Which of the following is the priority intervention for preventing a fat embolism in a client experiencing an open femur fracture?

IV antibiotics

Encouraging the patient not to bend at the hip

Early immobilization of the fractured leg

Irrigating the open wound with sterile Normal Saline

Answer and Explanation

The Correct Answer is C

A) IV antibiotics: Administering IV antibiotics is important to prevent infection, particularly in open fractures, but it does not directly address the prevention of fat embolism. Fat embolism syndrome occurs when fat droplets are released into the bloodstream, typically from bone marrow after a fracture, and antibiotics have no role in preventing this specific complication. Antibiotics would be more relevant for preventing infection from the open wound, not for managing fat embolism risk.

B) Encouraging the patient not to bend at the hip: While avoiding unnecessary movement or bending at the hip may help prevent further injury, it does not specifically address the prevention of fat embolism. Fat embolism is primarily a concern due to the fracture itself and the subsequent release of fat from the bone marrow into the bloodstream. Restricting hip movement alone is not a preventive strategy for this condition.

C) Early immobilization of the fractured leg: The most effective intervention for preventing fat embolism is early immobilization of the fractured leg. Immobilization stabilizes the bone, preventing the release of fat droplets from the bone marrow into the bloodstream, which is the primary mechanism behind fat embolism. Early stabilization of the fracture helps minimize this risk, making this the priority action in the immediate care of a client with an open femur fracture.

D) Irrigating the open wound with sterile Normal Saline: While wound irrigation is essential for preventing infection and is part of the standard care for an open fracture, it does not directly prevent fat embolism. The risk of fat embolism arises from the fracture itself, and the priority in this case is stabilization of the bone to prevent the release of fat into circulation. Irrigating the wound helps with infection control, but it is not the most critical step for fat embolism prevention.

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Correct Answer is D

Explanation

A. "You probably have a gastrointestinal infection":
This statement is incorrect. A positive result on the enzyme-linked immunosorbent assay (ELISA) indicates the presence of antibodies to HIV, which suggests exposure to the virus. It does not point to a gastrointestinal infection. HIV is a viral infection that primarily affects the immune system, not the gastrointestinal system. Misleading the client in this way would delay proper care and understanding of their health status.

B. "You are confirmed to be infected with the HIV virus.":
A positive ELISA test result does not automatically confirm an HIV diagnosis. ELISA is a screening test that detects HIV antibodies, but it can sometimes produce false-positive results. A positive ELISA result must be confirmed with a more specific confirmatory test, such as the Western blot test. Therefore, it would be premature to tell the client that they are "confirmed" to be infected with HIV without further confirmatory testing.

C. "This is a good result, which means you do not have HIV.":
This statement is also incorrect. A positive ELISA test result does not mean that the client does not have HIV. In fact, it indicates potential exposure to the virus. However, because the result is a screening test, it must be followed up with confirmatory testing. Telling the client that this is a "good result" would be misleading and could cause confusion or delay in appropriate care.

D. "Your result will need to be confirmed with a Western blot test.":
This is the correct response. The Western blot test is the confirmatory test used to verify a positive result from the ELISA. If the ELISA result is positive, the client should be informed that further testing, such as the Western blot, is needed to confirm the diagnosis of HIV infection. It is important to explain that the ELISA is a screening tool, and a positive result does not mean a definitive diagnosis without confirmation. This helps to set realistic expectations and ensures the client receives the appropriate follow-up care.

A. The medication should be given with 5-6 hours of the onset of stroke systems B. The medication is a primary treatment for haemorrhagic stroke. C. The medication can be given to prevent clot formation in the context of head trauma D. When given within a certain timeframe, the medication may dissolve an ischemic stroke

Correct Answer is D

Explanation

A) "The medication should be given with 5-6 hours of the onset of stroke symptoms":
. tPA (tissue plasminogen activator) is typically given for an ischemic stroke, and it is most effective when administered within 3 to 4.5 hours of the onset of stroke symptoms. After this time frame, the risk of bleeding complications increases, and the benefits of the medication diminish significantly. Giving tPA after 6 hours is generally considered outside the therapeutic window for ischemic stroke, though some centers may extend the window based on specific criteria.

B) "The medication is a primary treatment for hemorrhagic stroke":
. tPA is contraindicated in hemorrhagic stroke because it works by dissolving clots, which could worsen bleeding in the brain. Hemorrhagic stroke occurs when there is bleeding in the brain, and administering tPA would exacerbate the bleeding, leading to more severe brain injury and complications. The primary treatment for hemorrhagic stroke is controlling bleeding, often through surgical interventions or managing blood pressure.

C) "The medication can be given to prevent clot formation in the context of head trauma":
. tPA is not used to prevent clot formation, particularly in the setting of head trauma. It is used to dissolve existing clots in cases of ischemic stroke. Administering tPA after head trauma or brain injury could lead to catastrophic complications, such as worsening bleeding, and should be avoided. The use of tPA is contraindicated in trauma-related situations unless the stroke is clearly ischemic and there are no signs of hemorrhage.

D) "When given within a certain timeframe, the medication may dissolve an ischemic stroke":
. tPA is the standard treatment for ischemic strokes (caused by a clot blocking blood flow to the brain). When administered within 3 to 4.5 hours of the onset of symptoms, tPA can dissolve the clot, improving blood flow to the affected area of the brain and potentially minimizing the damage caused by the stroke. Timely administration is critical for maximizing its benefits in reducing disability and improving outcomes.

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Which of the following is the priority intervention for preventing a fat embolism in a client experiencing an open femur fracture?

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Naxlex Comprehensive Predictor Exams

A client is tested for human immunodeficiency virus (HIV) infection with an enzyme- linked immunosorbent assay (ELISA), and the test result & positive. What would the nurse tell the client?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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