The nurse recognizes that the client recovering from which of these surgeries is at highest risk for pulmonary embolism?

A.Aspiration precautions are implemented for clients with dysphagia, impaired gag reflexes, or neurological conditions that affect swallowing mechanics. Iron deficiency anemia does not directly interfere with the esophageal or pharyngeal phases of deglutition. Unless the client has a co-occurring condition like a stroke, these precautions are not the primary focus for managing an anemia diagnosis.

B.Seizure precautions are necessary for clients with epilepsy, metabolic disturbances, or brain injuries that lower the seizure threshold. Iron deficiency anemia causes a decrease in hemoglobin and oxygen-carrying capacity but does not typically trigger abnormal electrical activity in the cerebral cortex. There is no clinical indication to initiate these precautions based solely on the laboratory diagnosis of anemia.

C.Iron deficiency anemia leads to reduced oxygen delivery to tissues, which often manifests as dizziness, orthostatic vertigo, and generalized muscle weakness. In an older adult, these symptoms significantly increase the risk of instability and accidental falls during daily activities. The nurse must implement fall precautions to mitigate the danger posed by the physiological effects of decreased hemoglobin levels.

D.Contact precautions are used to prevent the transmission of infectious agents such as MRSA or C. difficile via direct or indirect contact. Iron deficiency anemia is a non-communicable hematologic condition caused by nutritional deficits or chronic blood loss. Initiating contact precautions would be an inappropriate use of infection control resources and would unnecessarily restrict the client's social interactions.

A.Prednisone is a potent glucocorticoid that works by suppressing the immune system and inhibiting the production of inflammatory mediators like prostaglandins and leukotrienes. In rheumatoid arthritis, this action effectively reduces the swelling, pain, and heat within the joints caused by the autoimmune attack on the synovium. This explanation provides the patient with an accurate and scientifically sound understanding of the drug's primary therapeutic goal.

B.Prednisone actually increases the risk of infection because it suppresses the overall immune response, including the activity of leukocytes and the production of antibodies. Patients on long-term corticosteroid therapy are considered immunocompromised and must be taught to avoid crowds and report any signs of illness immediately. Stating that the medication reduces the risk of infection is a dangerous medical error that could lead to poor outcomes.

C.Corticosteroids like prednisone do not improve blood flow to the kidneys and can actually contribute to fluid retention and hypertension through sodium and water reabsorption. While they may be used to treat certain inflammatory kidney diseases, their primary mechanism is not vasodilatory or related to renal perfusion. This response mischaracterizes the pharmacological action of the drug and provides irrelevant information regarding its use in rheumatoid arthritis.

D.Prednisone is well-known for causing significant bone loss and increasing the risk of osteoporosis, rather than protecting bone density. Glucocorticoids inhibit osteoblast activity and decrease calcium absorption in the gastrointestinal tract, leading to decreased bone mineral density over time. Patients on prednisone are often prescribed calcium and vitamin D supplements to counteract these detrimental effects on the skeletal system.