Crutches

▪ Place body weight on crutches

▪ Advance unaffected leg onto the stair

▪ Shift weight from crutches to unaffected leg

▪ Bring crutches and affected leg up to the stair

o Closed-suction drain nursing interventions

▪ Negative-pressure device

▪ Doesn’t require wall suction

▪ *Compress the drain reservoir after emptying (creates negative pressure)

▪ Do not need to put below bed (doesn’t use gravity)

o External fixation device

▪ Surgeon applies the external fixation device directly to the client’s bone to form a

rigid structure around the affected extremity

• Casts, boots, or splints are applied directly to the leg for internal fixation

▪ Client should wear external fixation device continuously for a period of 4-6 weeks

• Nurse should teach the client to perform care of the wound and pin sites at

home

▪ Use crutches with rubber tips

• Prevents the client from slipping and decreases fall risks

▪ Only the provider should adjust the client’s external fixation device in order to

maintain bone alignment

o Long-term mechanical ventilation complications

▪ Decreased cardiac output and hypotension, related to positive pressure from

mechanical ventilation inhibiting blood return to the heart

▪ Fluid retention related to decreased cardiac output

▪ Stress ulcers, related to elevated levels of HCl in the stomach

• Increase risk for systemic infection and require pharmacological treatment

▪ Hyponatremia, secondary to fluid retention

o Postoperative nursing interventions following mastectomy

▪ Instruct client that the drain will remain in place for 1-3 weeks after surgery and will

be removed when there is 25 mL of output or less in a 24-hour period

▪ Instruct client to start exercising the arm on side of surgery 24 hours after surgery

▪ Elevate arm on surgical side on a pillow to promote lymphatic fluid return

▪ Nurse should elevate the head of the client’s bed to at least 30 degrees to promote

drainage from the surgical site and facilitate breathing

o Patient teaching for active tuberculosis

▪ Sputum specimens are necessary every 2-4 weeks until there are three negative

cultures

• After 3 negative cultures, the client is no longer considered infectious

▪ Client’s infection is usually no longer contagious after taking TB medications for 2-3

weeks

▪ Family members do not need to follow airborne precautions because they have

already been exposed to TB