A nurse is assessing a client who is 4 hr. postoperative following arterial revascularization of the left femoral artery. Which of the following findings should the nurse report to the provider immediately?

Pallor in the affected extremity

Urine output 150 ml over 4 hr

Temperature of 37.9° C (100.2°F)

Bruising around the incisional site

Answer and Explanation

The Correct Answer is A

A) Pallor in the affected extremity:
Pallor in the affected extremity is a critical finding that indicates potential compromised blood flow to the area, which can be a sign of graft failure, arterial occlusion, or inadequate perfusion. This requires immediate evaluation by the healthcare provider to prevent serious complications such as limb ischemia or loss.

B) Urine output 150 ml over 4 hr:
While low urine output can be concerning, a urine output of 150 ml over 4 hours may not be immediately alarming unless there are other symptoms of acute kidney injury or dehydration. This would need to be monitored, but it is less urgent compared to signs of compromised blood flow.

C) Temperature of 37.9° C (100.2°F):
A temperature of 37.9°C (100.2°F) is mildly elevated and may indicate a low-grade fever, which can occur postoperatively due to various reasons, including inflammatory responses. It is not as immediately critical as signs of impaired perfusion.

D) Bruising around the incisional site:
Bruising around the incisional site is a common postoperative finding and typically not immediately concerning unless it is associated with significant bleeding or signs of hematoma formation. It should be monitored but does not generally require immediate reporting unless accompanied by other alarming symptoms.

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Correct Answer is D

Explanation

A) Thyroidectomy:
A thyroidectomy involves the removal of all or part of the thyroid gland and is not typically associated with fat embolism syndrome. This procedure does not involve trauma or surgery to large bone structures, which is a key risk factor for fat embolism syndrome.

B) Repair of a torn rotator cuff:
Repairing a torn rotator cuff involves the shoulder muscles and tendons, not major bones. While there are some risks associated with shoulder surgery, fat embolism syndrome is not commonly linked to this type of procedure.

C) Tympanoplasty:
A tympanoplasty is a surgical procedure to repair a perforated eardrum or reconstruct the middle ear. This type of surgery does not involve large bones or fat deposits, and thus is not a known risk factor for fat embolism syndrome.

D) Internal fixation of a fractured hip:
Internal fixation of a fractured hip is associated with a significant risk of fat embolism syndrome. This is because the procedure involves large bones, which, when fractured, can release fat globules into the bloodstream. These fat globules can then travel to the lungs, brain, or other organs, causing fat embolism syndrome.

A. "I will check my pulse before I take the medication." B. "I will try to limit foods that contain salt." C. "I'm going to include more cantaloupe in my diet." D. "I check my blood pressure so it doesn't get too high."

Correct Answer is C

Explanation

A) "I will check my pulse before I take the medication":
While checking the pulse is important for certain medications, it is not a primary concern for furosemide. Furosemide is a diuretic used to manage fluid overload, and its key adverse effects are related to electrolyte imbalances and dehydration rather than changes in heart rate.

B) "I will try to limit foods that contain salt":
Limiting salt intake is a relevant dietary adjustment for clients with heart failure, but it is not directly related to the adverse effects of furosemide. Furosemide works by increasing urine output and can lead to electrolyte imbalances, but salt restriction is more about overall management of heart failure rather than a specific adverse effect of the medication.

C) "I'm going to include more cantaloupe in my diet":
Cantaloupe is high in potassium, which is relevant for clients taking furosemide. Furosemide can cause potassium depletion, so increasing potassium-rich foods is an important measure to help prevent hypokalemia, a common adverse effect of this medication.

D) "I check my blood pressure so it doesn't get too high":
While monitoring blood pressure is important, the primary concern with furosemide is related to electrolyte imbalances and dehydration rather than blood pressure management. Furosemide can cause fluid loss, which may impact blood pressure, but the direct adverse effect of concern is electrolyte imbalance, particularly potassium levels.

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A nurse is assessing a client who is 4 hr. postoperative following arterial revascularization of the left femoral artery. Which of the following findings should the nurse report to the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A nurse is providing teaching to a client who is to start furosemide therapy for heart failure. Which of the following statements indicates that the client understands a potential adverse effect of this medication?

Correct Answer is C

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