Patient Data

Exhibits

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According to the laboratory values, the client has

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; related to

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, or

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.

A. Excessive aerobic exercise: Moderate aerobic exercise is generally protective for cardiovascular health. The client’s symptoms occurred during normal activity, and there is no indication that his exercise is excessive or harmful, so this is less of a concern.

B. Vegetarian diet: A vegetarian diet is usually associated with lower cardiovascular risk due to reduced saturated fat intake and higher consumption of fiber and antioxidants. This is unlikely to be a contributing risk factor in this client.

C. Family health history: Both parents had heart disease, and the father had diabetes, placing the client at increased genetic risk for cardiovascular disease. Exploring family history further helps identify inherited risk factors and guides preventive strategies.

D. History of hypertension: Although the client’s current blood pressure is controlled with atenolol, hypertension is a known cardiovascular risk factor. Assessing the duration and management of prior hypertension is important to evaluate cumulative risk.

E. Sexual history: While sexual history may be relevant in some cardiovascular assessments (e.g., erectile dysfunction as a marker), it is not a primary risk factor for heart disease in this context and does not require immediate exploration.

Rationale for correct choices:

• Pain: The client reports a pain level of 10/10 in the left arm, described as sharp and constant. Pain at this severity requires urgent management because uncontrolled pain can impair mobility. Immediate intervention for pain ensures comfort and supports further diagnostic and therapeutic procedures.

• Compartment syndrome: Findings of swelling, decreased sensation, coolness of the skin, and diminished left radial pulse suggest compromised circulation. These are classic warning signs of compartment syndrome, a limb-threatening complication caused by increased pressure within a muscle compartment.

Rationale for incorrect choices:

• Mobility: While the client’s long-term recovery will require mobility interventions, it is not the immediate priority in the acute emergency setting. Pain and neurovascular compromise take precedence over mobility at this stage because they directly affect safety and circulation.

• Swelling: Swelling is a significant concern, but it is a symptom rather than the priority need. Addressing pain and preventing complications such as compartment syndrome will indirectly reduce swelling by improving circulation and managing tissue injury.

• Venous thromboembolism: The client’s high BMI and reduced mobility put him at risk for VTE, but this is a longer-term complication. It does not outweigh the immediate need to manage severe pain and monitor for compartment syndrome, which can cause rapid tissue necrosis.

• Fat embolism syndrome: Fat embolism is a possible complication of long bone fractures, but there is no evidence here of a femoral fracture or respiratory distress. Although his weight and orthopedic history are risk factors, the current findings point more strongly toward compartment syndrome.