A nurse is caring for a client who is postoperative following a laminectomy with spinal fusion. Which of the following actions should the nurse take?
Position the client in a high-Fowler's position if clear drainage is noted on the dressing
Monitor sensory perception of the lower extremities.
Assist the client into a knee-chest position to manage postoperative discomfort.
Maintain strict bed rest for the first 48 hr postoperative.
The Correct Answer is B
A. Positioning the client in a high-Fowler's position if clear drainage is noted on the dressing is not a specific intervention for a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning and wound care.
B. Monitoring sensory perception of the lower extremities is a crucial nursing intervention after a laminectomy with spinal fusion. This is to assess for any signs of neurovascular compromise or nerve damage.
C. Assisting the client into the knee-chest position to manage postoperative discomfort is not a recommended position after a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning.
D. Maintaining strict bed rest for the first 48 hours postoperative is not typically indicated after a laminectomy with spinal fusion. Early mobilization and ambulation are often encouraged to prevent complications and promote recovery. The nurse should follow the surgeon's specific postoperative orders regarding activity and mobility.
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Related Questions
Correct Answer is D
Explanation
A. Cool extremities are not typically associated with carpal tunnel syndrome. They may be a sign of poor circulation, but this is not a specific finding for carpal tunnel syndrome.
B. Decreased radial pulse is not a characteristic finding of carpal tunnel syndrome. It may indicate issues with blood flow to the hand but is not specific to this condition.
C. Positive Chvostek's sign is associated with hypocalcemia and involves facial muscle twitching when the facial nerve is tapped. It is not related to carpal tunnel syndrome.
D. Positive Phalen's sign is a characteristic finding in carpal tunnel syndrome. It involves tingling or numbness in the median nerve distribution (usually thumb, index, middle, and part of the ring finger) when the wrist is flexed for 60 seconds.
Correct Answer is C
Explanation
A. Stating that ibuprofen is the first step in medication therapy for osteoarthritis is not an accurate statement. Medication choices should be made in consultation with a healthcare provider, and different medications may be prescribed based on individual needs.
B. Elevating the legs with pillows is generally not a specific intervention for osteoarthritis in the knees. While elevation can help with other conditions, it is not a primary recommendation for managing knee osteoarthritis.
C. Using either heat or ice can be helpful in relieving discomfort associated with osteoarthritis. This statement indicates an understanding of self-care strategies for managing symptoms.
D. Limiting physical activity is not typically recommended for osteoarthritis management. In fact, regular and appropriate physical activity can be beneficial for maintaining joint function and reducing pain in individuals with osteoarthritis.
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