In assessing a client's nailbeds, the nurse notes that the angle between the nail and the nailbed is 200 degrees. Which action should the nurse take?

A. The presence of crepitus, regardless of size, indicates air trapped in the subcutaneous tissue, which can be associated with various conditions including trauma, infection, or underlying lung issues. Therefore, it is important to evaluate the finding further rather than assuming it is insignificant.
B. This is the most accurate interpretation. Crepitus is indeed an abnormal finding and warrants further investigation. Its presence can indicate underlying issues such as subcutaneous emphysema, which may be related to trauma, infections, or other conditions that need to be addressed. A more detailed assessment, including possible imaging or additional diagnostic tests, should be pursued to determine the cause and appropriate management.
C. While it is true that subcutaneous air can be absorbed over time, the presence of crepitus is still an abnormal finding that needs to be evaluated. The underlying cause of the trapped air must be identified, as it may indicate an injury or other health issues that require intervention. Simply assuming that it will resolve on its own without further investigation could overlook a potentially serious condition.
D. While a fractured rib can cause crepitus, this finding alone does not necessarily mean an immediate chest x-ray is required. The decision to order an x-ray should be based on a comprehensive assessment of the client’s symptoms, history, and physical examination findings. Although a rib fracture is a possible cause, other conditions such as subcutaneous emphysema or infections should also be considered.

A. Nailbed clubbing is characterized by an increased angle between the nail and the nailbed, typically greater than 180 degrees. An angle of 200 degrees is consistent with clubbing, which can be a sign of chronic respiratory or cardiovascular conditions, such as chronic lung diseases, congenital heart defects, or other systemic conditions.
B. Consulting with a podiatrist to trim toenails is important for foot care but is not directly related to the finding of nailbed clubbing. The angle of the nailbed is more indicative of a systemic issue rather than a local foot care problem. Therefore, this action does not address the underlying concern suggested by the angle of 200 degrees.
C. While anemia or other blood conditions can affect the nails, the specific finding of a nailbed angle of 200 degrees is more indicative of clubbing rather than issues typically associated with hemoglobin levels. Therefore, while monitoring hemoglobin is important for overall health, it is not the immediate priority in response to the finding of nailbed clubbing.
D. Administering oxygen might be necessary if the client is experiencing symptoms of hypoxia or has a condition affecting oxygenation. However, the finding of nailbed clubbing itself does not immediately necessitate oxygen therapy. Oxygen administration should be based on specific symptoms or clinical indications of hypoxia rather than the nailbed angle alone.