A patient experiences a fracture of the lower leg and undergoes a closed reduction and placement of a fiberglass cast. The patient is 65 years old and has a medical 30-year history of diabetes mellitus. Which condition does the nurse recognize as a possible complication for this patient?

Malalignment of healed bones.

Delay or absence of healing.

Impaired mobility function.

Development of bone infection.

Answer and Explanation

The Correct Answer is B

A. Malalignment of healed bones. While malalignment can occur, it is not specifically associated with diabetes mellitus. Malalignment is more commonly related to inadequate immobilization or improper casting technique.
B. Delay or absence of healing: Diabetes mellitus impairs circulation and healing processes due to poor blood flow and neuropathy, making delayed union or non-union a significant risk.
C. Impaired mobility function. While diabetes and aging can contribute to impaired mobility, this is a general consideration and not directly related to the specific complication of the fracture healing process.
D. Development of bone infection. Although diabetics are at higher risk for infections, a closed reduction and proper cast care reduce this risk. Infection would be more of a concern with an open fracture or surgery.

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Correct Answer is D

Explanation

A. Provide an elevated toilet seat: This is important for preventing hip dislocation but is not the immediate priority.
B. Assist out of bed immediately following surgery: Mobilizing the patient is important to prevent complications such as deep vein thrombosis (DVT) and pneumonia, but this should be done safely and as prescribed.
C. Medicate with pain medications: Pain management is crucial for postoperative recovery but is part of comprehensive care rather than the single priority.
D. Maintain weight bearing as prescribed: Following weight-bearing restrictions is critical to ensure proper healing and prevent complications such as dislocation or prosthetic failure. This is the immediate priority in terms of preventing harm and ensuring recovery.

A. To fix bone fragments together using plates, screws, or other devices. B. To remove damaged cartilage and bone from the affected area. C. To repair damaged ligaments and tendons in the affected area. D. To stabilize the fractured bone externally using a cast or splint.

Correct Answer is A

Explanation

A. To fix bone fragments together using plates, screws, or other devices. This is the correct purpose of open reduction and internal fixation (ORIF). It stabilizes the bone fragments to ensure proper alignment and healing.

B. To remove damaged cartilage and bone from the affected area. This describes a debridement procedure, not ORIF. ORIF focuses on stabilizing the fracture, not removing tissue.

C. To repair damaged ligaments and tendons in the affected area. While ligament and tendon repair can be part of some orthopedic surgeries, ORIF specifically aims to fix bone fragments together.

D. To stabilize the fractured bone externally using a cast or splint. This describes external fixation or immobilization methods, not internal fixation.

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A patient experiences a fracture of the lower leg and undergoes a closed reduction and placement of a fiberglass cast. The patient is 65 years old and has a medical 30-year history of diabetes mellitus. Which condition does the nurse recognize as a possible complication for this patient?

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