What nursing intervention should be implemented for a patient with a fractured extremity before applying a cast?
Elevate the extremity to reduce swelling.
Apply ice packs to the fracture site.
Administer analgesics to manage pain.
Obtain baseline neurovascular assessment.
The Correct Answer is D
Before applying a cast, the nurse should obtain a baseline neurovascular assessment of the extremity to establish normal function. This assessment will serve as a reference for comparison throughout the cast's application and during the healing process.
a. Elevating the extremity to reduce swelling is a valuable intervention but is not directly related to applying a cast. It can be performed later as part of post-cast application care.
b. Applying ice packs to the fracture site can help reduce swelling and pain but is not a step in preparing for the cast application.
c. Administering analgesics to manage pain is important, but obtaining a baseline neurovascular assessment is the priority before applying a cast.
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Correct Answer is C
Explanation
In a patient with an open fracture (compound fracture), there is a risk of infection due to the exposure of the bone to the external environment. The nurse should assess for signs of infection, such as redness, warmth, swelling, drainage, and increased pain at the fracture site.
a. Assessing joint range of motion is important, but it is not the priority in a patient with an open fracture, where preventing infection is the main concern.
b. Assessing neurological function in the unaffected limb is not directly related to the open fracture and may not be the priority at this time.
d. Assessing the quality of pain experienced by the patient is important for pain management but is not the priority over assessing for signs of infection in an open fracture.
Correct Answer is C
Explanation
In a comminuted fracture, the bone is broken into multiple pieces, which may require more complex treatment and longer healing time.
a. Greenstick fracture: A greenstick fracture involves the bone bending and partially breaking, commonly seen in children. It does not result in multiple pieces.
b. Transverse fracture: A transverse fracture occurs when the bone breaks straight across its long axis, but it does not involve multiple pieces.
d. Spiral fracture: A spiral fracture is characterized by a twisting or spiraling break along the bone, but it does not result in multiple pieces.
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