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Bisphosphonates are generally safe for clients with diabetes and normal renal function (serum creatinine 0.8 mg/dL is within normal range, indicating adequate kidney function). These drugs inhibit osteoclast activity, reducing bone resorption, and are not contraindicated in diabetes unless renal impairment is present, which is not the case here.

Vertebral compression fractures are a common complication of osteoporosis. Bisphosphonates are often prescribed to strengthen bones and prevent further fractures by inhibiting bone resorption. Recent fractures do not contraindicate their use; in fact, they are indicated to improve bone density and reduce future fracture risk.

Calcium channel blockers, used for hypertension, do not interact significantly with bisphosphonates. These drugs work on different systems—bisphosphonates on bone metabolism and calcium channel blockers on vascular smooth muscle. There is no evidence suggesting this combination poses a risk, making bisphosphonates appropriate for this client.

Elevating the leg and applying ice may reduce swelling but does not address the potential dislocation indicated by leg shortening and pain. These interventions could delay critical assessment and management of neurovascular compromise, potentially worsening outcomes in a suspected dislocation scenario.

Administering pain medication may alleviate discomfort but does not address the underlying cause, such as a dislocated hip prosthesis. Pain relief is secondary to ensuring neurovascular integrity and confirming the surgical leg’s alignment, which are critical to prevent complications like tissue necrosis.

Attempting to place the leg in abduction without confirming the cause of shortening and pain risks further damage, especially if the hip is dislocated. Manipulation could exacerbate neurovascular compromise or prosthesis misalignment, leading to prolonged recovery or additional surgical intervention.

Regular liver function tests are recommended for clients on long-term acetaminophen to monitor for hepatotoxicity, as the drug is metabolized by the liver. This statement shows correct understanding, as it acknowledges the need to assess liver enzymes like ALT and AST for potential damage.

Checking other medications for acetaminophen content is crucial to prevent unintentional overdose, which can lead to acute liver failure. This statement reflects proper understanding, as combination drugs (e.g., cold remedies) often contain acetaminophen, contributing to cumulative toxicity if not monitored.

Using topical patches or creams for osteoarthritis pain is a valid adjunctive therapy. These deliver localized relief (e.g., NSAIDs or capsaicin) without systemic effects, complementing acetaminophen’s action. This statement indicates correct understanding of multimodal pain management strategies.

Celecoxib, a COX-2 inhibitor, can increase bleeding risk by inhibiting platelet aggregation. Reporting signs of bleeding or bruising is critical, as it may indicate gastrointestinal or systemic bleeding, a known adverse effect. This statement shows appropriate understanding of monitoring for serious side effects.

Taking celecoxib only as prescribed ensures adherence to the recommended dose and schedule, minimizing risks like gastrointestinal irritation or cardiovascular events. This statement reflects correct understanding of the importance of following medical guidance to optimize safety and efficacy.

Monitoring urine output is relevant, as celecoxib can cause renal toxicity, leading to decreased urine output or acute kidney injury. This statement shows appropriate awareness of the need to monitor for renal side effects, which is critical for safe use.

Controlled hypertension, when managed with medications, poses minimal risk to postoperative healing. Stable blood pressure ensures adequate tissue perfusion, supporting wound healing and recovery. It is not a significant risk factor compared to other conditions that directly impair tissue repair.

Osteoarthritis, the primary indication for knee arthroplasty, does not directly impair postoperative healing. It affects joint cartilage but not the body’s wound healing mechanisms, such as collagen synthesis or immune response, making it a less significant risk factor.

Mild osteopenia, a precursor to osteoporosis, indicates slightly reduced bone density but does not significantly affect soft tissue healing or surgical outcomes. It may influence implant stability long-term but is less critical for immediate postoperative healing compared to obesity.

Abdominal assessment is less critical in RA and Sjögren syndrome, as these conditions primarily affect joints and exocrine glands, respectively. Gastrointestinal issues may occur with RA medications (e.g., NSAIDs), but they are not the primary concern compared to ocular complications.

Oxygen saturation is not directly impacted by RA or Sjögren syndrome unless secondary complications like interstitial lung disease (rare in RA) are present. It is less relevant than ocular assessments for Sjögren syndrome’s hallmark dry eye complications.

Breath sounds may be assessed in RA for rare pulmonary complications, but Sjögren syndrome primarily causes sicca symptoms (dry eyes and mouth). Respiratory issues are not the primary concern, making this less critical than ocular assessment.

Providing socks to “slide easier” increases the risk of slipping during transfer, which could lead to falls or hip dislocation. Non-slip footwear is preferred to ensure stability and safety during mobilization post-hip arthroplasty.

Full weight bearing is typically restricted after uncemented hip arthroplasty to allow bone ingrowth into the prosthesis. Informing the patient that full weight bearing is allowed is incorrect and could lead to implant failure or dislocation.

Using a footstool to elevate the leg during transfer is inappropriate, as it may cause hip flexion beyond 90 degrees, increasing the risk of dislocation. Elevation is used in specific positions but not during initial transfers.

Methotrexate typically takes 6–12 weeks to achieve therapeutic effects in rheumatoid arthritis by suppressing immune-mediated inflammation. Stating 1–2 weeks is inaccurate, as it underestimates the time needed for the drug to modulate immune response and reduce joint inflammation.

Discussing cost and pharmacy plans is not a priority in health teaching about methotrexate’s clinical effects. While cost may be a concern, it is not relevant to the drug’s pharmacological action or patient safety education.

Alcohol consumption, even in moderation (2–3 glasses of wine weekly), is discouraged with methotrexate due to its hepatotoxic effects. Alcohol exacerbates liver damage risk, as methotrexate is metabolized by the liver, potentially leading to elevated liver enzymes or hepatotoxicity.

Placing the client in a high-Fowler position may improve breathing but does not assess the cause of shortness of breath. Post-femur repair, pulmonary embolism (PE) is a risk due to fat emboli or thromboembolism, requiring objective data like oxygen saturation first.

Starting oxygen therapy assumes hypoxia without confirmation. While it may be needed, assessing oxygen saturation first ensures the intervention is appropriate. Unwarranted oxygen administration could delay critical diagnostic steps for conditions like pulmonary embolism, which require anticoagulation or other therapies.

Contacting the provider is important but secondary to assessing oxygen saturation, which provides critical data to report. Without objective findings, the nurse cannot convey the urgency or specifics of the client’s condition, potentially delaying life-saving interventions for suspected embolism.

Removing traction during repositioning disrupts the continuous pull needed to maintain bone alignment in fractures. This could lead to misalignment, delayed healing, or increased pain, as traction counteracts muscle spasms and stabilizes the fracture site.

While skin assessment during a bed bath is important to detect pressure injuries, it is a general nursing responsibility, not specific to traction care. Traction-specific teaching focuses on maintaining the system’s integrity, such as ensuring proper weight function, over general hygiene tasks.

Using alcohol wipes for pin care in skeletal traction is inappropriate, as it may not adequately prevent infection. Pin sites require sterile technique with solutions like chlorhexidine to minimize osteomyelitis risk, making this an incorrect teaching point.