A child has just returned from surgery for repair of a fractured ...

[kshipps]

A child has just returned from surgery for repair of a fractured femur. The child has a long-leg cast on. The toes on the leg with the cast are edematous, but they have color, sensitivity, and movement.
 
  What action should the nurse take?
  a. Call the health care provider to report the edema.
  b. Elevate the foot and leg on pillows.
  c. Apply a warm moist pack to the foot.
  d. Encourage movement of toes.

Question 2

The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what?
 
  a. We'll keep the cast dry.
  b. We're happy this is the only cast our baby will need.
  c. We'll watch for any swelling of the foot while the cast is on.
  d. We're getting a special car seat to accommodate the cast.

[katieost]

Answer to Question 1

ANS: B
During the first few hours after a cast is applied, the chief concern is that the extremity may continue to swell to the extent that the cast becomes a tourniquet, shutting off circulation and producing neurovascular complications (compartment syndrome). One measure to reduce the likelihood of this problem is to elevate the body part and thereby increase venous return. The health care provider does not need to be notified because edema is expected and warm moist packs will not decrease the edema. The child should move the toes, but that will not help reduce the edema.

Answer to Question 2

ANS: B
The common approach to clubfoot management and treatment is the Ponseti method. Serial casting is begun shortly after birth. Weekly gentle manipulation and stretching of the foot along with placement of serial long-leg casts allow for gradual repositioning of the foot. The extremity or extremities are casted until maximum correction is achieved, usually within 6 to 10 weeks. If parents state that this is the only cast the infant will need, they need further teaching.

[kshipps]

Excellent

[Dnite]

Gracias!