A nurse is caring for a client who is newly diagnosed with HIV. Prior to discharge, the nurse would anticipate the client verbalizing which of the following statements?

A) Explaining the purpose, risks, benefit, and alternatives of the surgery: This is not the responsibility of the RN. The role of explaining the purpose, risks, benefits, and alternatives of the surgery falls under the responsibility of the surgeon or the healthcare provider performing the procedure. The RN can provide general information and support but is not responsible for explaining the details of the surgery or obtaining informed consent.

B) Witnessing the client’s signature on the consent form: This is within the RN’s scope of practice. The nurse's role in the consent process is to witness the client's signature, ensuring that it is voluntary and that the client appears to be competent and informed. The nurse does not explain the details of the procedure, but they confirm that the patient has been informed by the surgeon.

C) Conducting a baseline physical assessment and obtaining vital signs: This is an important responsibility of the RN. The nurse conducts a thorough pre-operative assessment, which includes gathering baseline physical data and vital signs. This helps establish a reference point for the client’s health status before surgery and allows for the identification of any abnormalities that may need to be addressed.

D) Ensuring the pre-operative checklist is completed: This is also the RN's responsibility. The nurse ensures that all aspects of the pre-operative checklist, which includes verifying consent, ensuring necessary tests are done, and confirming that the patient is prepared for surgery, are completed. This is part of the nurse’s role in preparing the patient for a safe surgical experience.

A) IV antibiotics: Administering IV antibiotics is important to prevent infection, particularly in open fractures, but it does not directly address the prevention of fat embolism. Fat embolism syndrome occurs when fat droplets are released into the bloodstream, typically from bone marrow after a fracture, and antibiotics have no role in preventing this specific complication. Antibiotics would be more relevant for preventing infection from the open wound, not for managing fat embolism risk.

B) Encouraging the patient not to bend at the hip: While avoiding unnecessary movement or bending at the hip may help prevent further injury, it does not specifically address the prevention of fat embolism. Fat embolism is primarily a concern due to the fracture itself and the subsequent release of fat from the bone marrow into the bloodstream. Restricting hip movement alone is not a preventive strategy for this condition.

C) Early immobilization of the fractured leg: The most effective intervention for preventing fat embolism is early immobilization of the fractured leg. Immobilization stabilizes the bone, preventing the release of fat droplets from the bone marrow into the bloodstream, which is the primary mechanism behind fat embolism. Early stabilization of the fracture helps minimize this risk, making this the priority action in the immediate care of a client with an open femur fracture.

D) Irrigating the open wound with sterile Normal Saline: While wound irrigation is essential for preventing infection and is part of the standard care for an open fracture, it does not directly prevent fat embolism. The risk of fat embolism arises from the fracture itself, and the priority in this case is stabilization of the bone to prevent the release of fat into circulation. Irrigating the wound helps with infection control, but it is not the most critical step for fat embolism prevention.