GENITOURINARY SYSTEM
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, A client has a newly fractured fibula, which is plaster casted in the emergency department.
Because the client will need to use crutches, the nurse plans to teach the client which crutch
walking gait before discharge?
Four-point alternate gait
Swing-through gait
Two-point gait
Three-point gait
Three-point gait
The client with a new fracture that is casted with a plaster cast needs to avoid weight-bearing
movements. Option 2 is the only option that identifies a gait that allows non-weight-bearing
movement on the affected extremity. The client should not bear weight on the affected
extremity until the physician evaluates the client on the follow-up examination.
The patient who undergoes total hip replacement may be prescribed prophylactic drugs such
as heparin or warfarin (Coumadin). The rationale for this is that it:
decreases the risk of systemic infection.
decreases the risk of hemorrhage.
decreases the risk of thrombus formation.
facilitates the wound-healing process.
decreases the risk of thrombus formation.
Treatment will include administration of anticoagulants, such as heparin or warfarin
(Coumadin), which decreases the risk of deep vein thrombus.
, A nurse is evaluating the client's use of a cane for left-sided weakness. The nurse would
intervene and correct the client if the nurse observed that the client:
Keeps the cane 6 inches out to the side of the right foot
Holds the cane on the right side
Leans on the cane when the right leg swings through
Moves the cane when the right leg is moved
The cane is held on the stronger side to minimize stress on the affected extremity and provide
a wide base of support. The cane is held 6 inches lateral to the fifth great toe. The cane is
moved forward with the affected leg. The client leans on the cane for added support while the
stronger side swings through.
A nurse is planning to reinforce instructions to the client about how to stand on crutches. In
the written instructions, the nurse plans to tell the client to place the crutches:
8 inches to the front and side of the client's toes
3 inches to the front and side of the client's toes
15 inches to the front and side of the client's toes
20 inches to the front and side of the client's toes
8 inches to the front and side of the client's toes
The classic tripod position is taught to the client before giving instructions on gait.
Thecrutches are placed anywhere from 6 to 10 inches in front and to the side of the
client,depending on the client's body size. This provides a wide enough base of support to the
clientand improves balance.
, Diagnosing carpal tunnel syndrome (CTS) includes test like Tinel's and Phalen's maneuver.
Phalen's is:
Presence of pain in the calf of the affected leg on dorsiflexion of the foot
Increased tingling with a gentle tap over the tendon sheath on the ventral surface of the
central wrist
Stimulating the facial muscles in the cheek region causes twitching or spasm of the facial
muscles.
Holding the wrists against each other in forced palmar flexion for 1 minutes causes numbness
and tingling
Holding the wrists against each other in forced palmar flexion for 1 minutes causes numbness
and tingling
A nurse is caring for an older client who had a hip pinned after being fractured. In planning
nursing care, which of the following would the nurse avoid to minimize the chance for further
injury?
Delays in responding to call light
Side rails in the "up" position
Use of night-light in hospital room and bathroom
Call bell placed within reach
Delays in responding to call light
Safe nursing actions intended to prevent injury to the client include keeping side rails
up,having the bed in a low position, and providing a call bell that is within the client's
reach.Responding promptly to the client's use of the call light minimizes the chance that the
clientwill try to get up alone, which could result in a fall.