Chapter 68: Musculoskeletal Problems

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?

Immobilization of the left leg

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?

How to administer prescribed antibiotics at home

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 nurse the need for additional teaching related to health maintenance?

“I think my left foot is starting to droop down.”

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?

“I did not have this bone cancer until my leg broke a week ago.”

A patient with muscular dystrophy is hospitalized with pneumonia. Which nursing action would the nurse include in the plan of care?

Assist the patient with ambulation.

Which information would the nurse include in the teaching plan for a patient who has acute low back pain and muscle spasms?

Keep the head elevated slightly and flex the knees when resting in bed.

A patient whose employment requires frequent lifting has a history of chronic back pain. After the nurse teaches the patient correct body mechanics, which patient statement indicates the teaching has been effective?

“I will begin doing exercises to strengthen and support my back.”

Which action would the nurse take when repositioning the patient who has just had a laminectomy and discectomy?

Place a pillow between the patient‘s legs and turn the entire body as a unit.

Which statement by a patient with discomfort from a bunion indicates to the nurse that more teaching is needed?

“I can only wear sandals, no closed-toe shoes.”

Which assessment finding for a 55-yr-old patient would alert the nurse to the presence of osteoporosis?

Loss of height

A 54-yr-old woman who recently reached menopause and has a family history of osteoporosis is diagnosed with osteopenia. Which information would the nurse explain to the patient?

Calcium loss from bones can be slowed by increasing calcium intake and weight-bearing exercise.

Which menu choice by a patient with osteoporosis indicates the nurse‘s teaching about appropriate diet has been effective?

Oatmeal with skim milk and fruit yogurt

What information would the review to evaluate the effectiveness of alendronate (Fosamax) therapy for a patient with Paget‘s disease?

Alkaline phosphatase

A patient has had surgical reduction of an open fracture of the right radius. Which assessment findings would the nurse report immediately to the health care provider?

Temperature 101.4F (38.6C)

After laminectomy with a spinal fusion to treat a herniated disc, a patient reports numbness and tingling of the right lower leg. What action would the nurse take?

Review the preoperative assessment data in the health record.

Which action would the nurse complete before administering alendronate (Fosamax) to a patient with osteoporosis?

Assist the patient to sit up at the bedside.

Which action included in the care of a patient after laminectomy can the nurse delegate to experienced assistive personnel (AP)?

Log roll the patient from side to side every 2 hours.

Which action would the nurse take when caring for a patient who has osteomalacia?

Remind the patient to avoid any sun exposure.

Which action would the nurse take first when a patient is seen in the outpatient clinic with neck pain?

Ask about numbness or tingling of the hands and arms.

A nurse who works on the orthopedic unit has just received change-of-shift report. Which patient would the nurse assess first?

Patient who has not voided 8 hours after a laminectomy