The nurse is caring for a patient who just returned from surgical decompression of the carpal tunnel. Which finding requires the nurse's immediate action?
The patient's fingers are pink and cool bilaterally.
The capillary refill time is 8 seconds.
The patient complains of generalized pain 5/10.
The patient's fingers swollen and warm.
The Correct Answer is B
A. Fingers being pink and cool bilaterally may be expected postoperatively due to anesthesia or positioning and does not indicate an immediate complication.
B. A capillary refill time of 8 seconds is significantly prolonged (normal is ≤2 seconds) and may indicate compromised circulation, possibly due to compartment syndrome or vascular compromise. This requires immediate action to preserve limb function.
C. A pain level of 5/10 is moderate and may be expected after surgery. It does not indicate an urgent issue unless unrelieved by medication or out of proportion to the procedure.
D. Swollen and warm fingers may be part of the normal inflammatory process after surgery but are not immediately life- or limb-threatening.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Colchicine is primarily used to treat acute gout attacks by reducing inflammation caused by urate crystal deposition in the joints.
B. Colchicine is not effective in lowering uric acid levels; medications like allopurinol or febuxostat are used for that purpose in chronic gout management.
C. Colchicine does not have antibacterial properties and is not used to treat infections.
D. While colchicine has anti-inflammatory effects, it is not commonly used for rheumatoid arthritis and is not considered a first-line treatment for that condition
Correct Answer is A
Explanation
A. Patients with bacterial meningitis often experience headaches, photophobia, and sensitivity to stimuli; a quiet, low-stimulation environment helps reduce discomfort.
B. Encouraging activities to reduce naps is not appropriate; rest is important for recovery.
C. While sterile technique is important for invasive procedures, routine care does not require sterile technique; standard precautions are used.
D. Limiting oral fluids is not generally necessary unless the patient has specific contraindications; hydration is important.
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