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. The ropes attach securely to the pin. Secure attachment of the ropes is important but not usually a problem that needs correction.

B. The ropes are in the center of the wheel grooves. Proper placement of the ropes in the wheel grooves is important for smooth movement, but this is not a common problem needing correction.

C. The weights are equal on each side. Ensuring equal weights is important but not typically a problem needing correction as it is usually set up correctly initially.

D. The weights rest against the foot of the bed. Correct. Weights should not rest against the foot of the bed; they must hang freely to maintain proper traction and alignment.

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

Correct Answer is D

Explanation

A. Fat embolism syndrome: Fat embolism syndrome can occur after fractures, particularly long bone fractures, but it typically presents with symptoms such as respiratory distress, petechiae, and neurological symptoms rather than severe pain and tingling in the affected extremity.
B. Osteomyelitis. Osteomyelitis, an infection of the bone, is characterized by localized pain, swelling, and fever but does not usually present immediately with severe pain and tingling following a fracture.
C. Pulmonary embolism. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs and presents with chest pain, shortness of breath, and possibly coughing up blood, not localized extremity pain and tingling.
D. Acute compartment syndrome. Acute compartment syndrome is a serious condition that involves increased pressure within a muscle compartment. It can lead to severe pain, tingling, and decreased blood flow, which is consistent with the symptoms described.

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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?

Nursing Test Bank

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