A provider prescribes cold application for a client who reports ankle joint stiffness. Which of the following assessment findings should the nurse identify as a contraindication to the application of cold?

2+ pitting edema

7.5 cm (3 in) diameter bruise on the ankle

Capillary refill 4 seconds

Warts on the affected ankle

Answer and Explanation

The Correct Answer is C

A.   2+ pitting edema is not a contraindication to cold application; in fact, cold application can help reduce edema.
B.   A 7.5 cm (3 in) diameter bruise on the ankle is not a contraindication to cold application; cold can help reduce swelling and alleviate pain.
C.   Capillary refill of 4 seconds suggests compromised blood flow, and cold application may further impair circulation. It is a contraindication.
D.   Warts on the affected ankle are not a contraindication to cold application.

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Correct Answer is A

Explanation

A. If the nurse still has concerns after seeking clarification, the appropriate action is to contact another provider for a second opinion to ensure the safety and well-being of the client.
B. Withholding the treatment without further consultation may not be the best course of action.
Seeking additional input is important.
C. Carrying out the prescription despite concerns about its safety may pose risks to the client.
D. Notifying the ethics committee should be considered if there are ongoing ethical concerns or if the issue cannot be resolved through collaboration with other providers.

A. The client places one crutch on each side when assuming a sitting position. B. The client places weight on the axillae when walking. C. The client moves the unaffected leg onto a step first when descending stairs. D. The client has slightly flexed elbows when ambulating with crutches.

Correct Answer is D

Explanation

A) Placing one crutch on each side when assuming a sitting position is not indicative of safe crutch use as it does not provide adequate support or balance during the transition from standing to sitting.
B) Placing weight on the axillae, or underarms, can cause nerve damage due to the pressure on the radial nerve located there; therefore, this is not a safe practice.
C) When descending stairs, the affected leg should be moved first, followed by the crutches and then the unaffected leg, to maintain balance and safety. Therefore, moving the unaffected leg onto a step first is not the safest option.
D) Having slightly flexed elbows allows for proper distribution of weight and helps in maintaining balance while ambulating with crutches, making it the correct and safe method.

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A provider prescribes cold application for a client who reports ankle joint stiffness. Which of the following assessment findings should the nurse identify as a contraindication to the application of cold?

Nursing Test Bank

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