A nursing is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?

Place the client in protective isolation.

Initiate the use of a PCA pump for pain control.

Keep the head of the bed at a 30° angle.

Reposition the client by log rolling every-4 hr.

Answer and Explanation

The Correct Answer is B

A: Placing the client in protective isolation is not necessary unless the client is immunocompromised or has another indication for isolation beyond the scoliosis repair.
B: A PCA (patient-controlled analgesia) pump allows the client to manage pain effectively by administering their own pain medication within prescribed limits, which is essential after the significant surgical intervention of scoliosis repair.
C: Keeping the head of the bed at a 30° angle is not specifically indicated for postoperative care following scoliosis repair with Harrington rod instrumentation. The position of the bed should be based on the client's comfort and specific postoperative orders.
D: Repositioning the client by log rolling every 4 hours is important to prevent complications such as pressure ulcers and to promote circulation, but it is not the priority intervention. Pain management postoperatively is crucial for client comfort, promoting mobility, and aiding in the recovery process.

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Correct Answer is B

Explanation

A. An IV infusion pump may be needed for intravenous therapy but is not specific to postoperative care following intermaxillary fixation.

B. This option is correct. Wire cutters are essential equipment in case of an emergency that requires the removal of the fixation wires.

C. An NG tube may be necessary for nutritional support, but it is not directly related to postoperative care following intermaxillary fixation.

D. A urinary catheter tray is not specific to postoperative care following intermaxillary fixation and may not be a priority in this situation.

A. Position weights against the foot of the bed, B. Examine the skin under the traction splint. C. Monitor peripheral pulses in the affected extremity. D. Assess the temperature of the affected extremity. E. just the prescribed weights every shift.

Correct Answer is ["B","C","D"]

Explanation

A. Position weights against the foot of the bed: Incorrect. Weights in Buck's traction are typically hung freely over the end of the bed to provide the necessary countertraction. Placing them against the foot of the bed would not serve this purpose.

B. Examine the skin under the traction splint: Correct. It's important to regularly assess the skin underneath the traction splint to ensure there are no signs of pressure ulcers or skin breakdown.

C. Monitor peripheral pulses in the affected extremity: Correct. This is essential to ensure that blood flow to the extremity is not compromised by the traction.

D. Assess the temperature of the affected extremity: Correct. Monitoring the temperature helps in identifying any signs of impaired circulation.

E. Adjust the prescribed weights every shift: This is not something that should be done without specific orders from the healthcare provider. Adjusting the weights should be done based on the specific plan of care and provider's instructions.

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A nursing is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following an intermaxillary fixation as a result of multiple facial fractures. Which of the following types of equipment should the nurse plan to have at the client's bedside?

Correct Answer is B

Explanation

A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

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