The nurse is caring for a client who has just returned from surgery following an open reduction internal fixation (ORIF) of a fractured hip. The nurse should monitor for which of the following complications?
Fat embolism
Pulmonary edema
Deep vein thrombosis
Myocardial infarction.
The Correct Answer is A
Choice A reason:
Fat embolism is a possible complication of ORIF of a fractured hip. A fat embolism occurs when fat droplets from the bone marrow enter the bloodstream and block small blood vessels in the lungs, brain, or other organs. This can cause serious symptoms such as shortness of breath, chest pain, confusion, seizures, or coma. Fat embolism syndrome is more common with fractures of long bones such as the femur.
Choice B reason:
Pulmonary edema is not a likely complication of ORIF of a fractured hip. Pulmonary edema is a condition where fluid accumulates in the lungs, making it difficult to breathe. Pulmonary edema can be caused by heart failure, kidney failure, lung infections, or high altitude. It is not directly related to bone fractures or surgery.
Choice C reason:
Deep vein thrombosis (DVT) is a possible complication of ORIF of a fractured hip. DVT is a blood clot that forms in a deep vein, usually in the leg. DVT can cause pain, swelling, redness, or warmth in the affected area. DVT can also break off and travel to the lungs, causing a pulmonary embolism, which is a life-threatening emergency. DVT is more likely to occur after surgery or prolonged immobility.
Choice D reason:
Myocardial infarction (MI) is not a likely complication of ORIF of a fractured hip. MI is a heart attack that occurs when the blood supply to the heart muscle is interrupted, causing damage or death of the heart tissue. MI can be caused by coronary artery disease, which is the buildup of plaque in the arteries that supply the heart. MI can also be triggered by stress, physical exertion, or other factors. MI is not directly related to bone fractures or surgery. A) Fat embolism B) Pulmonary edema C) Deep vein thrombosis D) Myocardial infarction
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
This is the correct answer. This is to prevent the risk of leaving a foreign object inside the patient, which can cause serious complications such as infection, abscess, bowel obstruction, or perforation.
Choice B reason:
This is incorrect. Notifying anesthesia personnel is not the priority action when an incorrect sponge count is reported. Anesthesia personnel are not responsible for counting or searching for sponges, and they cannot intervene in the surgical procedure without the surgeon's consent. The surgeon is the one who needs to be informed first, as they have the authority and ability to search the wound and decide whether to continue or stop the surgery.
Choice C reason:
This is incorrect. Notifying risk management is not the priority action when an incorrect sponge count is reported. Risk management is a department that deals with identifying, assessing, and minimizing potential hazards in health care settings. While it is important to report any adverse events or errors to risk management, this should be done after ensuring the patient's safety and resolving the issue. The priority is to notify the surgeon and search for the missing sponge.
Choice D reason:
This is incorrect. Notifying operating room supervisor is not the priority action when an incorrect sponge count is reported. The operating room supervisor is a person who oversees the daily operations of the surgical suite, such as staffing, scheduling, equipment, and supplies. While they may be involved in addressing any problems or conflicts that arise in the OR, they are not directly responsible for counting or searching for sponges, and they cannot interfere with the surgical procedure without the surgeon's consent. The priority is to notify the surgeon and search for the missing sponge.
Correct Answer is ["B","C"]
Explanation
Choice A reason:
This statement is correct. Regional anesthesia blocks the sensation of pain and other sensations from a specific part of the body, such as below the waist for spinal or epidural anesthesia. The client will not be able to move or feel anything in the affected area during the surgery.
Choice B reason:
This statement is incorrect. Regional anesthesia does not require the client to stay awake during the surgery, unless the client prefers to do so. The client can also receive sedation or general anesthesia along with regional anesthesia, depending on the type and duration of the surgery and the client's preference.
Choice C reason:
This statement is incorrect. Regional anesthesia can have residual effects on the client's motor and sensory function, as well as blood pressure and heart rate, for several hours after the surgery. The client will need someone to drive them home after the surgery and monitor them for any signs of complications.
Choice D reason:
This statement is correct. Regional anesthesia has some advantages over general anesthesia, such as less risk of nausea and vomiting, less blood loss, less stress response, and better postoperative pain control.
Choice E reason:
This statement is correct. Regional anesthesia does not affect the client's ability to swallow or protect their airway, unlike general anesthesia. However, the client will still have to fast for at least 8 hours before the surgery to prevent aspiration of stomach contents in case general anesthesia or sedation is needed or administered.
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