The nurse plans of care for a patient who has a fractured femur. During the 24 to 48 hours after the fracture, the nurse monitors the patient for the development of which complication?

Bone demineralization

Fat embolism syndrome

Muscle atrophy

Renal calculi

Answer and Explanation

The Correct Answer is B

A. Bone demineralization occurs over a longer period of immobilization and is not a primary concern within the first 24 to 48 hours following a fracture.
B. Fat embolism syndrome (FES) is a serious complication that can occur within 24 to 48 hours after a long bone fracture, especially a femur fracture. Fat droplets from the bone marrow can enter the bloodstream, leading to embolism in the lungs, brain, or heart, causing symptoms such as respiratory distress, confusion, and petechial rash.
C. Muscle atrophy is a concern with prolonged immobility, but it develops over a longer period of time, not within the first 24 to 48 hours after a fracture.
D. Renal calculi (kidney stones) are more commonly associated with long-term immobility or dehydration, not an immediate complication following a fracture.

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Correct Answer is C

Explanation

A. A fat embolism typically presents with respiratory distress, altered mental status, and petechial rash, not the symptoms of pale and cool toes with intact pulses. It is unlikely to cause localized pain in the toes alone.
B. Osteomyelitis is an infection of the bone and would not cause the pale, cool appearance of the toes in this scenario. Symptoms of osteomyelitis include fever, localized pain, and swelling, but it does not present with the same vascular and neurovascular changes as compartment syndrome.
C. Compartment syndrome occurs when there is increased pressure within a muscle compartment, leading to reduced blood flow. The symptoms of pale, cool toes with pain and intact pulses are indicative of impaired circulation due to increased pressure, which is a hallmark of compartment syndrome. This is a medical emergency that requires prompt intervention.
D. A pressure ulcer typically presents with localized skin damage due to prolonged pressure, but it would not cause pale, cool toes or pain in the way compartment syndrome would.

A. Request an antiemetic medication. B. Encourage the client to cough and deep breathe every 2 hr. C. Ensure an abductor pillow is in place while the client is in bed. D. Anticipate the administration of antibiotics. E. Obtain a culture of the drainage from the surgical site.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Request an antiemetic medication: Contraindicated
- Rationale: Antiemetic medications are not typically required unless the client is experiencing nausea or vomiting, which is not indicated in this scenario.
Encourage the client to cough and deep breathe every 2 hr: Indicated
- Rationale: Encouraging coughing and deep breathing helps prevent respiratory complications such as pneumonia, which is important postoperatively.
Ensure an abductor pillow is in place while the client is in bed: Indicated
- Rationale: An abductor pillow helps maintain proper hip alignment and prevents dislocation of the hip joint after surgery.
Anticipate the administration of antibiotics: Indicated
- Rationale: Administering antibiotics helps prevent infection, which is a common concern after surgical procedures.
Obtain a culture of the drainage from the surgical site: Indicated
- Rationale: Obtaining a culture of the drainage can help identify any potential infections and guide appropriate treatment.

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The nurse plans of care for a patient who has a fractured femur. During the 24 to 48 hours after the fracture, the nurse monitors the patient for the development of which complication?

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Naxlex Comprehensive Predictor Exams

A patient with a long leg cast reports pain in the toes. The nurse discovers that the toes are pale and cool to the touch with intact pulses and minimal neuropathy. The findings indicate that the patient may be experiencing which complications?

Correct Answer is C

Explanation

A nurse is caring for an older adult client who has had a total hip arthroplasty. Exhibits For each potential precaution, click to specify if the precaution is indicated or contraindicated for a client who has had a total hip arthroplasty.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

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