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 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.

A. Hematuria B. Impaired taste C. Diarrhea D. Increased thirst

Correct Answer is A

Explanation

A. Hematuria: This is the correct answer. Hematuria, which is the presence of blood in the urine, can be a common complication of pelvic fractures. This occurs due to the potential injury to the bladder or other structures within the pelvis. Monitoring for hematuria is crucial in assessing potential internal injuries and ensuring appropriate management.

B. Impaired taste: Impaired taste is not typically associated with pelvic fractures. It is more likely related to conditions involving the sense of taste or other unrelated factors. It is not a common complication of pelvic fractures.

C. Diarrhea: Diarrhea is not a common complication of pelvic fractures. It is more likely to be caused by gastrointestinal issues, infections, dietary factors, or other medical conditions. It is not directly related to pelvic fractures or their complications.

D. Increased thirst: Increased thirst is not a common complication of pelvic fractures. It may be related to various factors such as dehydration, certain medical conditions like diabetes, or side effects of medications. It is not a direct consequence of pelvic fractures or their associated complications.

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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

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