Week 3: Ortho

The nurse is caring for a client who is POD1 for a knee replacement. The nurse would be most concerned about which of the following findings? 

• Decreased sensation and tingling in their feet 

• Reports pain at the knee while ambulating with PT 

• Complaints of nausea and vomiting 

• Temperature 37.5 

The nurse is caring for a client who is 72 yrs old with a history of osteoarthritis. The client is POD1 for a total knee replacement of the R knee. The nurse arrives at the clients room during their assessment and finds the client to have 9/10 pain that is exacerbated by passive movement of the toes. The client reports the calf feeling tight with associated tingling sensation. The nurses next priority assessment or intervention would be:

• Notify the physician 

• Assess distal pulses 

• Perform ROM exercises 

• Provide analgesia 

The nurse is caring for a client who is 72 yrs old with a history of osteoarthritis. The client is POD1 for a total knee replacement of the R knee. The nurse arrives at the clients room during their assessment and finds the client to have 9/10 pain that is exacerbated by passive movement of the toes. The client reports the calf feeling tight with associated tingling sensation. After assessing the clients’ pedal pulses, the nurse identifies that they are weak. The nurse then notifies the physician of their assessment and recognizes that these are signs of: 

• Wound healing 

• Expected findings of an orthopedic surgery 

• Compartment syndrome 

• Acute pain response 

Which of the following indicates the client understood cast care: 

• I will use a ruler to scratch under my cast 

• I will not move the affected leg to ensure it does not misalign the fracture 

• I can walk on the cast immediately after application 

• I will cover my cast with a plastic cover if going out in the rain 

The nurse is caring for a client who has an ulcer to their left heal that has a moderate amount of purulent drainage for the last 2 months. Upon further assessment, the nurse identifies that the client has a temperature of 38.9C, erythema of the affected area, and tenderness to the affected area. The nurse identifies that these are potential signs of: 

• Deep vein thrombosis 

• Chronic osteomyelitis 

• Appropriate wound healing 

• Peripheral artery disease 

What are the early signs of compartment syndrome? Select all that apply 

• Pain

• Pallor

• Pressure

• Parasethesia

• Paralysis

What are the late signs of compartment syndrome? Select all that apply 

• Pallor

• Pressure

• Puffiness

• Paralysis

• Pulselessness

A client is POD2 for a L hip arthroplasty. Which of the following is an appropriate intervention by the nurse?

• While seated in bed, elevate the client’s affected limb on a pillow 

• Keep the client supine at all times

• Use a pillow to keep the legs abducted 

• Perform full range of motion exercises 

The nurse working on an orthopedic unit is caring for a client who is POD2 and has not mobilized. The client is restless, feels short of breath, and has chest pain with their respirations. The nurse identifies no adventitious sounds upon auscultation. Which of the following would the nurse be most concerned about?

• Pneumonia

• Pulmonary embolism

• COPD exacerbation

• Panic attack

The nurse working on an orthopedic unit is caring for a client who is POD2 and has not mobilized. To prevent any post-operative complications, which of the following would the nurse prioritize? Select all that apply.

• Ensure the client is on a low molecular weight heparin or other anticoagulant

• Review the clients mobility orders and educate the client on appropriate mobility exercises

• Apply sequential compression devices

• Monitor for signs and symptoms of a DVT