A nurse in an emergency department is caring for a 60-year-old client.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

1. Condition: Acute Compartment Syndrome

Justification: The presence of severe pain, swelling, numbness, and a weak radial pulse along with delayed capillary refill are classic signs of acute compartment syndrome. Immediate surgical intervention (fasciotomy) is necessary to relieve the pressure within the muscle compartments.

2. Actions to Take

Prepare for Fasciotomy:

Justification: This surgical procedure will relieve the internal pressure causing the symptoms.

Request Prescription for Pain Medication:

Justification: Adequate pain management is important for client comfort and can also indicate response to treatment.

3. Parameters to Monitor

Neurovascular Status:

Justification: Monitoring for further deterioration of symptoms such as worsening numbness or weak pulses is essential.

WBC Count:

Justification: Helps in the broader assessment of possible infection, though not directly related to acute compartment syndrome

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Correct Answer is C

Explanation

A. Hyperglycemia typically presents with symptoms such as polyuria, polydipsia, and blurred vision, rather than these symptoms.

B. Neuropathy involves symptoms like numbness and tingling, not headache, restlessness, fatigue, and hunger.

C. Hypoglycemia presents with symptoms including headache, restlessness, fatigue, and hunger.

D. Hypokalemia presents with symptoms like muscle weakness and cramping, not the symptoms described.

A. pH 7.25, HCO₃- 19 mEq/L, PaCO₂ 30 mm Hg B. pH 7.30, HCO₃- 26 mEq/L, PaCO₂ 50 mm Hg C. pH 7.50, HCO₃- 20 mEq/L, PaCO₂ 32 mm Hg D. pH 7.55, HCO₃- 30 mEq/L, PaCO₂ 31 mm Hg

Correct Answer is A

Explanation

A. pH 7.25, HCO₃- 19 mEq/L, PaCO₂ 30 mm Hg indicates metabolic acidosis with partial respiratory compensation. This is a common finding in chronic kidney disease due to the kidneys' reduced ability to excrete hydrogen ions and reabsorb bicarbonate.

B. pH 7.30, HCO₃- 26 mEq/L, PaCO₂ 50 mm Hg suggests respiratory acidosis with a normal bicarbonate level, which is not typical for chronic kidney disease.

C. pH 7.50, HCO₃- 20 mEq/L, PaCO₂ 32 mm Hg indicates respiratory alkalosis, which is not characteristic of chronic kidney disease.

D. pH 7.55, HCO₃- 30 mEq/L, PaCO₂ 31 mm Hg indicates metabolic alkalosis, which is also not typical for chronic kidney disease.

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Correct Answer is C

Explanation

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Correct Answer is A

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