A patient with an open fracture of the left femur that punctured ...

[SO00]

A patient with an open fracture of the left femur that punctured the skin waited 2 hours before getting to the hospital. What would be the priority problem to address when caring for this patient?
 
  1. insufficient nutrition
  2. high potential for infection
  3. low body temperature
  4. fear and anxiety

Question 2

The nurse suspects that a patient is experiencing fat embolism syndrome (FES). Which assessment data support the nurse's clinical decision?
 
  Select all that apply.
  1. pulse oximetry 88
  2. petechiae observed on the chest and upper arms
  3. complaints of shortness of breath
  4. respiratory rate 32
  5. skin warm and dry

[Mollythedog]

Answer to Question 1

Correct Answer: 2

The open bone fracture has been exposed to contaminants. The delay in treatment prolongs the patient's exposure to bacteria. This patient is at risk for infection that can delay healing and possibly result in osteomyelitis and ultimately a loss of the limb. There is no indication that the patient is malnourished or has a low body temperature. The patient might be fearful and anxious, but this is not a priority at this time.

Answer to Question 2

Correct Answer: 1, 2, 3, 4

Pulmonary circulation may be disrupted, and free fatty acids damage the alveolar-capillary membrane. Pulmonary edema, impaired surfactant production, and atelectasis can result in significant respiratory distress syndrome. Petechiae may result from microvascular clotting or the accompanying thrombocytopenia. Respiratory manifestations of dyspnea and tachypnea are often the first indicators of FES. Warm, dry skin is a normal finding.