A nurse is caring for a client who is 6 hr postoperative following application of an external fixator for a tibial fracture. Which of the following actions should the nurse take?
Maintain the affected extremity in a dependent position.
Palpate the dorsalis pedis pulse.
Wrap sterile gauze on the sharp point of the pins.
Adjust the clamps on the fixator frame.
The Correct Answer is B
Palpating the dorsalis pedis pulse is an essential action to monitor for adequate circulation and perfusion in an extremity with an external fixator, which is a device that stabilizes and aligns fractured bones with metal pins and rods outside of the skin. The other options are incorrect because they could cause complications such as edema, infection, or malalignment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A chest physiotherapy vest is a device that delivers high-frequency chest wall oscillation to loosen and mobilize mucus from the airways . This helps improve lung function and prevent respiratory infections in patients with cystic fibrosis, who have thick and sticky mucus production . A peak flow meter is used to measure the peak expiratory flow rate, which reflects the degree of airway obstruction in patients with asthma .
An NG tube with suction apparatus is used to decompress the stomach and remove gastric contents in patients with bowel obstruction, paralytic ileus, or gastroparesis . A chest tube with a drainage system is used to remove air or fluid from the pleural space in patients with pneumothorax, hemothorax, or pleural effusion .
Correct Answer is C
Explanation
This is because peritonitis is an infection of the peritoneal cavity that can occur as a complication of peritoneal dialysis. Peritonitis can cause inflammation and irritation of the peritoneum, which can lead to cloudy or milky appearance of the dialysate fluid that drains out of the abdomen (also known as effluent). Cloudy effluent is often the first and most reliable sign of peritonitis in peritoneal dialysis patients. Other signs and symptoms of peritonitis may include increased heart rate, generalized abdominal pain, fever, nausea, vomiting, loss of appetite, and malaise.
The nurse should instruct the client and his partner to inspect the effluent for clarity every time they perform an exchange and to report any changes to their health care provider immediately. The nurse should also teach them how to prevent peritonitis by following strict aseptic technique when handlingcatheters and supplies, washing hands before and after each exchange, wearing a mask during exchanges, and storing supplies in a clean and dry place.
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