A nurse cares for a client with a fractured fibula. Which ...

[pragya sharda]

A nurse cares for a client with a fractured fibula. Which assessment should alert the nurse to take immediate action?
 
  a. Pain of 4 on a scale of 0 to 10
  b. Numbness in the extremity
  c. Swollen extremity at the injury site
  d. Feeling cold while lying in bed

Question 2

A nurse cares for an older adult client with multiple fractures. Which action should the nurse take to manage this client's pain?
 
  a. Meperidine (Demerol) injections every 4 hours around the clock
  b. Patient-controlled analgesia (PCA) pump with morphine
  c. Ibuprofen (Motrin) 600 mg orally every 4 hours PRN for pain
  d. Morphine 4 mg intravenous push every 2 hours PRN for pain

[Loise Hard]

Answer to Question 1

ANS: B
The client with numbness and/or tingling of the extremity may be displaying the first signs of acute compartment syndrome. This is an acute problem that requires immediate intervention because of possible decreased circulation. Moderate pain and swelling is an expected assessment after a fracture. These findings can be treated with comfort measures. Being cold can be treated with additional blankets or by increasing the temperature of the room.

Answer to Question 2

ANS: B
The older adult client should never be treated with meperidine because toxic metabolites can cause seizures. The client should be managed with a PCA pump to control pain best. Motrin most likely would not provide complete pain relief with multiple fractures. IV morphine PRN would not control pain as well as a pump that the client can control.

[pragya sharda]

Thank you

[Loise Hard]

Happy to help you