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 B

Explanation

Choice A reason: Administering prescribed corticosteroids is not the appropriate action for dyspnea associated with fluid overload from IV infusion. Corticosteroids are typically used to manage inflammatory conditions and are not indicated for this scenario.

Choice B reason: Slowing the infusion rate is the correct action when signs of fluid overload are present, such as dyspnea and hypertension. This helps to prevent further fluid accumulation. Contacting the provider is essential for further evaluation and management, which may include adjusting the fluid regimen or prescribing diuretics to manage the fluid overload.

Choice C reason: Lowering the head of the bed to a semi-Fowler's position may provide temporary relief for dyspnea but does not address the underlying issue of fluid overload. It is a supportive measure but should be accompanied by other interventions to manage the client's condition.

Choice D reason: Changing the infusion to lactated Ringer's would not address the issue of fluid overload and could potentially exacerbate the situation if the rate is maintained. The type of IV fluid is less important than the volume and rate of administration in the case of fluid overload.

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 necessary and could lead to skin irritation from the frequent removal and application of the adhesive. Ostomy pouches are designed to be worn for several days, and the schedule for changing them can vary based on the type of pouch and individual needs.

Choice B reason: Emptying the ostomy pouch when it is 2/3 full is the correct instruction. This prevents the pouch from becoming too heavy, which could pull on the stoma and cause discomfort or damage. It also reduces the risk of leaks and odors.

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 trimmed to match the size of the stoma to provide a secure fit and prevent leakage of the contents onto the skin, which could cause irritation or infection.

Choice D reason: Applying lotion to the peristomal skin when changing the ostomy pouch is not recommended. Lotions or creams can interfere with the adhesive of the ostomy appliance and reduce the effectiveness of the seal. The peristomal skin should be clean and dry to ensure the best adherence 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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