A nurse is reinforcing discharge teaching to a client following arthroscopic (joint) surgery.
To prevent postoperative complications which of the following actions should be reinforced during the teaching of Continuous passive motion (CPM)?

The correct answer is choice A: Fat embolism syndrome.

Choice A rationale:

The client with an open fracture to the right femur is at risk for developing Fat Embolism Syndrome (FES) FES occurs when fat globules from the bone marrow or other tissues enter the bloodstream, leading to systemic complications. In this case, with an open fracture, there is a higher risk of fat emboli entering the circulation. The clinical manifestations of FES include respiratory distress, altered mental status, and petechial rash. These symptoms typically occur within 24-72 hours after the injury, which aligns with the timeline mentioned in the progress report on Day 1 of admission.

Choice B rationale:

Osteomyelitis is less likely to develop within the first 24 hours following a motor vehicle crash. It is an infection of the bone and typically takes more time to manifest. The early concerns in an open fracture involve the risk of infection, but osteomyelitis is not an immediate threat in this scenario.

Choice C rationale:

Compartment syndrome is a potential concern in orthopedic injuries, but it primarily arises due to increased pressure within a muscle compartment, causing reduced blood flow. While it is a valid concern, it is not typically associated with fat embolism syndrome, which is more specific to the release of fat globules into the bloodstream.

Choice D rationale:

Deep vein thrombosis (DVT) is a concern in immobile patients or those with significant trauma, but it is not the most immediate concern in this case. DVT usually develops over time and is more associated with prolonged immobilization rather than the early stages of admission.

The correct answer is d. Wipe any excess medication from the inner canthus outward.

Choice A reason: Gently massaging the eyelid is not recommended because it does not facilitate the absorption of ophthalmic ointment and may cause additional irritation or spread the infection.

Choice B reason: The instruction is incorrect because the child has been prescribed bacitracin, not erythromycin. It’s important to follow the prescribed medication and dosage instructions.

Choice C reason: Placing an occlusive dressing over the eye is not advised for bacterial conjunctivitis as it can create a moist environment that may promote bacterial growth.

Choice D reason: This is the correct action. After applying the ointment, wiping away excess from the inner canthus outward prevents the spread of infection and keeps the area clean. This method prevents potential irritation and ensures that the medication does not obstruct vision.