Question of the Week – March 30, 2022

Rationale:

Answer: 3 Rationale: If the client with an amputation has a cast or elastic compression bandage that slips off, the nurse must wrap the residual limb immediately with another elastic compression bandage. Otherwise, excessive edema will form rapidly, which could cause a significant delay in rehabilitation. If the client had a cast that slipped off, the nurse would have to call the PHCP so that a new one could be applied. Elevation on 1 pillow is not going to impede the development of edema greatly once compression is released. Ice would be of limited value in controlling edema from this cause. If the PHCP were called, the prescription likely would be to reapply the compression dressing anyway.

Additional Info:

Level of Cognitive Ability: Analyzing

Client Needs: Physiological Integrity

Integrated Process: Nursing Process—Implementation

Content Area: Adult Health: Musculoskeletal

Health Problem: Adult Health: Musculoskeletal: Amputation

Priority Concepts: Clinical Judgment; Tissue Integrity

Reference: Lewis et al. (2017), p. 1487.