A nurse is assessing a client who has a puncture wound on his foot.
Which of the following findings is a manifestation of acute osteomyelitis?
Localized erythema.
Numbness of toes on the affected foot.
Bradycardia.
Hypothermia.
The Correct Answer is A
Choice A rationale
Localized erythema, along with warmth, swelling, and tenderness, is a cardinal sign of acute osteomyelitis. This inflammation is a direct result of the host's immune response to bacterial invasion within the bone. The increased blood flow to the affected area, mediated by inflammatory cytokines and vasodilatation, causes the characteristic redness and heat observed during the acute phase of infection.
Choice B rationale
Numbness of the toes on the affected foot is more indicative of neurological involvement or peripheral neuropathy rather than a primary manifestation of acute osteomyelitis. While severe swelling from osteomyelitis could potentially impinge on nerves, numbness is not a direct or common initial symptom of bone infection. Acute osteomyelitis primarily presents with inflammatory signs and systemic symptoms.
Choice C rationale
Bradycardia, an abnormally slow heart rate (typically below 60 beats per minute for adults), is not a typical manifestation of acute osteomyelitis. Acute infections, including osteomyelitis, commonly trigger a systemic inflammatory response, which usually leads to tachycardia, an elevated heart rate, as the body attempts to compensate for increased metabolic demands and fight the infection.
Choice D rationale
Hypothermia, a core body temperature below 35°C (95°F), is not a common manifestation of acute osteomyelitis. Instead, clients with acute osteomyelitis frequently present with fever, indicating a systemic inflammatory response to the infection. Hypothermia might occur in severe sepsis or septic shock, but it is not a direct or initial symptom of localized bone infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Kyphosis, an exaggerated outward curvature of the thoracic spine, is a common spinal deformity in older adults with osteoporosis. This occurs due to vertebral compression fractures, where the weakened bone structure collapses anteriorly, leading to a "hunchback" appearance and loss of height, affecting posture and balance.
Choice B rationale
Ankylosis refers to the stiffening and immobility of a joint due to fusion of bones. While joint issues can occur in older adults, ankylosis is not a direct spinal deformity associated with osteoporosis; rather, it is more commonly linked to inflammatory conditions like ankylosing spondylitis or severe osteoarthritis.
Choice C rationale
Scoliosis is a lateral curvature of the spine, often appearing as an S or C shape. While it can occur in older adults, it is not primarily a direct consequence or expected spinal deformity of osteoporosis. Adult degenerative scoliosis is often due to disc degeneration and facet joint arthritis, not solely bone demineralization.
Choice D rationale
Lordosis is an excessive inward curvature of the lumbar spine. While some degree of lumbar lordosis is normal, hyperlordosis can occur, but it is not the characteristic spinal deformity expected in osteoporosis. Osteoporosis typically leads to kyphosis due to anterior wedging of vertebral bodies, not increased lumbar curvature.
Correct Answer is C
Explanation
Choice A rationale
Hypothyroidism, particularly if untreated, can contribute to bone loss, but levothyroxine therapy typically normalizes thyroid function, mitigating this risk. While age is a risk factor, other choices present more significant and direct risks for accelerated bone demineralization and osteoporosis development.
Choice B rationale
Estrogen plays a crucial role in bone density maintenance by inhibiting osteoclast activity and promoting osteoblast activity. A bilateral salpingo-oophorectomy removes the primary source of estrogen, leading to premature menopause and rapid bone loss, significantly increasing osteoporosis risk if hormone therapy is refused.
Choice C rationale
Prednisone, a corticosteroid, is a potent cause of secondary osteoporosis. It directly inhibits osteoblast function, promotes osteoclast activity, and impairs calcium absorption, leading to significant bone density loss. Long-term use post-transplant makes this patient at exceptionally high risk.
Choice D rationale
Excessive alcohol intake (more than 2-3 drinks daily) is a risk factor for osteoporosis by impairing bone formation and nutrient absorption. Limiting sun exposure can cause vitamin D deficiency, also contributing to reduced bone density. However, this patient's alcohol intake is moderate, and vitamin D deficiency is more easily corrected.
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