A client suffered a fractured femur and is scheduled for surgery one day after sustaining the injury. The client develops acute respiratory distress syndrome (ARDS) and the healthcare provider suspects fat embolism (FES) based on which of the following clinical manifestations? (Select all that apply.)
Decreased PaO2 <60mmHg.
PaO2 greater than 80mmHg.
Decreased platelet count and hematocrit levels.
Changes in ST segment and T-wave.
PaCO2 40mmHg.
Correct Answer : A,C,D
A. Decreased PaO2 <60mmHg: A hallmark of fat embolism syndrome (FES) is hypoxemia, which results in a PaO2 less than 60 mmHg. This is a key indicator of the severity of respiratory compromise in FES and ARDS.
B. PaO2 greater than 80mmHg: This would not be consistent with FES. Fat embolism often causes significant hypoxemia, and PaO2 greater than 80 mmHg would indicate adequate oxygenation.
C. Decreased platelet count and hematocrit levels: In fat embolism syndrome, there is often a decrease in platelet count and hematocrit due to disseminated intravascular coagulation (DIC), which can occur as a complication of fat embolism.
D. Changes in ST segment and T-wave: Electrocardiographic changes, including changes in ST segment and T-wave, are commonly seen in fat embolism syndrome due to myocardial injury, hypoxemia, or shock.
E. PaCO2 40mmHg: A PaCO2 of 40 mmHg is within normal limits and does not indicate any significant respiratory distress or abnormality that would be expected in fat embolism syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Obtaining an arterial blood gas and ordering a chest x-ray may be necessary to evaluate the client further, but the nurse must first assess the client to determine the presence of clinical signs of fat embolism syndrome (FES), such as respiratory distress or neurological changes.
B. Keeping the client on strict bed rest may help reduce the risk of further complications, but it is not the first priority. Immediate assessment of the client’s condition is necessary to identify signs of fat embolism syndrome.
C. Assessing the client for dyspnea and altered mental status is the first priority because these symptoms are early indicators of fat embolism syndrome. Early recognition and intervention are critical in preventing further complications.
D. Contacting the healthcare provider for a ventilation and perfusion scan may be appropriate after assessing the client, but it is not the first action. Immediate assessment is essential to determine the urgency of the situation.
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}
Explanation
A. Diarrhea: Not relevant to the client's condition of impaired mobility and recent hip fracture.
B. Hypocalcemia: Not directly related to the client's current condition and symptoms.
C. Pulmonary embolism: The client is at risk due to limited mobility and signs of deep vein thrombosis.
D. Deep vein thrombosis: The client has symptoms such as a warm, reddened area on the calf, indicating a potential DVT.
E. Hypertension: The client's blood pressure is within normal limits, so this is not a primary concern.
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