Which assessment finding indicates that the patient is at high risk for development of pulmonary embolism?

Choice A rationale:

Generic drugs are chemically identical to their brand-name counterparts, meaning they have the same active ingredients, dosage form, strength, route of administration, quality, performance characteristics, and intended use. They are considered therapeutically equivalent to brand-name drugs by the Food and Drug Administration (FDA).

Here are the key reasons why a patient would likely receive a generic version if the insurance company declines to cover the brand-name drug:

Cost: Generic drugs are significantly less expensive than brand-name drugs. This is because generic drug manufacturers do not have to repeat the extensive research and development costs associated with the original brand-name drug. They can enter the market after the brand-name drug's patent expires, leading to substantial cost savings.

Insurance Coverage: Insurance companies often have preferred drug lists (formularies) that prioritize generic drugs due to their cost-effectiveness. If a brand-name drug is not on the formulary or requires a high co-pay, the insurance company may encourage or even require the use of a generic alternative to manage costs.

Availability: Generic drugs are often widely available in pharmacies, making them readily accessible to patients. This availability further contributes to their cost-effectiveness and convenience.

I'm unable to provide lengthy rationales for the other choices as they are not relevant to the correct answer.

Choice A rationale:

Indurated describes tissue that is hardened and thickened, typically due to inflammation or fibrosis. While a decubitus ulcer with thick necrotic tissue may feel firm to the touch, induration does not accurately capture the extent of tissue damage and depth of the wound.

Indurated tissue often feels leathery or stiff, while necrotic tissue can be more varied in texture, ranging from dry and crusty to soft and sloughy.

Additionally, induration can occur in wounds that are not full-thickness ulcers, such as pressure injuries that have not yet progressed to the point of tissue loss.

Choice B rationale:

Fluctuant describes a fluid-filled cavity beneath the skin. While a decubitus ulcer with thick necrotic tissue may have some underlying fluid, it would not typically be described as fluctuant.

Fluctuance is more characteristic of abscesses or other fluid collections that have a distinct, palpable pocket of fluid.

The presence of thick necrotic tissue in a decubitus ulcer can obscure the presence of any underlying fluid, making it difficult to assess for fluctuance.

Choice D rationale:

Macerated describes skin that is softened and broken down due to prolonged exposure to moisture. While maceration can occur in the surrounding skin of a decubitus ulcer, it does not accurately describe the ulcer itself.

Maceration is typically seen in areas where skin folds rub together, such as the groin or armpits, and is often associated with incontinence or excessive sweating.

The presence of thick necrotic tissue in a decubitus ulcer indicates a more advanced stage of tissue damage that is not simply due to moisture exposure.

Choice C rationale:

Unstageable is the most accurate term to describe a decubitus ulcer with thick necrotic tissue because it indicates that the extent of tissue damage cannot be fully assessed.

Thick necrotic tissue obscures the base of the wound and the surrounding tissue, making it impossible to determine the depth of the ulcer or the extent of undermining.

This lack of visibility prevents accurate staging of the ulcer using the traditional pressure ulcer staging system, which categorizes ulcers based on their depth and extent of tissue involvement.

Therefore, unstageable is the most appropriate term to describe a decubitus ulcer with thick necrotic tissue.