An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?

The longer the joint is displaced, the more difficult it is to get it back in place.

Avascular necrosis may develop at the site if it is not promptly resolved.

The client's pain will increase until the joint is realigned.

Dislocation can become permanent if the process of bone remodeling begins.

Answer and Explanation

The Correct Answer is A

A. The longer the joint is displaced, the more difficult it is to get it back in place:
This statement is correct. Prompt reduction of a dislocated joint is important because the longer the joint remains out of place, the more difficult it becomes to realign it. Delayed reduction can lead to complications and makes the process more challenging for healthcare providers.

B. Avascular necrosis may develop at the site if it is not promptly resolved:
Avascular necrosis is a condition where bone tissue dies due to a lack of blood supply. While it is a potential complication of hip dislocation, it is not the immediate rationale for considering hip dislocation a medical emergency. The urgency primarily lies in the difficulty of reducing the dislocation and preventing further complications.

C. The client's pain will increase until the joint is realigned:
This statement is partially correct. While it is true that dislocated joints are extremely painful, the urgency in reducing the dislocation is not solely based on pain management. It is essential to prevent complications, restore joint function, and minimize long-term damage to the affected area.

D. Dislocation can become permanent if the process of bone remodeling begins:
This statement is accurate. If a dislocated joint is not promptly reduced, the surrounding tissues may undergo changes, and the process of bone remodeling can begin. This can lead to the dislocation becoming more difficult or even impossible to reduce, resulting in a permanent dislocation. Early intervention is essential to prevent this outcome.

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Correct Answer is C

Explanation

A. Manage bladder irrigation following the procedure. - Bladder irrigation is not typically performed after ESWL. It may be used in other urological procedures, but it is not a standard post-procedural care for ESWL.

B. Administer a bolus of 750 mL normal saline following the procedure. - While maintaining hydration is important, there is no specific requirement for a bolus of normal saline after ESWL. Hydration is usually encouraged, but the amount and method of administration are determined based on the client's overall fluid status and medical condition.

C. Strain the client's urine following the procedure.
After extracorporeal shock wave lithotripsy (ESWL), it is essential to strain the client's urine to collect any stone fragments. Straining allows healthcare providers to analyze the composition of the stones, ensuring that all fragments have been passed. This information helps in assessing the effectiveness of the procedure and guides further management.

D. Insert a urinary catheter for 24 to 48 hours after the procedure. - Inserting a urinary catheter is not a routine post-procedural measure after ESWL. Catheterization might be necessary in certain situations or for specific medical reasons, but it is not a standard practice after ESWL for all clients.

A. Remove heel boots B. Reposition every 3 hours C. Apply cornstarch to keep the skin dry D. Provide high protein diet

Correct Answer is A

Explanation

A. Remove heel boots:
Heel boots are often used to protect the heels from pressure ulcers. However, it's important to assess the skin regularly and remove heel boots periodically to inspect the skin underneath. Leaving them on continuously without proper inspection can cause moisture buildup, leading to skin breakdown.

B. Reposition every 3 hours
Repositioning the client every 3 hours is a crucial intervention to prevent skin breakdown, especially in individuals at risk, such as older adults. Prolonged pressure on specific areas of the body can lead to pressure ulcers or bedsores. Regular repositioning helps relieve pressure on vulnerable areas, improving circulation and reducing the risk of skin breakdown.

C. Apply cornstarch to keep the skin dry:
While it's essential to keep the skin clean and dry, using cornstarch can sometimes lead to moisture retention, especially in skin folds. Excess moisture can contribute to skin breakdown and fungal infections. Instead, proper hygiene practices and the use of moisture-wicking products are recommended.

D. Provide high protein diet:
Adequate nutrition, including a high-protein diet, is essential for overall skin health and healing. Protein is necessary for tissue repair and regeneration. While a balanced diet is crucial for overall health, it is not a specific intervention solely focused on maintaining skin integrity.

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An emergency department client is diagnosed with a hip dislocation. The client's family is relieved that the client has not suffered a hip fracture, but the nurse explains that this is still considered to be a medical emergency. What is the rationale for the nurse's statement?

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A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?

Correct Answer is C

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A nurse is caring for an older adult client who is at risk for skin breakdown. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin?

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