Which clinical manifestation is often present in a stress fracture?
Severe pain and deformity
Sudden onset of swelling and bruising
Gradual onset of localized pain with activity
Inability to bear weight on the affected limb
The Correct Answer is C
: Stress fractures are small, hairline cracks in the bone that occur due to repetitive stress or overuse. They typically present with a gradual onset of localized pain that worsens with activity.
a. Severe pain and deformity: Severe pain and deformity are more commonly seen in acute fractures resulting from trauma or high-impact injuries, not stress fractures.
b. Sudden onset of swelling and bruising: Sudden onset of swelling and bruising is more indicative of acute fractures, not stress fractures.
d. Inability to bear weight on the affected limb: Inability to bear weight may be present in some fractures, but it is not a specific characteristic of stress fractures.
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Correct Answer is D
Explanation
Patients with external fixation require close monitoring of the pin sites for signs of infection, as they are at risk of developing pin site infections.
a. Providing passive range of motion exercises: Passive range of motion exercises may be appropriate in some cases, but they are not specific to external fixation management.
b. Changing the dressing daily: Dressing changes for external fixation are typically done as instructed by the healthcare provider, which may not necessarily be daily.
c. Loosening the fixation screws every 4 hours: Fixation screws should not be loosened without proper medical guidance, as this can compromise the stability of the external fixation device.
Correct Answer is A
Explanation
It is essential for the patient to avoid moving the cast to relieve itching as this can lead to skin breakdown, discomfort, and improper healing. The nurse should instruct the patient to use cool air or apply ice packs on the outside of the cast to alleviate itching without disturbing the cast's positioning.
b. Using a hairdryer on a warm setting to dry the inside of the cast is not recommended. The heat can cause discomfort and may not effectively dry the interior of the cast, leading to skin irritation and potential infection.
c. Sticking objects under the cast to scratch the skin can damage the skin and introduce bacteria, increasing the risk of infection. The patient should be instructed not to insert any objects under the cast.
d. Removing the cast if it becomes loose is not within the patient's scope of practice. If the cast becomes loose or uncomfortable, the patient should seek immediate medical attention for evaluation and adjustment by a healthcare professional.
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