The nurse is caring for a patient with an external fixation device. Which of the following actions should the nurse implement? Select all that apply.

Clean pins with hydrogen peroxide four times daily.

Monitor pin sites at least daily.

Loosen screws holding the pins during cleaning.

Use strict aseptic technique for pin care.

Follow agency protocol for pin care.

Avoid touching the pins.

Answer and Explanation

Correct Answer : B,D,E

A. Clean pins with hydrogen peroxide four times daily. Hydrogen peroxide is not recommended for routine pin care as it can damage tissue and delay healing. Overuse can also lead to the formation of oxygen bubbles in the tissue, which may cause complications. Recommended cleaning solutions often include saline or a mild antiseptic, depending on the facility's protocol.
B. Monitor pin sites at least daily: Regular monitoring of pin sites is essential to detect early signs of infection or complications such as redness, swelling, warmth, or discharge. Early detection allows for prompt intervention, which is crucial in preventing more severe infections and complications.
C. Loosen screws holding the pins during cleaning. Loosening screws can destabilize the fixation device and disrupt the bone alignment, potentially causing injury and delaying healing. Screws and pins should remain securely tightened unless adjustments are being made by a qualified healthcare provider.
D. Use strict aseptic technique for pin care: Using strict aseptic technique helps prevent the introduction of microorganisms at the pin sites. This is critical because external fixation devices create a direct pathway for pathogens to enter the body, which can lead to serious infections like osteomyelitis.
E. Follow agency protocol for pin care: Each healthcare facility may have specific protocols and guidelines for pin care based on evidence-based practices. Following these protocols ensures that the care provided is consistent and meets the latest standards for infection control and patient safety.
F. Avoid touching the pins. While it is crucial to avoid unnecessary handling of pins to prevent contamination, touching the pins during necessary cleaning and care using aseptic technique is allowed. Completely avoiding touching the pins could result in inadequate cleaning and care.

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Correct Answer is B

Explanation

A. "I will avoid crossing my legs at the knees.": This is appropriate because crossing legs can reduce blood flow and increase the risk of blood clots, exacerbating PVD symptoms.
B. "I will wear stockings with elastic tops.": This indicates a need for further teaching. Stockings with tight elastic tops can constrict blood flow and are not recommended for patients with PVD. They should use graduated compression stockings if prescribed.
C. "I will use a thermometer to check the temperature of my bath water.": This is appropriate as it prevents burns in patients with reduced sensation due to PVD.
D. "I will not go barefoot.": This is appropriate to avoid injuries and infections, which can be problematic for individuals with PVD due to poor circulation.

A. Ecchymosis B. Stasis ulcers C. Angina D. Intermittent claudication

Correct Answer is D

Explanation

A. Ecchymosis: Ecchymosis (bruising) is not a typical symptom of peripheral arterial occlusive disease. It generally indicates bleeding or trauma to the skin and subcutaneous tissues.
B. Stasis ulcers: Stasis ulcers are associated with chronic venous insufficiency, not peripheral arterial disease.
C. Angina: Angina refers to chest pain due to reduced blood flow to the heart, and it is associated with coronary artery disease, not peripheral arterial occlusive disease.
D. Intermittent claudication: This is the classic symptom of peripheral arterial occlusive disease, characterized by muscle pain or cramping in the legs triggered by physical activity and relieved by rest. It is due to insufficient blood flow to the muscles during exercise.

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The nurse is caring for a patient with an external fixation device. Which of the following actions should the nurse implement? Select all that apply.

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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