A nurse is caring for a group of clients who are 12 hours postoperative. The nurse should identify that the client who had which of the following procedures is at risk for developing fat embolism syndrome?

Thyroidectomy

Internal fixation of a fractured hip

Repair of a torn rotator cuff

Tympanoplasty

Answer and Explanation

The Correct Answer is B

Choice A reason: Thyroidectomy is a surgical procedure that involves the removal of all or part of the thyroid gland. While there are risks associated with any surgery, thyroidectomy is not typically associated with fat embolism syndrome (FES). FES is more commonly linked to orthopedic procedures and trauma, particularly those involving long bones.

Choice B reason: Internal fixation of a fractured hip is a procedure that carries a risk for developing FES. FES is a serious and potentially life-threatening condition that occurs when fat globules enter the bloodstream and lodge within the blood vessels of the lungs or other organs. Hip fractures, especially those involving the long bones, can result in the release of fat globules into the bloodstream during the surgical repair process. Early surgical fixation is thought to reduce the risk of FES.

Choice C reason: Repair of a torn rotator cuff involves the shoulder joint and, while it is a significant surgical procedure, it is not typically associated with a high risk of FES. The rotator cuff is composed of muscles and tendons, and its repair does not usually involve manipulation of the long bones where fat embolism is more likely to occur.

Choice D reason: Tympanoplasty is a surgical procedure to repair a hole in the eardrum. It is an otologic procedure that does not involve the long bones or orthopedic manipulation. Therefore, it is not associated with a risk of developing FES.

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Correct Answer is C

Explanation

Choice A reason: Digoxin is primarily used to treat atrial fibrillation and heart failure. It is not the first-line medication for sinus bradycardia with ST-segment elevation, as it can further slow down the heart rate.

Choice B reason: Sotalol is a beta-blocker and an antiarrhythmic medication that can be used to treat ventricular arrhythmias and maintain sinus rhythm in atrial fibrillation. However, it is not indicated for sinus bradycardia and could exacerbate the condition.

Choice C reason: Atropine is the medication of choice for symptomatic sinus bradycardia. It works by blocking the action of the vagus nerve on the heart, leading to an increased heart rate. Atropine can quickly reverse the symptoms of bradycardia, such as dizziness and shortness of breath.

Choice D reason: Lidocaine is an antiarrhythmic medication used to treat ventricular arrhythmias. While it can be used in acute settings, it is not the first choice for sinus bradycardia with ST-segment elevation.

A. Change the ostomy pouch daily. B. Empty the ostomy pouch when it is 2/3 full. C. Trim the opening of the ostomy seal to be 1/2 inch wider than the stoma. D. Apply lotion to the peristomal skin when changing the ostomy pouch.

Correct Answer is B

Explanation

Choice A reason: Changing the ostomy pouch daily is not typically necessary. Most pouches can be worn comfortably for several days before needing to be changed. Frequent changes are not only unnecessary but can also irritate the skin around the stoma.

Choice B reason: Emptying the ostomy pouch when it is 2/3 full is recommended to prevent leaks and overfilling, which can lead to discomfort and potential skin irritation. It is important to monitor the fullness of the pouch and empty it regularly to maintain hygiene and comfort.

Choice C reason: Trimming the opening of the ostomy seal to be 1/2 inch wider than the stoma is incorrect. The opening should be cut to match the size of the stoma to ensure a snug fit that prevents leakage and protects the skin around the stoma.

Choice D reason: Applying lotion to the peristomal skin when changing the ostomy pouch is not advised. Lotions or creams can interfere with the adhesive of the ostomy appliance and should be avoided. The peristomal skin should be clean and dry to ensure proper adhesion of the ostomy appliance.

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A nurse is caring for a group of clients who are 12 hours postoperative. The nurse should identify that the client who had which of the following procedures is at risk for developing fat embolism syndrome?

Nursing Test Bank

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Explanation

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