A client was admitted with a possible diagnosis of osteomyelitis. Based on the documentation below, which laboratory result is the priority for the nurse to report to the physician?  03/12/XX 0900 Client admitted with elevated temperature of 102o F, complaining of bone pain and muscle spasms. Laboratory called with the following results; rheumatoid factor negative, blood culture positive (+) for Staphylococcus aureus, alkaline phosphate 60 International Units/Liter, erythrocyte sedimentation rate 10mm/hr.                                         Susan Wright, RN  

The nurse is caring for a client who is post total hip replacement and reports that they heard a “popping” sensation in the affected hip, what is the best action by the nurse?

A client comes into the Emergency Room and states “I think I dislocated my shoulder playing tennis.”  What assessment will the nurse make?

Case Study Question 2  The nurse is caring for a 23-year-old client admitted to the medical-surgical unit following surgery for a compound fracture of the right tibia and fibula. Nurses’ Notes   0830: Admitted from Post Anesthesia Care Unit following surgery to repair an open fracture with internal fixation with application of a fiberglass cast. R lower extremity elevated. IV infusing as ordered. Client medicated for pain prior to transport. Vital Signs BP 110/72, HR 90, RR 29, Temp 99F (37.2C). Unable to assess pedal pulse on R lower extremity due to cast. Motion of toes limited by pain and cast. Will monitor for signs of acute complications. 0930: Client resting at this time. Will continue to monitor. 1100: Client reporting pain 10/10 in R lower extremity. Updated neurovascular checks.    Neurovascular Flowsheet   Right Lower Extremity Pain Score  0-10/10 Motion F = full L = limited N = none Sensation F = full P = partial N = none Capillary Refill B = brisk < 3 seconds S = sluggish > 3 seconds Color N = normal P = pale D = dusky C = cyanotic Warmth H = hot W = warm T = tepid C = cold   Pulse 4+ bounding 3+ increased 2+ normal 1+ weak 0 absent UTA unable to assess     Time:  0830 3/10 L F B N W UTA 0930 3/10 L F B N W UTA 1030 4/10 L F B N W UTA 1100 10/10 N N S P T UTA Orders   0830: Admission Orders: Bedrest with right leg elevated on 2 pillows May use bedside commode with assistance, no weight bearing to R lower extremity Advance to Regular diet as tolerated VS and neurovascular checks every hour for 4 hours then every 4 hours   *Please select ALL the signs of “acute complications” you may find during your patient assessment. 

The nurse evaluates his or her client teaching as effective when the client with a closed leg fracture preparing for discharge identifies which sign and symptoms must be reported to the physician promptly?

The nurse is caring for a client who is being treated with colchicine and a non-steroidal anti-inflammatory (NSAID).  What assessment  best determines the effectiveness of the medications?

The nurse has taught a client with rheumatoid arthritis about energy conservation and coping strategies to help with activities of daily living. What statement by the client indicates the need for additional teaching? 

The client is taking methotrexate.  The nurse should evaluate the client for which adverse effect?

The nurse is developing a teaching plan for a client who is prescribed acetaminophen for muscle pain.  What information will the nurse include in the teaching plan? Select all that apply.

The nurse is caring for a client in skeletal traction.  Which nursing action will best prevent infection?