A nurse is working with a group of clients on stretching.
Which of the following statements about muscles is correct?

Choice A rationale

Monitoring for signs of infection is a standard postoperative nursing action that involves assessing the incision for erythema, warmth, edema, and purulent drainage. While vital for detecting complications like surgical site infections, it is not the primary intervention for preventing skin breakdown. Skin breakdown is more directly related to mechanical forces such as pressure, friction, and shear rather than the inflammatory or bacterial processes associated with a localized incisional infection.

Choice B rationale

Administering anticoagulants such as heparin or enoxaparin is essential for preventing deep vein thrombosis and pulmonary embolism following major orthopedic surgery. These medications modify the coagulation cascade to inhibit thrombus formation during periods of immobility. However, anticoagulation therapy does not directly address the risk of pressure ulcers or skin integrity. Preventing skin breakdown requires physical interventions that redistribute pressure and manage the microclimate of the skin surface during the recovery phase.

Choice C rationale

Maintaining hip abduction using pillows or an abduction wedge is the priority intervention to ensure proper joint alignment and prevent prosthesis dislocation. In terms of skin integrity, properly aligned pillows also help in distributing weight and preventing the knees or ankles from rubbing together, which reduces the risk of pressure injury. Maintaining the prescribed position ensures that the soft tissues around the surgical site are not subjected to unnecessary tension or compressive forces during repositioning.

Choice D rationale

Encouraging early ambulation is a critical component of postoperative recovery that helps prevent many complications, including pneumonia and venous stasis. While moving the patient helps relieve pressure on the skin over bony prominences, the specific priority in the immediate post-arthroplasty period is maintaining the stability of the new joint. Ambulation must be balanced with the need for strict alignment protocols to ensure the surgical repair remains intact while the surrounding musculature and skin heal.

Choice A rationale

This statement is physiologically incorrect because osteoarthritis does not involve rapid bone growth that enhances movement. Instead, the body may attempt to repair damaged cartilage by creating osteophytes or bone spurs. These bony projections actually restrict the range of motion in the joint and increase friction. Rather than reducing discomfort, these changes contribute significantly to the chronic pain and mechanical stiffness associated with progressive joint degeneration in patients.

Choice B rationale

The pathophysiology of osteoarthritis is not defined by repeated joint infections or scar tissue accumulation. While septic arthritis involves infection, osteoarthritis is primarily a non-inflammatory, degenerative condition. The stiffness felt by patients results from the mechanical breakdown of the joint structures rather than the presence of fibrotic scar tissue from previous infections. Attributing the disease to infection ignores the primary role of mechanical stress and chondrocyte dysfunction in the breakdown of articular cartilage.

Choice C rationale

This is the accurate description of the disease process as it involves the progressive degradation of hyaline cartilage. As the protective cartilage thins, the subchondral bone is exposed, leading to increased pressure and friction during movement. This bone-on-one contact triggers nociceptors and leads to the characteristic pain and crepitus. Understanding this wear and tear mechanism helps patients realize why weight management and joint protection are vital for managing their specific symptoms.

Choice D rationale

Osteoarthritis is not an autoimmune disorder; that description applies to rheumatoid arthritis. In rheumatoid arthritis, the immune system targets the synovium, causing systemic inflammation. In contrast, osteoarthritis is localized and characterized by the mechanical failure of the joint. While minor secondary inflammation may occur due to cartilage debris, the underlying cause is not a systemic immune attack. Proper identification is crucial because treatments for autoimmune conditions, like DMARDs, are not effective for osteoarthritis.