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: Sputum is the most appropriate specimen to collect prior to the initiation of antibiotic therapy in a client with suspected pneumonia. Sputum cultures can help identify the specific bacteria or other pathogens causing the infection, allowing for targeted antibiotic therapy. Collecting the sputum sample before starting antibiotics ensures that the culture results are not influenced by the medication, leading to more accurate identification of the causative agent and more effective treatment.
Choice B reason: Urine is not the appropriate specimen to collect for diagnosing pneumonia. While urine cultures can be useful for diagnosing urinary tract infections or detecting certain pathogens through urine antigen tests, they are not relevant to identifying the etiology of a respiratory infection like pneumonia. The focus should be on obtaining samples directly from the respiratory system.
Choice C reason: A throat smear can be useful for diagnosing upper respiratory tract infections, such as strep throat, caused by Group A Streptococcus. However, it is not the most relevant test for diagnosing pneumonia, which affects the lower respiratory tract. A sputum sample is more appropriate for identifying the pathogens responsible for pneumonia.
Choice D reason: Blood cultures can be useful for detecting bacteremia or septicemia, especially in severe cases of pneumonia where the infection has spread to the bloodstream. However, they are not the primary method for identifying the specific cause of pneumonia. Blood cultures are typically used in conjunction with other tests, such as sputum cultures, to provide a comprehensive diagnosis.

Choice A reason: Maintaining the client in a recumbent position is not typically necessary on the first postoperative day following an appendectomy. While it is important to ensure the client is comfortable and to monitor for signs of complications, encouraging mobility as soon as it is safe is generally beneficial. Prolonged bed rest can lead to complications such as deep vein thrombosis (DVT) and respiratory issues. Therefore, this intervention is not the most appropriate for promoting recovery and ensuring the client's well-being.
Choice B reason: Applying moist heat for pain relief is generally not recommended in the immediate postoperative period following an appendectomy. The use of heat can increase blood flow to the surgical site and potentially exacerbate inflammation or swelling. Pain management should be approached with appropriate analgesics as prescribed by the healthcare provider. Additionally, it is crucial to monitor for signs of complications such as infection or hematoma, and moist heat may not be the safest method for addressing postoperative pain in this context.
Choice C reason: Restricting ambulation to the bathroom only may be overly restrictive and can hinder the client's recovery process. Encouraging early and safe ambulation is important to prevent complications like DVT, promote circulation, and support overall recovery. While it is essential to ensure that the client does not overexert themselves, completely restricting movement to only bathroom trips is not conducive to optimal postoperative care. Gradual, supervised ambulation should be encouraged as the client's condition permits.
Choice D reason: Documenting the first bowel movement is a crucial intervention following an appendectomy. It provides important information about the return of gastrointestinal function, which can be affected by both the surgery and anesthesia. Monitoring and recording bowel movements help ensure that the client is not experiencing postoperative ileus, a common complication characterized by a temporary cessation of bowel activity. Early detection of such issues allows for timely intervention and supports the client's overall recovery.