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?
Localized edema and discoloration occurring hours after the injury
Pain relieved after taking 4 mg of hydromorphone
Pedal pulses cannot be located with a Doppler and complaints of increasing pain
Generalized weakness and pain at the site of injury
The Correct Answer is C
A. Localized edema and discoloration are expected findings after a fracture and do not typically require immediate reporting unless they are accompanied by signs of compartment syndrome or other complications.
B. Pain relieved by hydromorphone indicates that the pain is being effectively managed. This does not require immediate reporting to the healthcare provider.
C. The absence of pedal pulses, even with the use of a Doppler, combined with increasing pain, is a critical finding that suggests compromised circulation, possibly due to compartment syndrome. This is a medical emergency requiring immediate intervention to prevent permanent tissue damage or loss of the limb.
D. Generalized weakness and pain at the site of injury are common findings after a fracture and do not indicate an urgent complication unless associated with other concerning symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
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.
Correct Answer is D
Explanation
A. Fluticasone is an inhaled corticosteroid often used to manage asthma. It does not pose a direct risk to a client with heart failure and asthma, so clarification is not needed for this medication.
B. Amoxicillin is an antibiotic and does not directly affect asthma or heart failure. It is not contraindicated in clients with these conditions, so clarification is not necessary.
C. Isosorbide dinitrate is a nitrate used to treat heart failure by reducing cardiac workload and improving oxygen delivery. It does not affect asthma and does not require clarification.
D. Carvedilol is a beta-blocker that is commonly used to manage heart failure, but it is a non-selective beta-blocker, which can exacerbate asthma symptoms by causing bronchoconstriction. In clients with a history of asthma, beta-1 selective blockers are preferred, so clarification of this order is necessary.
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