FREE Orthopaedic Nurse Questions and Answers

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The patient's arm is in a sling and a long-arm posterior splint with the elbow in 90-degree flexion following a right total elbow arthroplasty. Which sleeping position is most likely to be cozy for the patient, who needs to keep their right arm raised?

Correct! Wrong!

Explanation:
The most comfortable position for the patient following a right total arthroplasty (or any surgery on the elbow or shoulder) is typically supine with the head of the bed somewhat elevated and the arm elevated and resting on one or two pillows. The arm muscles are not strained in this position. In the initial postoperative time following an arthroplasty, the patient must refrain from utilizing the arm in any way. The patient should change positions by grabbing a trapeze with the other hand. If the patient shifts to the side that won't undergo surgery, the arm needs to be securely propped up with pillows.

A distal femoral osteosarcoma patient will undergo limb-salvage surgery. How long will the patient need to go through physical therapy to learn to walk on the saved limb?

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Explanation:
It typically takes a patient up to a year to learn to walk on the salvaged limb due to the complicated nature of limb-salvage surgery for the treatment of osteosarcoma. Due to the possibility that the recovery time may be longer than for an amputation, patients must be dedicated to therapy and engaged participants. A prosthesis or bone transplant is used to replace a portion of removed bone. If a youngster has a prosthesis, it could need to be changed when the child grows up.

A 16-year-old kid was identified as having spinal muscular atrophy, type III, after experiencing weakness in his lower extremities and trouble walking. Which of the following complications should the nurse advise the parents to prepare for?

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Explanation:
The mildest form of spinal muscular atrophy (SMA), type III, often begins between the ages of 2 and 17. Patients frequently have lower extremity weakness at first, have trouble walking, and could also endure scoliosis and muscle and tendon shortening around the joints. Despite being susceptible to respiratory infections, patients frequently lead normal lives. Type I SMA, which usually causes mortality within two years after beginning in infancy. Depending on the patient's age of onset, Type II SMA can cause weakness in the arms and legs, though some sufferers can sit and walk.

A kid with achondroplasia experiences numbness, sleep apnea, widespread weakness, urine and fecal incontinence, and rapid reflexes. Which of the following complications needs to be evaluated at the beginning for the child?

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Explanation:
Cervico-medullary compression, a potentially fatal consequence, is characterized by increasing difficulty walking, urine and fecal incontinence, widespread weakness, quick reflexes, and numbness. The foramen magnum may be stenosed in some children with achondroplasia; as a result, the child's brain stem may compress as they grow due of tight and abnormal bone growth. If the brain stem is not surgically decompressed, children may start to display sleep apnea or other signs of respiratory insufficiency, which may cause respiratory arrest and rapid death.

How can a nurse tell if a cervical collar is tight enough when it is being fitted?

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Explanation:
The patient should flex their chin forward when the nurse asks them to put on a cervical collar. The collar is too loosely fitted if the chin slides under it. Tighten the collar until the chin stays outside of it. The patient should also be able to swallow without feeling restricted and breathe easily. Anyone wearing a cervical collar should maintain a neutral head position and refrain from turning their head from side to side.

Contraindications to ultrasound therapy include

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Explanation:
Ultrasound therapy, which is used to treat soft-tissue injuries like sprains, strains, and bursitis, is contraindicated in cases of suspected fractures. The procedure raises tissue temperature using sound waves. The transducer is run over the skin in a circular motion for a few minutes after applying a gel medium. Both active and passive workouts are typically done after treatment. If a patient has peripheral vascular disease, ultrasound therapy shouldn't be applied to the lower extremities.

Which kind of metastasis should be carefully watched for in a patient with osteosarcoma of the proximal end of the humerus?

Correct! Wrong!

Explanation:
Within two years, lung metastasis affects about 90% of osteosarcoma patients, though it is possible that other skeletal sites are also affected. Amputation or limb-sparing operations, radiation, and chemotherapy are possible forms of osteosarcoma treatment. Surgery may be used to remove lung tumors. Osteosarcomas are extremely aggressive tumors that often develop in the second decade of life. Patients may initially feel a mass, along with localized discomfort and edema, decreased mobility, exhaustion, and weight loss.

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