Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

After ORIF of the tibia, what should the perianesthesia nurse do for a patient reporting severe pain and pale foot?

1. Apply a splint to the affected limb

2. Place the affected limb at heart level

3. Initiate physical therapy to the affected limb

4. Wrap the affected limb with warm blankets

The correct answer is: Place the affected limb at heart level

Placing the affected limb at heart level is the most appropriate action in this scenario for a patient experiencing severe pain and a pale foot after open reduction and internal fixation (ORIF) of the tibia. This position can help promote adequate blood flow to the extremity by reducing venous pressure and facilitating venous return, which is particularly important in cases of compromised circulation indicated by the pale foot. In a clinical context, pale coloration of the foot, combined with severe pain, can suggest complications such as compartment syndrome or vascular insufficiency. Elevating the limb above heart level may exacerbate these issues by limiting blood flow. Therefore, maintaining the limb at heart level ensures a balance that can aid in restoring blood circulation while monitoring the patient's status closely. This choice prioritizes vascular assessment and intervention based on the clinical presentation of the patient and aligns with best practices in managing pain and potential ischemia in a post-operative setting.