After being hospitalized for 3 days with a right femur fracture, ...

[leilurhhh]

After being hospitalized for 3 days with a right femur fracture, a 32-year-old patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, I feel like I am going to die Which action should the nurse take first?
 
  a. Stay with the patient and offer reassurance.
  b. Administer the prescribed PRN oxygen at 4 L/min.
  c. Check the patient's legs for swelling or tenderness.
  d. Notify the health care provider about the symptoms.

Question 2

A patient is being discharged 4 days after hip replacement surgery using the posterior approach. Which patient action requires immediate intervention by the nurse?
 
  a. The patient uses crutches with a swing-to gait.
  b. The patient leans over to pull shoes and socks on.
  c. The patient sits straight up on the edge of the bed.
  d. The patient bends over the sink while brushing teeth.

[Moriaki]

Answer to Question 1

ANS: B
The patient's clinical manifestations and history are consistent with a pulmonary embolus, and the nurse's first action should be to ensure adequate oxygenation. The nurse should offer reassurance to the patient, but meeting the physiologic need for oxygen is a higher priority. The health care provider should be notified after the oxygen is started and pulse oximetry and assessment for fat embolus or venous thromboembolism (VTE) are obtained.

Answer to Question 2

ANS: B
Leaning over would flex the hip at greater than 90 degrees and predispose the patient to hip dislocation. The other patient actions are appropriate and do not require any immediate action by the nurse to protect the patient.