Author Question: A 32-year-old patient who has had an open reduction and internal fixation (ORIF) of left lower leg ... (Read 142 times)

ap345 · **on:** Jun 25, 2018

A 32-year-old patient who has had an open reduction and internal fixation (ORIF) of left lower leg fractures continues to complain of severe pain in the leg 15 minutes after receiving the prescribed IV morphine.

Pulses are faintly palpable and the foot is cool. Which action should the nurse take next?
a. Notify the health care provider.
b. Assess the incision for redness.
c. Reposition the left leg on pillows.
d. Check the patient's blood pressure.

Question 2

A patient who is to have no weight bearing on the left leg is learning to walk using crutches. Which observation by the nurse indicates that the patient can safely ambulate independently?

a. The patient moves the right crutch with the right leg and then the left crutch with the left leg.
b. The patient advances the left leg and both crutches together and then advances the right leg.
c. The patient uses the bedside chair to assist in balance as needed when ambulating in the room.
d. The patient keeps the padded area of the crutch firmly in the axillary area when ambulating.

moormoney · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
The patient's clinical manifestations suggest compartment syndrome and delay in diagnosis and treatment may lead to severe functional impairment. The data do not suggest problems with blood pressure or infection. Elevation of the leg will decrease arterial flow and further reduce perfusion.

Answer to Question 2

ANS: B
Patients are usually taught to move the crutches and the injured leg forward at the same time and then to move the unaffected leg. Patients are discouraged from using furniture to assist with ambulation. The patient is taught to place weight on the hands, not in the axilla, to avoid nerve damage. If the 2- or 4-point gaits are to be used, the crutch and leg on opposite sides move forward, not the crutch and same-side leg.