The nurse is caring for a client who sustained a crushed injury to the lower extremity and has developed compartment syndrome. What intervention should the nurse plan for next?
Insertion of central venous access
Phlebotomy
Fasciotomy
Insertion of arterial line
The Correct Answer is C
A. Insertion of central venous access: This is not relevant to compartment syndrome management. Central venous access is used for fluid administration or monitoring central venous pressure.
B. Phlebotomy: This is unrelated to the management of compartment syndrome, as it involves drawing blood and does not address the increased pressure.
C. Fasciotomy: Compartment syndrome is a medical emergency where increased pressure within a closed compartment compromises circulation and tissue function. A fasciotomy involves surgically opening the compartment to relieve the pressure, prevent tissue necrosis, and save the limb. This is the definitive treatment.
D. Insertion of arterial line: While this may be useful for monitoring blood pressure in critical situations, it does not relieve compartment syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hypokalemia: U waves are often seen on an electrocardiogram in clients with hypokalemia. They represent delayed repolarization of the Purkinje fibers due to low potassium levels.
B. Hypercalcemia: Hypercalcemia affects the QT interval, typically shortening it, but it does not cause U waves.
C. Hyponatremia: Electrocardiographic changes are not commonly associated with hyponatremia.
D. Hyperkalemia: Hyperkalemia causes peaked T waves, prolonged PR intervals, and wide QRS complexes, not U waves.
Correct Answer is D
Explanation
A. Able to localize pain: A score of 6 is too low for a client to localize pain, which would require higher motor function.
B. Is verbally responsive, but confused: Verbal responsiveness would require a higher score, as a GCS of 6 indicates severe impairment.
C. Moves arms as directed: Following commands is consistent with a higher GCS score.
D. Opens eyes to deep pain only: This response aligns with the minimal responsiveness expected for a GCS score of 6.
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