A nurse is caring for a group of clients who are 12 hr postoperative. The nurse should identify that the client who had which of the following procedures is at risk for developing fat embolism syndrome?

The client is at highest risk for wound infection as evidenced by the blood glucose level

Rationale

Type 2 diabetes mellitus: The client has poorly controlled diabetes with a preoperative Hemoglobin A1C of 9.5% and elevated glucose levels (280 mg/dL currently). Elevated blood glucose levels impair immune function and increase the risk of surgical site infections, including wound infections.

Postoperative state: After total knee arthroplasty, surgical wounds are vulnerable to infection. Hyperglycemia (high blood glucose levels) further increases susceptibility to infections due to impaired wound healing and compromised immune response.

Evidence: The client's current blood glucose level of 280 mg/dL (normal range 74 to 106 mg/dL) indicates poor glycemic control, which is a significant risk factor for developing wound infections postoperatively.

A A perforated eardrum can lead to conductive hearing loss, where sound waves cannot efficiently travel through the middle ear to the inner ear.

D. Chronic infections of the middle ear (otitis media) can cause damage to the delicate structures of the middle ear, including the ossicles (bones) and the eardrum, leading to conductive hearing loss or, if severe and untreated, sensorineural hearing loss.

E. Loop diuretics such as furosemide can sometimes cause ototoxicity, which means they can damage the inner ear and lead to hearing loss. This is an important consideration for individuals who are prescribed loop diuretics for medical conditions.

B. High birth weight is not typically considered a significant risk factor for hearing loss unless it was associated with other complications that affected the ears during infancy or childhood.

C. Frequent exposure to low-volume noise is not typically associated with an increased risk of hearing loss