Question

3:57 F X Copy of CS_Ch_41.doc Case Study, Chapter 41, Musculoskeletal Care Modalities 1. June Frankel, a 23-year-old patient, presents to the emergency department with a sports-related fracture injury to her right arm and receives a long-arm fiberglass cast. (Learning Objective 2) a. What nursing assessment should the nurse provide after the cast has been applied? b. What nursing interventions should the nurse provide? 2. Sue Newhart, a 55-year-old patient, is admitted to the medical-surgical unit after a total hip arthroplasty due to osteoarthritis. (Learning Objective 7) a. What considerations should the nurse follow when positioning the patient in bed after hip surgery? b. What nursing interventions should the nurse provide the patient?

Answer 1

1. Assessment after casting:

Neurovascular status of casted extrimity.

Skin interior

Presence of wound and drainage.

Alignment and positions.

Respiratory, abdominal and urological status.

2. Nursing intervention:

Infirm patient about thermal changes on cast application.

Observe for skin color changes which may indicates impairment of circulation.

Check peripheral pulse frequently.

Elevate and immobilized the casted extremities.

Provide active and passive exercise.

Assess for cast edge for irritation

Educate the patient on care of cast.

II.

1. Positioning:

Position comfortably on the back and place pillow on feet and abduction pillow between the knees.

2. Intervention:

Observe dressing for bleeding and drainage

Ice as ordered

Neuro vascular check

Pain medication as ordered

Active flexion of foot q1h while awake

Continuous passive motion device

Early ambulation with knee mobilizer device

Physical therapy as ordered.