Question

The nurse is participating in the orientation of a new nurse on the orthopedic unit. Which action by the new nurse requires intervention? A. Asking the client with a cast on the leg to move the toes B. Checking and documenting the weight amounts on the client's with traction C. Assisting with a bed change on a client with traction by removing and replacing the linen top to bottom D. Helping a family member get a client with a prosthetic hip into a straight chair

Short answer

Answer: C. Assisting with a bed change on a client with traction by removing and replacing the linen top to bottom.

Step-by-step solution

Analyze option A

In this option, the new nurse asks the client with a cast on the leg to move the toes. This is an appropriate action, as it helps to ensure the patient maintains circulation to the toes and prevents complications such as blood clots.

Analyze option B

In option B, the new nurse checks and documents the weight amounts on the client's traction. This is also an appropriate action because documenting and monitoring the weights in traction is essential for the patient's safety and progress.

Analyze option C

In option C, the new nurse assists with a bed change on a client with traction by removing and replacing the linen top to bottom. This action is incorrect because it is important to maintain the patient's alignment and avoid disrupting the traction during linen changes. The proper way to change the linens is to roll the patient side to side to maintain alignment and avoid unnecessary movements.

Analyze option D

In option D, the new nurse helps a family member get a client with a prosthetic hip into a straight chair. This action is appropriate as long as the nurse ensures the proper positioning and alignment of the patient during the transfer. The straight chair provides support and stability for the patient with a prosthetic hip.

Determine the correct answer

Based on the analysis of each option, the action that requires intervention is option C: assisting with a bed change on a client with traction by removing and replacing the linen top to bottom. Therefore, the correct answer is C.

Key concepts

Orthopedic Nursing

Orthopedic nursing focuses on the care of patients with musculoskeletal system conditions, which includes bones, joints, muscles, and ligaments. This specialization in nursing requires a strong understanding of both anatomy and medical interventions to provide effective care. Nurses in this field often manage patients who have undergone surgeries, have sustained injuries, or are dealing with chronic conditions involving the skeletal system.

They are integral in helping patients regain mobility, manage pain, and ensure that healing occurs appropriately. Tasks can include assessing patient conditions, managing pain through medication or other therapies, and educating patients about exercises and lifestyle changes for recovery.

• Monitoring and Documentation: Nurses must document patient conditions accurately, especially with treatments like traction or cast care, as in the case of checking the weight amounts in traction to ensure patient safety.
• Patient Education: Educating patients on post-care activities like moving toes with a cast to prevent complications such as swelling and blood clots is key.
• Collaborative Care: Collaboration with physiotherapists and other healthcare professionals is essential for the synchronization of care plans.

Patient Safety

Patient safety is the cornerstone of nursing practice, and it involves protecting patients from harm and ensuring optimal health outcomes. Nurses must be vigilant in monitoring and maintaining the safety of patients, especially in an orthopedic setting where injuries and post-operative conditions present unique challenges.

Safety measures in orthopedic nursing include ensuring correct traction weights, proper alignment during bed changes, and safe patient transfers—avoiding unnecessary movements that could disrupt healing or cause further injury. For example, changing linens top to bottom on a patient with traction is unsafe as it may disrupt alignment, thus intervention is necessary.

• Risk Assessment: Ongoing evaluation of potential risks such as falls or complications from immobilization is crucial.
• Safe Equipment Use: Proper use and monitoring of medical devices like traction equipment are necessary to prevent malfunctions and harm.
• Error Prevention: Nurses must double-check procedures and protocols to prevent human error and ensure patients’ safety is maintained.

Clinical Skills

Clinical skills in nursing are the hands-on techniques and critical thinking abilities used to provide effective patient care. In orthopedic nursing, these skills are particularly focused on managing specific needs related to musculoskeletal conditions and ensuring both recovery and safety.

Nurses must master several skills, including how to properly support a patient with a prosthetic during transfers or practicing sterile techniques when treating open wounds or post-surgical sites. These skills are crucial for patient recovery and preventing complications.

• Technical Skills: This involves hands-on techniques like measuring traction weights accurately and executing safe bed changes without disrupting a patient's alignment.
• Communication Skills: Effective communication with patients and their families ensures proper understanding of care plans and safety precautions.
• Critical Thinking: Analyzing situations quickly, such as identifying inappropriate actions like improper bed linen changes, and taking corrective actions ensures the patient’s care remains on the right track.