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) "Increased viral load":
An increased viral load would indicate that the HIV virus is actively replicating in the body. This suggests that the antiretroviral therapy (ART) is not effective, as it has failed to suppress the viral replication. The goal of ART is to lower the viral load to undetectable levels, indicating that the virus is well controlled.

B) "Decreased neutrophil count":
. A decreased neutrophil count (neutropenia) is not directly related to the effectiveness of ART in managing HIV. Neutropenia can occur due to various causes, such as certain medications (including some ART medications), infections, or other underlying conditions. While neutropenia could be a side effect of ART, it does not directly reflect the effectiveness of HIV treatment. Monitoring CD4-T-cell counts and viral load is a better indicator of ART effectiveness.

C) "Decreased white blood cell count":
. A decreased white blood cell count (leukopenia) is also not an indicator of ART effectiveness. While some ART medications may lead to a decrease in white blood cell count, especially in the early stages of treatment, a decrease in the white blood cell count is not a measure of how well the therapy is controlling HIV. The effectiveness of ART is primarily assessed by the viral load and CD4-T-cell count.

D) "Increased CD4-T-cell count":
. CD4-T-cell count is a critical marker for monitoring the immune system's function in patients with HIV. CD4-T-cells are a type of T lymphocyte (white blood cell) that are targeted and destroyed by the HIV virus. A higher CD4-T-cell count indicates that the immune system is recovering and functioning better, which is a sign that the ART is effective in controlling the virus. Ideally, ART should result in a higher CD4-T-cell count and lower viral load, showing that the treatment is effectively suppressing the virus and preserving the immune system.

A. "Following up with your dentist frequently will be important. B. Take an ant acid with the medication if indigestion occurs. C. *Alcoholic beverages should be limited to 1-2 per day while taking phenytoin.* D. "Phenytoin may turn your urine orange

Correct Answer is A

Explanation

A. "Following up with your dentist frequently will be important.":
This is the correct and important advice to give. Phenytoin (Dilantin), an anticonvulsant, can cause gum overgrowth (gingival hyperplasia), which makes it important for the patient to have regular dental check-ups. Poor oral hygiene combined with gingival hyperplasia can increase the risk of infection and other oral health issues. Therefore, advising the patient to follow up frequently with a dentist is essential to manage this side effect.

B. "Take an antacid with the medication if indigestion occurs.":
advice. Taking an antacid with phenytoin can interfere with its absorption. Antacids, especially those containing aluminum or magnesium, can reduce the effectiveness of phenytoin, leading to suboptimal therapeutic levels. It’s important to separate phenytoin from antacids by at least 2 hours to avoid this interaction. Therefore, antacids should not be used with phenytoin to manage indigestion.

C. "Alcoholic beverages should be limited to 1-2 per day while taking phenytoin.":
This is inaccurate advice. Alcohol can significantly affect the metabolism of phenytoin, increasing the risk of both toxicity and reduced effectiveness. Alcohol may lower the seizure threshold and interfere with the therapeutic effect of phenytoin, especially in higher amounts. Therefore, it is generally recommended that patients taking phenytoin avoid alcohol altogether, or at the very least limit consumption significantly and discuss it with their healthcare provider.

D. "Phenytoin may turn your urine orange.":
information. Phenytoin does not cause urine to turn orange. Urine discoloration can occur with some medications (like rifampin, for example), but not with phenytoin. This statement could cause unnecessary confusion for the patient. It is essential to provide accurate information to avoid misconceptions about medication side effects.

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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

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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