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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Administering a bronchodilator before postural drainage helps open the airways, making it easier to mobilize and clear secretions during the procedure. This improves the effectiveness of the therapy.

B. Restricting fluid intake before the procedure is not appropriate. Adequate hydration is essential to thin secretions, making them easier to clear during postural drainage.

C. While deep breathing exercises are beneficial for lung expansion and oxygenation, they are not specifically required immediately after postural drainage. The focus is on clearing secretions during the procedure.

D. The supine position is not ideal for postural drainage. The client should be placed in specific positions depending on the lung segment being targeted, such as Trendelenburg or lateral decubitus positions, to facilitate drainage by gravity.

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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Naxlex Comprehensive Predictor Exams

Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic obstructive pulmonary disease (COPD). Which intervention should the nurse include in the plan of care?

Correct Answer is A

Explanation

A nurse is caring for a client who is experiencing impaired mobility. Exhibits Drag words from the choices below to fill in each blank in the following sentence. The client is at risk for developing dropdown and dropdown

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}

Explanation

A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on oxygen therapy. Which instruction should the nurse include in the discharge teaching?

The nurse teaches a patient with chronic obstructive pulmonary disease (COPD) about pursed-lip breathing (PLB). Which action by the patient would indicate to the nurse that no further teaching is needed?

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A nurse is caring for a client diagnosed with a fractured left tibia and fibula. Which data should the nurse report to the healthcare provider immediately?

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