A nurse is reviewing the medical history of a client who is luted for surgery. Which of the following findings places the client at risk for a complication of incisional hematoma forming?

The client is underweight.

The client takes anticoagulant medications.

The client has urinary incontinence

The client has peripheral vascular disease

Answer and Explanation

The Correct Answer is B

A) The client is underweight:
Being underweight is not directly associated with an increased risk of incisional hematoma formation. However, underweight individuals may have a lower amount of subcutaneous fat, which could affect wound healing. While nutritional status plays a role in recovery after surgery, being underweight does not specifically increase the risk of hematoma formation at
the incision site.

B) The client takes anticoagulant medications:
Taking anticoagulant medications (e.g., warfarin, heparin, or newer anticoagulants like dabigatran) increases the risk of bleeding and the formation of an incisional hematoma. Anticoagulants work by reducing the blood's ability to clot, making it more difficult to stop bleeding after surgery. This increases the likelihood of blood accumulating in the tissue around the incision site, potentially forming a hematoma.

C) The client has urinary incontinence:
Urinary incontinence does not directly increase the risk of incisional hematoma formation. However, it can lead to other complications, such as skin irritation or infection, but it is not a primary risk factor for hematoma formation in the surgical wound. The main concern with urinary incontinence in the perioperative period is ensuring proper skin care to prevent moisture-associated skin damage.

D) The client has peripheral vascular disease:
Peripheral vascular disease (PVD) affects circulation in the extremities, which can impair wound healing due to decreased blood flow. While PVD can contribute to delayed healing and complications like infection, it is not the most significant factor for the formation of incisional hematomas.

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Correct Answer is A

Explanation

A) Dehydration:
Diarrhea, especially when prolonged for several days, leads to significant fluid and electrolyte loss, which can result in dehydration. Common signs of dehydration include dry mucous membranes, decreased skin turgor, low urine output, hypotension, and increased heart rate. Dehydration is one of the most expected findings in a patient with prolonged diarrhea due to the loss of water and electrolytes from the body.
B) Rigid abdomen:
A rigid abdomen could indicate peritonitis or a serious abdominal condition such as bowel perforation, which is a medical emergency. This would not be expected in a patient with uncomplicated diarrhea. Rigid abdominal muscles are typically associated with acute abdominal emergencies rather than simple diarrhea.
C) Hypothermia:
Hypothermia is generally not associated with diarrhea. Diarrhea is more likely to cause fever or a normal body temperature due to the body's inflammatory response to infection or irritation. Hypothermia typically occurs in cases of prolonged exposure to cold or in critically ill patients, but it is not a typical response to diarrhea alone.
D) Decreased bowel sounds:
While decreased or absent bowel sounds can be seen in bowel obstruction or paralytic ileus, it is not typically a finding associated with diarrhea. In fact, in the early stages of diarrhea, increased bowel sounds (hyperactive bowel sounds) are often noted due to the rapid peristalsis and gastrointestinal irritation.

A. Cataracts B. Diabetic retinopathy C. Macular degeneration D. Glaucoma

Correct Answer is A

Explanation

A) Cataracts:
A cloudy, opaque area over the lens of the eye is a classic sign of cataracts. Cataracts occur when the lens of the eye becomes cloudy or opaque, leading to blurry vision and, in some cases, eventual blindness if left untreated. Cataracts typically develop slowly and can be caused by aging, injury, or other conditions like diabetes. Symptoms include difficulty seeing at night, glare, and a decrease in color intensity.

B) Diabetic retinopathy:
Diabetic retinopathy is a complication of diabetes that affects the blood vessels of the retina. It leads to vision problems such as blurred vision, floaters, and even blindness. However, it is characterized by damage to the retina, not cloudiness or opacity over the lens.

C) Macular degeneration:
Macular degeneration affects the macula, the part of the retina responsible for central vision. It leads to a loss of central vision, causing difficulty with tasks like reading or recognizing faces. There is often blurriness or distortion in the center of the visual field.

D) Glaucoma:
Glaucoma is a group of eye conditions that lead to damage to the optic nerve often due to high intraocular pressure. It can result in peripheral vision loss and, if untreated, can lead to blindness. However, glaucoma does not cause a cloudy, opaque lens but rather affects the optic nerve and peripheral vision.

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A nurse is reviewing the medical history of a client who is luted for surgery. Which of the following findings places the client at risk for a complication of incisional hematoma forming?

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