The nurse is providing care for a patient following an open reduction surgery of a fracture. Which finding should the nurse report immediately to the HCP?

There is numbness and tingling sensations in the surgical limb.

Surgical pain is a 4 on a scale 0-10.

The foot on the surgical limb is slightly cooler that the other limb.

There are +2 pulses and the surgical limb is pink in color.

Answer and Explanation

The Correct Answer is A

A. There is numbness and tingling sensations in the surgical limb. Numbness and tingling may indicate neurovascular compromise, such as compartment syndrome or nerve damage, requiring immediate medical attention.

B. Surgical pain is a 4 on a scale 0-10. Pain at a level 4 postoperatively is generally manageable and expected. It does not indicate an immediate complication.

C. The foot on the surgical limb is slightly cooler than the other limb. While a slightly cooler foot could be a concern, it is less urgent than numbness and tingling. Monitoring and comparing with other symptoms are necessary.

D. There are +2 pulses and the surgical limb is pink in color. This indicates good circulation and is a positive sign, not requiring immediate reporting.

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Correct Answer is B

Explanation

A. Explain the use of assistive devices. While explaining the use of assistive devices is important, it is not the primary preoperative care focus.

B. Clean skin with antibacterial skin cleaning cloths. Correct. Preoperative skin cleaning with antibacterial cloths is crucial to reduce the risk of postoperative infections.

C. Teach postoperative exercises. Teaching postoperative exercises is important but is typically part of preoperative education rather than immediate preoperative care.

D. Ask if a consent form was signed. Ensuring that consent forms are signed is necessary but is not the primary preoperative care focus.

A. Hypovolemic shock B. Fat embolism C. Thrombophlebitis D. Osteomyelitis

Correct Answer is B

Explanation

A. Hypovolemic shock: While disorientation and low SaO2 could be signs of hypovolemic shock, the presence of petechiae is not a typical symptom. Hypovolemic shock is usually associated with blood loss and does not present with petechiae.

B. Fat embolism: Fat embolism syndrome (FES) is a common complication after fractures, especially long bones like the tibia. The classic triad includes respiratory distress, neurological symptoms, and petechiae, making this the most likely diagnosis.

C. Thrombophlebitis: Thrombophlebitis involves inflammation of a vein due to a blood clot, typically presenting with localized pain, swelling, and redness, not petechiae or disorientation.

D. Osteomyelitis: Osteomyelitis is an infection of the bone. Symptoms include pain, fever, and redness over the infected area, but it does not typically present with disorientation, low SaO2, or petechiae.

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The nurse is providing care for a patient following an open reduction surgery of a fracture. Which finding should the nurse report immediately to the HCP?

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