force any movements.
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Related Questions
Correct Answer is D
Explanation
A. Instructing the client on the use of crutches is important but not the most crucial immediately postoperatively. Ensuring the client's neurovascular status is stable takes priority.
B. Directing the client to perform ankle and toe exercises is important for preventing complications like deep vein thrombosis (DVT) and maintaining joint mobility. However, it is not the most critical action in the immediate postoperative period.
C. Medicating the client for pain is essential for comfort and recovery, but it should be based on a pain assessment and should not take precedence over assessing neurovascular status.
D. Performing neurovascular checks of the extremities is the most crucial action in the postoperative period after orthopedic surgery. It helps to ensure there is adequate blood flow and nerve function to the affected limb, which is essential for preventing complications such as compartment syndrome or vascular compromise.
Correct Answer is C
Explanation
A. Looseness of the stump dressing may indicate the need for adjustment, but it is not a complication in itself.
B. The dressing forming a cone shape over the stump is a not sign of complications.
C. Pitting edema around the stump dressing may indicate swelling, which is common after an amputation. It is important to monitor for excessive edema as it is a sign of potential complication.
D. Figure-eight wrapping around the stump is a technique used to provide even pressure and support, helping to prevent edema and promote healing. It is not a complication.
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