MULTIPLE CHOICE
1. A patient with acute osteomyelitis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention would the nurse include in the initial plan of care?
a. Quadriceps-setting exercises
b. Immobilization of the left leg
c. Positioning the left leg in ...
Harding: Lewis’s Medical -Surgical Nursing, 12th Edition MULTIPLE CHOICE 1. A patient with acute osteomye litis of the left femur is hospitalized for regional antibiotic irrigation. Which intervention would the nurse include in the initial plan of care? a. Quadriceps -setting exercises b. Immobilization of the left leg c. Positioning the left leg in flexion d. Assisted wei ght-bearing ambulation ANS: B Immobilization of the affected leg helps to decrease pain and reduce the risk for pathologic fracture. Weight -bearing exercise increases the risk for pathologic fractures and is not recommended until the infection is treated. Muscle contractions with exercises may lead to muscle spasms, causing pain, but will be used after the infection is resolved. Flexion of the affected limb is avoided to prevent contractures. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Planning MSC: NCLEX: Physiological Integrity 2. A patient is being discharged after 1 week of IV antibiotic therapy for osteomyelitis in the right leg. Which information would the nurse include in the discharge teaching? a. How to administer prescribed antibiotics a t home b. How to apply warm packs to the leg to reduce pain c. The need for daily aerobic exercise to maintain muscle strength d. The need to stop taking the antibiotics when the leg pain decreases ANS: A Most patients start on IV antibiotics then switch to oral th erapy; the patient will be taking antibiotics for several months and should not stop when the pain decreases. Patients are instructed to avoid exercise and heat application because these will increase swelling and the risk for spreading infection. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Implementation MSC: NCLEX: Physiological Integrity 3. A patient is receiving IV antibiotics at home to treat chronic osteomyelitis of the left femur. Which statement by the patient would indicate to the nur se the need for additional teaching related to health maintenance? a. “I take my oral temperature twice a day.” b. “I‘m frustrated with this endless treatment!” c. “I think my left foot is starting to droop down.” d. “I use crutches to avoid bearing weight on the left leg.” ANS: C Foot drop is an indication that the foot is not being supported in a neutral position by a splint. Using crutches and monitoring the oral temperature are appropriate self -care activities. Frustration with the length of treatment is not an indi cator of ineffective health maintenance of the osteomyelitis. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Analysis MSC: NCLEX: Physiological Integrity 4. The nurse instructs a patient who has osteosarcoma of the tibia about a scheduled above -the-knee amputation. Which patient statement indicates to the nurse that additional teaching is needed? a. “I will need to participate in physical therapy after surgery.” b. “I wish I did not need to have chemotherapy after this surgery.” c. “I did not have this bo ne cancer until my leg broke a week ago.” d. “I can use the patient -controlled analgesia (PCA) to manage postoperative pain.” ANS: C Osteogenic sarcoma may be diagnosed following a fracture, but it is not caused by the injury. The other statements indicate pa tient teaching has been effective. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Evaluation MSC: NCLEX: Physiological Integr ity
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