A nurse is providing discharge teaching to a client who has a fracture of the right tibia and a fiberglass cast. Which of the following instructions should the nurse include in the teaching?
Report any worsening or unrelieved pain.
Avoid moving the affected leg.
Use a cotton swab to relieve itching under the cast.
Use a blow dryer on a moderate heat setting to dry the cast after showering.
The Correct Answer is A
A. Reporting any worsening or unrelieved pain is important because increasing or unrelieved pain could indicate complications such as inadequate immobilization, pressure sores, or compartment syndrome. Prompt reporting allows for timely intervention and prevention of further complications
B. Movement of the affected leg could disrupt the alignment of the bones and impede the healing process. Immobilization is essential for bone healing in a fiberglass cast. However, reporting features of compartment syndrome is priority.
C. Patients should be advised not to insert anything under the cast and instead use other methods such as blowing cool air under the cast or gently tapping on the outside of the cast to relieve itching.
D. Using a blow dryer on a moderate heat setting can help speed up the drying process of the cast after it gets wet. However, it's important to ensure that the heat is not too high to avoid causing burns or softening the cast material excessively.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Asking the client to wiggle their toes assesses motor function and nerve integrity. In a neurovascular assessment, intact nerve function is crucial, as impaired nerve function can manifest as weakness or paralysis.
A. This technique assesses the circulation in the lower extremity by checking for the presence, strength, and symmetry of the pulse. However, it assesses for vascular component proximal to the fracture.
B. Edema in the calf muscle is mostly used as a marker for deep venous thrombosis. Although it can affect circulation. It may be a late sign.
D. Significant differences in thigh circumference between the affected and unaffected limb may indicate vascular compromise or other issues. This is however, a late sign of vascular compromise.
Correct Answer is D
Explanation
D. Petechiae, which are small red or purple spots caused by bleeding under the skin, are a classic manifestation of fat embolism syndrome. They typically appear on the upper chest, axilla (armpit), and conjunctiva of the eyes. Petechiae result from the occlusion of small blood vessels by fat globules, leading to microvascular bleeding.
A Paresthesia distal to the fracture site is not a typical manifestation of fat embolism syndrome. Instead, paresthesia may suggest nerve compression or injury related to the fracture itself rather than fat emboli.
B Fever is not a specific manifestation of fat embolism syndrome. While fever can occur with various types of infections or inflammatory conditions, it is not a hallmark symptom of fat embolism.
C Swelling of the calf can occur with conditions such as deep vein thrombosis (DVT), which is a potential complication of lower limb fractures. However, it is not a typical manifestation of fat embolism syndrome.
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