A nursing is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?

Place the client in protective isolation.

Initiate the use of a PCA pump for pain control.

Keep the head of the bed at a 30° angle.

Reposition the client by log rolling every-4 hr.

Answer and Explanation

The Correct Answer is B

A: Placing the client in protective isolation is not necessary unless the client is immunocompromised or has another indication for isolation beyond the scoliosis repair.
B: A PCA (patient-controlled analgesia) pump allows the client to manage pain effectively by administering their own pain medication within prescribed limits, which is essential after the significant surgical intervention of scoliosis repair.
C: Keeping the head of the bed at a 30° angle is not specifically indicated for postoperative care following scoliosis repair with Harrington rod instrumentation. The position of the bed should be based on the client's comfort and specific postoperative orders.
D: Repositioning the client by log rolling every 4 hours is important to prevent complications such as pressure ulcers and to promote circulation, but it is not the priority intervention. Pain management postoperatively is crucial for client comfort, promoting mobility, and aiding in the recovery process.

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Correct Answer is A

Explanation

A. "Your pain will gradually become less severe." This statement is accurate and provides realistic expectations for the client. After an amputation, there will be initial post operative pain, but it should gradually decrease over time.

B. "The pain will disappear soon." This statement is not accurate. While the pain will eventually decrease, it may not completely disappear immediately after the procedure.

C. "It's likely that you will have only a tingling sensation." This statement is not accurate. While some clients may experience tingling sensations, it is not the only sensation they may feel, and this statement does not cover the full range of possible experiences.

D. "Phantom pain is mostly psychological." This statement is not accurate. Phantom pain is a real sensation that some individuals experience after an amputation. It is believed to be related to nerve endings that continue to send signals to the brain even though the limb is no longer present. It is not purely psychological.

A. Fat embolism syndrome B. Pulmonary embolism C. Acute compartment syndrome D. Osteomyelitis

Correct Answer is C

Explanation

A. Fat embolism syndrome - This is characterized by respiratory distress, altered mental status, and petechial rash. It is not associated with increasing edema.

B. Pulmonary embolism - This occurs when a blood clot (usually from the legs) travels to the lungs and can present with symptoms like chest pain, shortness of breath, and rapid heart rate. It is not associated with increasing edema around a fracture site.

C. Acute compartment syndrome - This is a serious condition that occurs when increased pressure within a muscle compartment impairs blood supply, leading to tissue ischemia and necrosis. Increasing edema is an early sign of compartment syndrome.

D. Osteomyelitis - This is an infection of the bone and is not typically associated with increasing edema around a fracture site. It may present with local signs of infection like warmth, redness, and tenderness.

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A nursing is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

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Correct Answer is C

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