Two weeks after cast application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?
Prepare to assist in applying a new cast to reduce pressure points.
Report the client's concern to the healthcare provider.
Explain this is an expected part of the bone healing process.
Teach the client strategies to prevent further calluses.
The Correct Answer is C
A callus is a normal response of the body during bone healing, where new bone tissue forms around the fracture site to provide stability and support. It helps in the process of bridging the fracture and promoting healing.
The PN can provide reassurance to the client by explaining that the presence of a callus indicates that the bone is healing and progressing toward recovery. It is important to educate the client about the expected timeline for bone healing and the need for continued follow-up with the healthcare provider.
Incorrect:
A. Prepare to assist in applying a new cast to reduce pressure points: This choice assumes that the client's concern is related to discomfort or pressure points caused by the current cast.
However, the client's concern is about the formation of a callus, which is a normal part of bone healing. There is no indication that a new cast is necessary at this point.
B. Report the client's concern to the healthcare provider: While it's important to address client concerns and communicate any changes in their condition to the healthcare provider, in this case, the formation of a callus is an expected part of the bone healing process. It is not necessary to report this concern to the healthcare provider as it is a normal occurrence.
D. Teach the client strategies to prevent further calluses: The formation of a callus in this context is a natural response of the body to promote bone healing. It is not necessary to teach the client strategies to prevent further calluses, as callus formation is a temporary and beneficial part of the healing process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Regular insulin is the medication of choice for treating DKA. Its main action is to lower blood glucose levels by promoting the uptake of glucose into cells and inhibiting the production of glucose by the liver. Therefore, checking the fingerstick blood glucose level is an important indicator of the effectiveness of the insulin treatment.
A decrease in the blood glucose level indicates that the insulin is working to lower the high blood sugar associated with DKA. This measurement helps the PN assess the response to treatment and adjust the insulin dosage if necessary.
The other actions mentioned are also important assessments in the care of a client with DKA, but they do not specifically evaluate the effectiveness of the insulin dosage:
A. Smelling the client's breath for resolution of a fruity odor is important as it indicates a decrease in ketone production, which is a marker of improving DKA. However, it does not directly evaluate the effectiveness of the insulin dosage.
B. Determining the client's orientation to time and space is part of assessing their neurological status, which is crucial in managing DKA. However, it does not specifically assess the effectiveness of the insulin dosage.
C. Measuring the client's urinary output for an increased volume is important to monitor hydration status and renal function, but it does not directly evaluate the effectiveness of the insulin dosage.
Correct Answer is A
Explanation
The finding that is the highest priority for the PN to report to the charge nurse is the blood urea nitrogen (BUN) level of 75 mg/dL or 12.9 mmol/L. This result indicates an elevated BUN level, which can be indicative of impaired kidney function. In a client receiving chemotherapy, an elevated BUN level may suggest chemotherapy-induced nephrotoxicity or other kidney-related complications. Prompt reporting is crucial to ensure appropriate intervention and management of the client's kidney function.
B. While the platelet count of 135,000/mm3 or 135 x 109/L is slightly below the normal reference range, it does not pose an immediate life-threatening risk. However, it should still be monitored and reported to the healthcare team for ongoing assessment and evaluation.
C. Decreased deep tendon reflexes may be an expected side effect of certain chemotherapy medications or a manifestation of neurotoxicity. While this finding should be documented and monitored, it is not as urgent as the elevated BUN level.
D. Periodic nausea and vomiting are common side effects of chemotherapy, but they may also be indicative of other underlying issues such as dehydration, electrolyte imbalances, or gastrointestinal complications. While this finding should be addressed and managed, it is not the highest priority compared to the elevated BUN level.
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