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. Performing range of motion:
Explanation: Range of motion exercises are important for preventing joint stiffness and muscle atrophy, especially in clients with casts. However, this is not the first priority. Ensuring adequate circulation and perfusion is crucial before initiating any exercises or movements, as compromised circulation could lead to serious complications.

B. Managing pain:
Explanation: Pain management is important for the client's comfort, but it is not the first priority in this context. Assessing circulation and ensuring there are no signs of compromised perfusion takes precedence. Pain management can follow once circulation has been confirmed as adequate.

C. Checking capillary refill:
Explanation: Checking capillary refill is the first priority when assessing a client with a cast. Capillary refill assesses peripheral circulation by pressing on the nail bed and observing how quickly color returns. Delayed capillary refill could indicate compromised blood flow, which is a serious concern and requires immediate intervention.

D. Discussing cast care:
Explanation: Educating the client about cast care is important, but it is not the first priority. Ensuring proper circulation and ruling out any signs of impaired perfusion must be addressed before discussing cast care instructions.

A. Increased thickness of the subcutaneous skin layer B. Changes in the character and quantity of bacterial skin flora C. Increased time required for wound healing D. Increased elasticity of the skin

Correct Answer is C

Explanation

A. Increased thickness of the subcutaneous skin layer - Aging typically results in thinning of the skin and subcutaneous tissue, making older adults more vulnerable to pressure ulcers rather than having increased thickness.

B. Changes in the character and quantity of bacterial skin flora - This is a common age-related change; however, it is not directly related to the course of treatment for a sacral pressure ulcer. Proper wound care can mitigate the impact of changes in skin flora.

C. Increased time required for wound healing - Aging often leads to a decline in the body's ability to repair and regenerate tissues, which can prolong the healing process of wounds, including pressure ulcers. Older adults may experience delayed wound healing compared to younger individuals.

D. Increased elasticity of the skin - Skin elasticity decreases with age, making older adults more susceptible to skin breakdown and pressure ulcers due to reduced skin resilience and ability to redistribute pressure. Increased elasticity would not affect the course of treatment positively but rather negatively in this context.

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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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