A patient presents to the Level I trauma center after being involved in a 70-car pile-up on Interstate 35. He has multiple injuries and was crushed between several cars. This is a life-threatening injury, and he has severe muscle trauma. What is your suspicion regarding the possible complications this patient might be experiencing? (Select all that apply)
Hydration to prevent kidney injury from myoglobin
Rhabdomyolysis
Electrolyte monitoring, especially for potassium, to manage the risk of hyperkalemia
Acute kidney injury (AKI)
Monitoring kidney function, including creatinine, BUN, and urine output
Correct Answer : B,C,D,E
Choice A reason: Hydration is a treatment, not a complication. Rhabdomyolysis, hyperkalemia, and AKI are complications of crush injuries, with kidney function monitoring essential. This describes an intervention, not a complication, so it’s incorrect.
Choice B reason: Rhabdomyolysis is likely from severe muscle trauma in a crush injury, releasing myoglobin and electrolytes, risking kidney damage. This matches the patient’s injury, making it a correct complication.
Choice C reason: Electrolyte monitoring, especially potassium, is critical due to hyperkalemia risk from muscle breakdown. This can cause arrhythmias, making it a correct selection for complications.
Choice D reason: Acute kidney injury (AKI) is common in rhabdomyolysis, as myoglobin damages kidneys. Given the crush injury, AKI is likely, making this a correct complication.
Choice E reason: Monitoring kidney function (creatinine, BUN, urine output) detects AKI from rhabdomyolysis. This ensures timely intervention, making it a correct choice for complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Aspirin inhibits TXA2 synthesis, reducing platelet adhesion and clotting. This is a true mechanism of aspirin’s antiplatelet effect, so it’s incorrect as the exception.
Choice B reason: Aspirin reduces prostaglandin production, which decreases platelet aggregation. This is a valid antiplatelet mechanism, so it’s incorrect for the action aspirin does not perform.
Choice C reason: Aspirin does not inhibit fibrinogen-to-fibrin conversion; this is part of the coagulation cascade, not platelet function. Aspirin targets platelets, making this the correct action it doesn’t perform.
Choice D reason: Aspirin inhibits ADP-induced platelet aggregation, minimizing plug formation. This is a true antiplatelet effect, so it’s incorrect as the action aspirin does not do.
Correct Answer is B
Explanation
Choice A reason: Necrotic bladder implies tissue death, not a nerve-related obstruction. Neurogenic bladder, caused by nerve supply interruption, leads to functional obstruction, making this incorrect for the described condition.
Choice B reason: Neurogenic bladder results from nerve supply interruption, causing dysfunctional bladder control and obstruction. This matches the description of a functional urinary tract issue, making it the correct term.
Choice C reason: Retrograde bladder is not a medical term; retrograde refers to urine backflow. Neurogenic bladder accurately describes nerve-related obstruction, so this is incorrect for the condition.
Choice D reason: Obstructed bladder is vague and not specific to nerve issues. Neurogenic bladder directly addresses nerve supply disruption causing obstruction, making this incorrect for the term.
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