Question

Case Study, Chapter 41, Musculoskeletal Care Modalities 1. June Frankel, a 23-year-old patient, presents to the emergency department witha 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) What considerations should the nurse follow when positioning the patient in bed after hip surgery? a. b. What nursing interventions should the nurse provide the patient?

Answer 1

.QUESTION 1

what nursing evaluation should the medical attendant give after the cast have been applied?
(i) Assess the neuro vascular compromise like agony, whiteness(pallor), paresthesia, loss of motion(paralysis) etc
.(ii) Asses for swellings
(iii) Assess for somewhat blue or whitish staining of the fingers
(iv) Make beyond any doubt the mortar cast is dry
(v) Check fringe pulse
(vi) Assess for hot and wet spots on or close to the threw area
(vii) Assess for neurovascular status and for potential difficulty like signs and side effects of infection.
b. What nursing mediation should the medical caretaker provide?
1. Cast ought to be revealed and open to air to dry properly
2.They may feel hot for 10-15 minutes or up to 30minutes
3.It takes 24-72 hours to dry completely
4.Teach the patient to keep the arm raised, it helps for simple venous drainage
5.Position change in each 1-2 hours
6.Assess each 1-2hours for (CWCM), shading, warmth, flow, and movement
7. Show the patient to maintain a strategic distance from utilization of powder and treatment on the threw area
8.Assess for the 5 P's (Pain, Pallor, Paresthesia, Paralysis, Pulse)

QUESTION 2

What contemplations should the medical caretaker pursue when situating the patient in bed after hip medical procedure?

• When situating the patient in the prostrate position, the medical caretaker should utilize the abductor brace or cushion support to forestall separation of the prosthesis.

• When turning the patient, two medical caretakers encourage the patient: one attendant backings the influenced leg, keeping the leg stole and straight, as the second attendant turns the patient to the unaffected side. The abductor pad or brace is utilized. A cushion bolster is utilized to keep the leg snatched.

• When sitting the patient up in bed, raise the leader of the bed 60 degrees or less, as guided by the specialist to forestall separation of the hip prosthesis.

What nursing intercessions should the medical caretaker give the patient?

• Assess vital signs, incision site and portable suction waste device , neurovascular minds right hip and leg, and torment evaluation as requested

• Use crack skillet and teach the patient to flex the left leg and hip and utilize the trapeze bar to get onto the bedpan or to get off the bedpan and not to put weight or flex the correct knee and hip all the while

• Keep a draw sheet under the patient from go to feet to use in turning or moving the patient up in the bed, and utilize the assistance of two medical attendants

• Instruct the patient to perform practices that the physical specialist recommended to forestall contractures and to advance versatility

• Provide thromboembolism-counteractive action measures, including the use of endorsed hostile to embolism hose, consecutive pressure boots, and low molecular weight heparin, for example, enoxaparin (Lovenox)

• Instruct the patient to utilize the motivation spirometer, hack and profound inhale at regular intervals while alert. Report any adjustment in the shading of sputum and indications of respiratory contamination promptly to the doctor.