A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Anxiety attack

Pneumonia

Pulmonary embolism

Asthma exacerbation

Answer and Explanation

The Correct Answer is C

A. While anxiety can cause rapid breathing and confusion, the patient's clinical presentation (dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation) is more consistent with a serious physical condition, such as a pulmonary embolism, rather than an anxiety attack.

B. Pneumonia could cause dyspnea and confusion, but the rapid onset of symptoms, along with the patient's history of prolonged bed rest and risk factors, suggests a pulmonary embolism rather than pneumonia.

C. Pulmonary embolism (PE) is a life-threatening condition that can occur in patients on prolonged bedrest, especially after a pelvic fracture. The patient’s symptoms of dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation are classic signs of PE. This requires immediate intervention, including anticoagulation and possibly thrombolytic therapy.

D. Asthma exacerbation typically presents with wheezing and difficulty breathing, but it would not typically cause the severe hypotension, confusion, and rapid oxygen desaturation seen in this patient.

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Correct Answer is D

Explanation

A. Tidal fluctuation in the water seal chamber is an expected finding in a chest tube drainage system. It indicates that the pleural space is still connected to the atmosphere, and the lungs are expanding and contracting normally.

B. Continuous bubbling in the suction control chamber is normal when the chest tube is connected to suction. This shows that the suction system is functioning properly.

C. Chest tube eyelets not being visible is expected when the chest tube is properly positioned inside the pleural space. This finding does not require immediate notification.

D. Development of subcutaneous emphysema (air trapped under the skin) may indicate an air leak or improper chest tube placement. This finding requires immediate notification of the provider to address the underlying cause and prevent complications.

A. "Fragments of bone have splintered into the surrounding tissue." B. "The sharp edge of the bone has broken through the skin." C. "The bone ends have been forced toward each other." D. "The bone is broken on one side and bent on the other side."

Correct Answer is D

Explanation

A. This description refers to a comminuted fracture, where the bone is broken into multiple fragments. It is not characteristic of a greenstick fracture.

B. This description refers to a compound or open fracture, where the bone breaks through the skin. A greenstick fracture typically does not involve the bone piercing the skin.

C. This description refers to a compression or impacted fracture, where the bone ends are driven into each other. This is not the nature of a greenstick fracture.

D. A greenstick fracture occurs when the bone breaks on one side but bends on the other, similar to how a green twig might break. This is common in children due to the flexibility of their bones.

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A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Nursing Test Bank

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