A nurse is caring for a client who is postoperative following a laminectomy with spinal fusion. Which of the following actions should the nurse take?
Position the client in a high-Fowler's position if clear drainage is noted on the dressing
Monitor sensory perception of the lower extremities.
Assist the client into a knee-chest position to manage postoperative discomfort.
Maintain strict bed rest for the first 48 hr postoperative.
The Correct Answer is B
A. Positioning the client in a high-Fowler's position if clear drainage is noted on the dressing is not a specific intervention for a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning and wound care.
B. Monitoring sensory perception of the lower extremities is a crucial nursing intervention after a laminectomy with spinal fusion. This is to assess for any signs of neurovascular compromise or nerve damage.
C. Assisting the client into the knee-chest position to manage postoperative discomfort is not a recommended position after a laminectomy with spinal fusion. The nurse should follow the surgeon's specific postoperative orders regarding positioning.
D. Maintaining strict bed rest for the first 48 hours postoperative is not typically indicated after a laminectomy with spinal fusion. Early mobilization and ambulation are often encouraged to prevent complications and promote recovery. The nurse should follow the surgeon's specific postoperative orders regarding activity and mobility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Cool extremities are not typically associated with carpal tunnel syndrome. They may be a sign of poor circulation, but this is not a specific finding for carpal tunnel syndrome.
B. Decreased radial pulse is not a characteristic finding of carpal tunnel syndrome. It may indicate issues with blood flow to the hand but is not specific to this condition.
C. Positive Chvostek's sign is associated with hypocalcemia and involves facial muscle twitching when the facial nerve is tapped. It is not related to carpal tunnel syndrome.
D. Positive Phalen's sign is a characteristic finding in carpal tunnel syndrome. It involves tingling or numbness in the median nerve distribution (usually thumb, index, middle, and part of the ring finger) when the wrist is flexed for 60 seconds.
Correct Answer is C
Explanation
A. Russell's traction does not use skeletal pins. Skeletal traction involves the use of pins, wires, or screws inserted directly into the bone to stabilize a fracture.
B. Russell's traction does not involve the use of a pelvic girdle belt. Pelvic girdle belts are more commonly associated with some other forms of traction used for different purposes.
C. Russell's traction is specifically used for the treatment of a fracture of the femur, and it involves a sling placed under the knee to support and immobilize the affected leg.
D. Russell's traction is not used to decrease cervical muscle spasms. Cervical traction, using a cervical halter, is a separate form of traction used for cervical spine-related issues.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today