A trauma nurse cares for several clients with fractures. Which ...

[rmenurse]

A trauma nurse cares for several clients with fractures. Which client should the nurse identify as at highest risk for developing deep vein thrombosis?
 
  a. An 18-year-old male athlete with a fractured clavicle
  b. A 36-year old female with type 2 diabetes and fractured ribs
  c. A 55-year-old woman prescribed aspirin for rheumatoid arthritis
  d. A 74-year-old man who smokes and has a fractured pelvis

Question 2

A nurse assesses an older adult client who was admitted 2 days ago with a fractured hip. The nurse notes that the client is confused and restless. The client's vital signs are heart rate 98 beats/min, respiratory rate 32 breaths/min, blood pressure 132/78
 
  mm Hg, and SpO2 88. Which action should the nurse take first?
 
  a.
  Administer oxygen via nasal cannula.
  b.
  Re-position to a high-Fowler's position.
  c.
  Increase the intravenous flow rate.
  d.
  Assess response to pain medications.

[guyanai]

Answer to Question 1

ANS: D
Deep vein thrombosis (DVT) as a complication with bone fractures occurs more often when fractures are sustained in the lower extremities and the client has additional risk factors for thrombus formation. Other risk factors include obesity, smoking, oral contraceptives, previous thrombus events, advanced age, venous stasis, and heart disease. The other clients do not have risk factors for DVT.

Answer to Question 2

ANS: A
The client is at high risk for a fat embolism and has some of the clinical manifestations of altered mental status and dyspnea. Although this is a life-threatening emergency, the nurse should take the time to administer oxygen first and then notify the health care provider. Oxygen administration can reduce the risk for cerebral damage from hypoxia. The nurse would not restrain a client who is confused without further assessment and orders. Sitting the client in a high-Fowler's position will not decrease hypoxia related to a fat embolism. The IV rate is not related. Pain medication most likely would not cause the client to be restless.

[rmenurse]

Thank you

[guyanai]

Happy to help you