A patient with facial and chest injuries from a motor vehicle ...

[jman1234]

A patient with facial and chest injuries from a motor vehicle accident has rhonchi in the upper airways. For which problem should the nurse plan care?
 
  1. inability to clear the airway
  2. problem with swallowing
  3. changes in oral mucous membrane integrity
  4. potential for additional injury

Question 2

The nurse is caring for a patient with a long leg cast. What should the nurse include when assessing this patient for indications of compromised circulation?
 
  Select all that apply.
  1. swelling of the toes
  2. drainage on the cast
  3. increased temperature
  4. foul odor
  5. a tight cast

[lin77x]

Answer to Question 1

Correct Answer: 1

The patient has facial fractures with subsequent edema that will compromise the airway. The airway must be maintained by helping the patient clear secretions from the oropharynx. There is no evidence of changes in oral mucous membrane integrity or a risk for additional injuries. Although problems swallowing may be a possibility, they are not a priority at this time.

Answer to Question 2

Correct Answer: 1, 5

Constriction of circulation reduces venous return and increases pressure within the vessels. Fluid then shifts into the interstitial space, causing edema. Edema can cause the cast to become tight. A tight-fitting cast can lead to compartment syndrome. Foul odor, drainage, and increased temperature would indicate potential infection.

[jman1234]

Excellent

[nguyenhoanhat]

TYSM