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
Migraine headaches are classically characterized by unilateral, throbbing pain, often preceded by a prodrome including photophobia (sensitivity to light) or phonophobia (sensitivity to sound), and have a strong genetic predisposition, frequently running in families.
Choice B rationale
Cluster headaches are typically characterized by severe, unilateral pain located around the eye or temple, often accompanied by autonomic symptoms like tearing or nasal congestion, but they are not commonly described as throbbing or associated with photophobia as a premonitory symptom.
Choice C rationale
Tension-type headaches are usually described as a bilateral, pressing or tightening sensation, often mild to moderate in intensity. They are generally not throbbing, unilateral, or associated with significant photophobia as a prominent premonitory symptom.
Choice D rationale
Frontal-type headaches are a descriptive localization of pain rather than a distinct headache type. While pain may be in the frontal region, this term does not encompass the specific clinical characteristics like throbbing nature, premonitory photophobia, and family history indicative of migraine.
Correct Answer is C
Explanation
Choice A rationale
Nitroglycerin is a vasodilator used for angina and does not directly interact with contrast media to cause acute kidney injury. Its primary mechanism involves nitric oxide release, leading to smooth muscle relaxation and improved blood flow, unrelated to renal clearance of contrast.
Choice B rationale
Carvedilol is a beta-blocker that primarily affects heart rate and blood pressure. It does not have a direct interaction with iodinated contrast material that specifically increases the risk of acute kidney injury; its metabolism and excretion pathways do not significantly involve competitive renal mechanisms.
Choice C rationale
Metformin, an oral hypoglycemic agent, interacts with iodinated contrast material. In the presence of acute kidney injury induced by the contrast, metformin can accumulate, leading to lactic acidosis. This risk is due to its renal excretion and interference with mitochondrial respiration.
Choice D rationale
Atorvastatin is a statin used for lipid lowering. It primarily undergoes hepatic metabolism and does not have a known significant interaction with iodinated contrast media that predisposes clients to acute kidney injury. Its mechanism of action is unrelated to renal elimination or nephrotoxicity with contrast.
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