A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the following findings should cause the nurse to suspect a skull fracture?

Clear fluid drainage from the nares

Report of pain around the eyes

Dried blood in the mouth

Mandibular asymmetry

Answer and Explanation

The Correct Answer is A

A. Clear fluid drainage from the nares, especially if it is continuous or persistent, may indicate a cerebrospinal fluid (CSF) leak, which can occur with a skull fracture.

B. Pain around the eyes is more commonly associated with a nasal fracture or orbital fracture, rather than a skull fracture.

C. Dried blood in the mouth may indicate nasal bleeding but does not necessarily indicate a skull fracture.

D. Mandibular asymmetry may indicate a jaw fracture or injury but is not typically associated with a skull fracture.

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Correct Answer is B

Explanation

A. Constipation can occur as a side effect of TPN due to decreased bowel motility, but it is not typically considered a serious complication.

B. Respiratory depression can occur as a complication of TPN, particularly if the solution contains high concentrations of dextrose or if the client has underlying respiratory issues.

C. Hypotension can occur as a complication of TPN if the solution is administered too rapidly, leading to fluid overload, but it is less common than respiratory depression.

D. Electrolyte imbalance, particularly hyperglycemia and hypertriglyceridemia, is a common complication of TPN, but it is less likely to cause immediate respiratory depression compared to other complications such as fluid overload.

A. Monitoring the insertion site for infection B. Checking for orthostatic hypotension C. Forcing fluids D. Immobilizing the affected extremity E. None F. None

Correct Answer is D

Explanation

A. Monitoring the insertion site for infection:
Monitoring for infection is important in the long-term care of a client following cardiac catheterization, but it is not the immediate priority. Infection typically develops over time, not in the immediate postprocedure period.

B. Checking for orthostatic hypotension:
Orthostatic hypotension is not typically associated with cardiac catheterization. Instead, hypotension following the procedure would likely result from bleeding or hypovolemia. Monitoring for vital sign changes is important but not specific to orthostatic hypotension in this context.

C. Forcing fluids:
Encouraging fluids is necessary after cardiac catheterization to help flush out contrast dye and prevent nephropathy. However, this action is not the immediate priority compared to managing the risk of bleeding and maintaining hemostasis at the insertion site.

D. Immobilizing the affected extremity:
Immobilizing the extremity used for catheter insertion (usually the femoral artery) is the immediate priority. This action prevents complications such as bleeding, hematoma formation, or disruption of the arterial puncture site. Maintaining hemostasis and ensuring the integrity of the insertion site are critical during the immediate postprocedure period.

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A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the following findings should cause the nurse to suspect a skull fracture?

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