Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site? A.Thoroughly irrigate the wound before collecting the specimen. B.Use a sterile swab and wipe the crusty area around the outside of the wound. C.Gently roll a sterile swab from the center of the wound outward to collect drainage. D.Use a sterile swab to collect drainage from the dressing.
NURSING ALERT If the cast or elastic dressing comes off, the residual limb must be immediately wrap with an elastic compression bandage. If not, excessive edema will develop leading to a delay in rehabilitation. Notify the surgeon so that another cast can be applied promptly
Nrs Dx: Impaired body image Nrs Dx: Grieving Relationship of trust Pt. care for limb Independence Realistic goals Support systems Referrals
Nrs Dx: Self Care Deficit Practice Nursing impact
Nursing Alert The residual limb should not be placed on a pillow because a flexion contracture of the hip may result.
A client hospitalized with MRSA (methicillin- resistant staph aureus) is placed on contact precautions. Which statement is true regarding precautions for infections spread by contact? A.The client should be placed in a room with negative pressure. B.Infection requires close contact; therefore, the door may remain open. C.Transmission is highly likely, so the client should wear a mask at all times. D.Infection requires skin-to-skin contact and is prevented by hand washing, gloves, and a gown.
A client who is admitted with an above-the- knee amputation tells the nurse that his foot hurts and itches. Which response by the nurse indicates understanding of phantom limb pain? A."The pain will go away in a few days.“ B."The pain is due to peripheral nervous system interruptions. I will get you some pain medication." C."The pain is psychological because your foot is no longer there." D.“The pain and itching are due to the infection you had before the surgery."
The primary reason for rapid continuous rewarming of the area affected by frostbite is to: A.Lessen the amount of cellular damage B.Prevent the formation of blisters C.Promote movement D.Prevent pain and discomfort
You are assigned to care for a patient with a Below the Knee Amputation (BKA). Among the patient’s orders is one which states that the patient should be placed in the prone position twice daily. The nurse knows that the reason for this is: A.Changing the patient’s position will help to prevent skin breakdown B.To observe the stump for signs of infection C.To assist the patient in doing ROM (Range of Motion) exercises D.To stretch the flexor muscles and prevent flexion contractures
Small Group Questions 1.Look at the list of complications associated with an amputation. Identify ways to assess for each complication and treatment. 2.Describe the assessment of a patient going into surgery for a non-traumatic BKA.
What is the number one reason people go to their doctor? A.Respiratory infection B.Back pain C.Ear infection D.Head aches E.Complaint of symptoms assoc. with heart attacks
What is the number TWO reason people go to their doctor? A.Complaints of arthritis in the hands B.Back pain C.Ear infection D.Head aches E.Complaint of symptoms assoc. with heart attacks
Carpal Tunnel Syndrome Surgery Open nerve release Endoscopic laser Local anesthetic Cut carpal ligament
Small Group Questions 1.What medications are frequently prescribed to a clinic with acute low back pain? What are their actions 2.What are the 3-R’s of Low Back pain treatment? 3.Mr. Jones is suffering from acute back pain, what would you advice him to do? (What would your teaching plan include)? 4.Describe the pathophysiology of carpal tunnel syndrome. 5.Demonstrate how to perform the Tinel sign.
Osteoporosis: Pg. 1089
Osteoporosis: Pathophysiology Bone resorption Bone formation osteoclasts osteoblasts
Osteoporosis: Pathophysiology Bone Resorption > Bone formation = bone mass
Osteoporosis: Pathophysiology / Hormones Age related changes Calcitonin – Resorption – Formation
Osteoporosis: Pathophysiology / Hormones Age related changes Estrogen – Resorption Inhibits
Osteoporosis: Pathophysiology / Hormones Age related changes PTH – Resorption – Formation
Osteomalacia Medical Management Rx – Calcium – Vit. D – Bisphosphonate – Calcitonin
Small Group Questions 1.What is the pathophysiology of Osteoporosis? 2.What effect do the hormones calcitonin, estrogen and PTH have on bone remodeling? 3.What are Bisphosphonates? What advice would you give to a client with these? 4.What is a Colles’ fracture? What is a compression fx (of the vertebrae) 5.What is the pathophysiology of Paget’s Disease and Osteomalacia? 6.How are Paget’s Disease and Osteomalacia similar and how are they different?
During a home visit, a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate? A.Administer an antibiotic B.Contact the physician for an order for immune globulin C.Administer an antiviral D.Tell the client that he should remain in isolation for 2 weeks
A client is discharged home with a prescription for Coumadin (sodium warfarin). The client should be instructed to: A.Have a Protime done monthly B.Eat more fruits and vegetables C.Drink more liquids D.Avoid crowds
Following an amputation, the advantage to the client for an immediate prosthesis fitting is: A.Ability to ambulate sooner B.Less chance of phantom limb sensation C.Dressing changes are not necessary D.Less edema