A nurse is preparing to administer a continuous heparin infusion at 1600 units/hr. Available is heparin 25.000 units in dextrose 5% in water (DSW) 500 mL The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Hypovolemic shock is characterized by a significant loss of blood volume. While it can occur due to severe trauma, the symptoms of shortness of breath and chest pain are more indicative of a potential respiratory issue, making Fat Embolism Syndrome (FES) a higher concern in this case.

B. Correct. Given the client's recent multiple long bone fractures and the symptoms of shortness of breath and chest pain, the nurse should be concerned about the possibility of fat embolism syndrome (FES). FES can occur as a result of long bone fractures, particularly those involving the femur, pelvis, or tibia. Fat emboli can enter thebloodstream and potentially obstruct blood vessels, leading to symptoms such as shortness of breath, chest pain, and altered mental status.

C. Venous thromboembolism (VTE) is a condition involving the formation of blood clots in the veins, which can lead to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). While this is a consideration for clients with immobilization due to fractures, it is not the primary concern in this case based on the presenting symptoms.

D. Compartment syndrome is a condition characterized by increased pressure within a muscle compartment, leading to decreased blood flow and potential tissue damage. While it can occur after fractures, it typically presents with symptoms like severe pain, swelling, and tense muscles, rather than shortness of breath and chest pain.

A. Ecchymosis of the distal foot may be expected after the application of a cast and is not necessarily an immediate concern unless it is severe or rapidly worsening.

B. Dependent edema distal to the cast can occur as a normal response to immobilization. It is not an immediate concern unless it is severe or associated with other concerning symptoms.

C. A moderate level of pain can be expected after the application of a cast. It should be managed appropriately, but it is not an immediate concern unless it is severe or uncontrolled.

D. Inability to flex the toes of the casted foot suggests a potential issue with circulation or nerve function, which requires immediate notification of the provider.