It is most important for the practical nurse (PN) to observe for which complication when caring for a client who had a long bone fracture repaired yesterday?

Choice A reason: Fat emboli, or fat embolism syndrome (FES), is the most critical complication to monitor for in a client who had a long bone fracture repaired. This condition occurs when fat droplets from the bone marrow enter the bloodstream and travel to the lungs, brain, or other organs. Symptoms can include respiratory distress, confusion, and a petechial rash. FES can develop within 24 to 72 hours after the injury or surgery and can be life-threatening. Therefore, it is essential to observe for signs such as sudden shortness of breath, rapid breathing, changes in mental status, and the characteristic rash. Early detection and intervention are crucial to manage this potentially severe complication.
Choice B reason: Urinary retention is a possible postoperative complication due to anesthesia or immobility. It is important to monitor urine output and ensure that the client is voiding adequately. However, it is not as immediately life-threatening as a fat embolism. While urinary retention requires attention and management, the practical nurse should prioritize monitoring for signs of fat embolism due to its more severe and acute nature.
Choice C reason: Nonunion refers to the failure of the fracture to heal properly, which can lead to chronic pain and functional impairment. This complication typically develops over a more extended period rather than immediately postoperatively. Monitoring for signs of nonunion, such as persistent pain and lack of healing on follow-up X-rays, is important. However, it is not the most urgent concern in the immediate postoperative period when compared to the risk of a fat embolism.
Choice D reason: Muscular spasms can occur after a fracture as the muscles around the injury site contract to protect and stabilize the affected area. These spasms can be painful and impact the client's comfort and mobility. While it is necessary to address muscle spasms through pain management and physical therapy, they are generally not life-threatening. The practical nurse should focus on monitoring for signs of fat embolism, which poses a more immediate risk to the client's health.

Choice A reason: Suction equipment is essential for a client who has undergone fixation of a mandible fracture. Due to the nature of the surgery and the presence of wiring, the client may have difficulty managing oral secretions. Suction equipment ensures that any secretions can be promptly and effectively removed, preventing aspiration and maintaining a clear airway. This equipment is vital for managing the client's immediate postoperative needs and ensuring their safety.
Choice B reason: A crash cart, while critical in emergency situations, is not specifically required to be present in the client's room following mandible fracture fixation. Crash carts are typically available on the unit and can be quickly brought to the room if needed. The practical nurse should be familiar with the location of the crash cart and how to access it, but it does not need to be permanently stationed in the client's room.
Choice C reason: A non-rebreather mask is used to deliver high concentrations of oxygen to clients experiencing severe respiratory distress or hypoxemia. While it is an important piece of equipment for respiratory emergencies, it is not specifically necessary to have in the room of a client with a mandible fracture fixation. The priority is to have suction equipment and wire cutters immediately available, while other oxygen delivery devices can be accessed as needed.
Choice D reason: A nasogastric tube is used for decompression of the stomach or for feeding clients who are unable to take oral nutrition. It is not specifically required for a client with a mandible fracture fixation unless there are additional complications or indications for its use. The practical nurse should focus on equipment directly related to managing the fixation and maintaining the client's airway.
Choice E reason: Wire cutters are a critical item to have in the room of a client with a mandible fracture fixation. In the event of an emergency, such as vomiting or respiratory distress, the wires securing the mandible may need to be quickly cut to ensure the client's airway is not compromised. Having wire cutters immediately available ensures that the practical nurse can respond swiftly and effectively to any urgent situations, maintaining the client's safety and airway patency.