The nurse teaches the client who has an external skeletal fixation device on a leg fracture for discharge. Which does the nurse include in client teaching?

Question

1. Apply warm, moist heat for muscle spasms.
2. Manage muscle spasms with muscle relaxants.
3. Cleanse the pin sites daily with soap and water.
4. Ambulate to the bathroom for physical activity.

Answer 1

2
2. The nurse instructs the client to expect and to manage muscle spasms with muscle relaxants for self-care of an external fixation device because spasms are common after fractures and with traction. The nurse cautions the client, however, about drowsiness, dizziness, and unsteady gait after taking a muscle relaxant and instructs the client to call for help before getting up to prevent client injury.
1. Warm, moist heat can be indicated for a muscle spasm; however, applying heat potentially results in increased blood flow. Because the client has pins inserted into bone, increasing regional blood flow can increase regional edema and, because the client has a mobility problem from the external fixation device, increasing the ex-tremity's weight with edema can increase the risk of client injury with mobilization. In addition, edema can render tissue more fragile, increasing the risk for skin break-down and infection.
3. The client cares for the pin sites at home after careful teaching by the nurse. The pin care includes measures to remove debris, decrease microorganism counts, protect the pin site, and prevent cross-contamination to maintain clean and dry insertion sites.
4. As long as the client moves slowly and is steady, the client remains active to pre-vent complications of immobility and limits some activity to keep the pin sites clean and dry.