The nurse is contributing to the plan of care for a patient who has a traumatic finger amputation. What should the nurse consider?

Risk of infection is great.

Replantation can occur.

Postoperative therapy will be required.

Prosthetic fitting is often prescribed.

Answer and Explanation

Correct Answer : A,B,C

A. Risk of infection is great.: Traumatic amputations create an open wound, increasing the risk of infection. Proper wound care and monitoring for signs of infection are critical.
B. Replantation can occur.: Depending on the severity of the injury and the viability of the amputated part, replantation is possible and is a common consideration in the plan of care.
C. Postoperative therapy will be required.: Rehabilitation, including physical therapy, is essential for restoring function and mobility in the affected limb after amputation or replantation.
D. Prosthetic fitting is often prescribed.: While prosthetics can be used for finger amputations, not all cases require them, especially if replantation is successful. This is less common compared to major limb amputations.

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Correct Answer is B

Explanation

A. A patient with a BP of 170/80 mm Hg with a mild headache: Although high, this BP is not as immediately critical as 180/120 mm Hg. The patient is experiencing only a mild headache, indicating less urgency.
B. A patient with a BP of 180/120 mm Hg who is asymptomatic: This BP level indicates a hypertensive crisis, which can lead to life-threatening complications such as stroke or heart attack, even if the patient is asymptomatic. Immediate intervention is needed to lower the BP safely.
C. A patient with a BP of 150/60 mm Hg who is anxious: This BP is elevated but not critically so. Anxiety management may be necessary but is not as urgent as managing a hypertensive crisis.
D. A patient with a blood pressure (BP) of 140/70 mm Hg who has a nosebleed: This BP is relatively mild compared to 180/120 mm Hg and is less immediately threatening, even with a nosebleed.

A. Instruct the patient to wear constrictive clothing. B. Encourage frequent ambulation. C. Encourage the patient to keep legs in a dependent position. D. Apply compression stockings.

Correct Answer is D

Explanation

A. Instruct the patient to wear constrictive clothing: This is incorrect. Constrictive clothing can impede blood flow and worsen venous stasis.
B. Encourage frequent ambulation: This is correct. Ambulation promotes circulation, helps prevent blood stasis, and encourages the healing of ulcers.
C. Encourage the patient to keep legs in a dependent position: This is incorrect. Keeping the legs in a dependent position can increase venous pressure and exacerbate edema, which is counterproductive for managing venous stasis ulcers.
D. Apply compression stockings: This is correct. Compression stockings help to improve venous return, reduce edema, and promote ulcer healing by preventing blood from pooling in the legs.

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The nurse is contributing to the plan of care for a patient who has a traumatic finger amputation. What should the nurse consider?

Nursing Test Bank

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