The practical nurse (PN) is providing care for a client suspected of adrenal cortex failure. Which laboratory value would indicate the functioning of the adrenal gland?

Choice A reason: While respiratory rate is an important vital sign to monitor, changes in respiratory rate are not the most critical indicator of an imminent complication related to an abdominal aneurysm. Respiratory rate can be influenced by various factors such as pain, anxiety, or underlying respiratory conditions. However, it does not directly correlate with the risk of aneurysm rupture, which is the primary concern in clients with an abdominal aneurysm.
Choice B reason: Urinary output is an important indicator of renal function and overall fluid balance. However, changes in urinary output are not the most immediate concern in the context of an abdominal aneurysm. While it is essential to monitor urine output to ensure adequate kidney function, it is not the primary parameter that would signal an imminent complication or rupture of the aneurysm.
Choice C reason: Temperature can provide valuable information about the presence of an infection or systemic inflammation. However, changes in temperature are not directly related to the risk of aneurysm rupture. Although an elevated temperature may warrant further investigation, it is not the most critical finding to report in the context of an abdominal aneurysm.
Choice D reason: Blood pressure is the most important assessment finding to monitor and report in a client with an abdominal aneurysm. Elevated blood pressure can increase the risk of aneurysm rupture due to the added stress on the arterial wall. Conversely, a sudden drop in blood pressure can indicate a potential rupture or internal bleeding, which is a medical emergency. Monitoring and reporting changes in blood pressure are crucial in providing timely interventions to prevent or address complications related to an abdominal aneurysm.

Choice A reason: Fat embolism syndrome (FES) is a serious complication that can occur after a long bone fracture. It happens when fat droplets from the bone marrow enter the bloodstream and travel to the lungs, brain, or other organs, causing a range of symptoms. These can include respiratory distress, cerebral symptoms like confusion or agitation, and petechial rash. The practical nurse must be vigilant for early signs of fat embolism, such as changes in mental status, tachypnea, and hypoxia, as timely intervention is critical to prevent severe outcomes. Monitoring the client's oxygen saturation, respiratory rate, and level of consciousness is essential in detecting this potentially life-threatening condition.
Choice B reason: Urinary retention can be a concern postoperatively due to anesthesia and immobility. While it is important to monitor urinary output and ensure the client is voiding adequately, urinary retention is not as immediately life-threatening as a fat embolism. The practical nurse should still assess bladder function and encourage measures to promote voiding, such as adequate hydration and mobility. However, this complication does not take precedence over the potential for a fat embolism in the early postoperative period following a long bone fracture repair.
Choice C reason: Nonunion refers to the failure of the fracture to heal properly, which can lead to chronic pain and functional impairment. It is a significant complication that requires attention, but it typically develops over a longer period rather than immediately postoperatively. The practical nurse should monitor for signs of nonunion, such as persistent pain and lack of healing on follow-up X-rays. However, this is not the most urgent concern in the immediate postoperative period when compared to the risk of a fat embolism.
Choice D reason: Muscular spasms can occur after a fracture as the muscles around the injury site contract to protect and stabilize the affected area. While muscle spasms can be painful and affect the client's comfort and mobility, they are generally not life-threatening. The practical nurse should address muscle spasms through pain management strategies and physical therapy, but this complication is not as critical as the potential for a fat embolism in the immediate postoperative period.