A client is reporting pain in her casted leg and the nurse notes some swelling distal to the cast. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the client states the pain is unrelieved. The nurse should identify the warning signs of what complication?

Compartment syndrome

Muscle wasting

Skin breakdown

Joint Stiffness

Answer and Explanation

The Correct Answer is A

A. Compartment syndrome. The client’s unrelieved pain, despite analgesics, and the presence of swelling distal to the cast are warning signs of compartment syndrome. This is a medical emergency that occurs when increased pressure within a closed muscle compartment reduces blood flow, leading to tissue damage and pain.

B. Muscle wasting. Muscle wasting typically occurs over time due to disuse and is not a sudden, acute complication like compartment syndrome.

C. Skin breakdown. Skin breakdown could occur from improper cast fitting or prolonged pressure, but it would not cause unrelieved pain in the same way as compartment syndrome.

D. Joint stiffness. Joint stiffness can occur in casted limbs after removal, but it is not an acute complication like compartment syndrome.

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Correct Answer is ["A","B","C","E"]

Explanation

A. Compartment syndrome: This is a serious complication that can occur with fractures, including femur fractures. It occurs when increased pressure in the muscle compartment impairs circulation and nerve function.

B. Hemorrhage: Fractures, particularly of long bones like the femur, can result in significant bleeding. Monitoring for hemorrhage is important.

C. Deep vein thrombosis (DVT): DVT is a common complication in clients with fractures and immobilization. The client is at risk for blood clots forming in the legs due to limited movement and prolonged bed rest.

D. Complex regional pain syndrome: While this can occur after fractures, it is less common and typically develops weeks to months after the injury.

E. Fat embolism: A fat embolism is a potential complication of long bone fractures, especially the femur. Fat globules can enter the bloodstream and cause respiratory distress, neurological impairment, and petechial rash.

A. Administer oxygen via nasal cannula B. Administer prescribed pain medications C. Administer NS IV fluid D. Ask the provider for a dopamine prescription

Correct Answer is A

Explanation

A. Administer oxygen via nasal cannula: The client's symptoms of dyspnea, chest pain, syncope, and hypotension suggest a possible acute cardiovascular event, such as a myocardial infarction (MI) or pulmonary embolism (PE). Administering oxygen should be the priority to improve oxygenation and prevent hypoxia, which could exacerbate the client's symptoms and further compromise cardiac function.

B. Administer prescribed pain medications. Pain relief may be necessary, but stabilizing oxygen levels is the priority.

C. Administer NS IV fluid. Fluid administration may be helpful, but oxygenation is more critical in this situation to address the potential underlying respiratory or cardiac issue.

D. Ask the provider for a dopamine prescription. While dopamine may be used in cases of shock, the immediate action should be to ensure the client is adequately oxygenated.

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Naxlex Comprehensive Predictor Exams

A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until his femur can be surgically repaired. What complications should the nurse monitor for? Select All That Apply

Correct Answer is ["A","B","C","E"]

Explanation

Correct Answer is A

Explanation

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