The nurse is caring for a client with a fracture of the right humerus. Which assessment finding could be an early sign of a fat embolus?

Choice A reason: Client with difficulty swallowing food and fluids who requires assistance with feeding is not an appropriate assignment for UAP. This client is at risk of aspiration and needs close monitoring and intervention by a licensed nurse.

Choice B reason: Client requiring a colostomy irrigation is not an appropriate assignment for UAP. This is a sterile procedure that involves inserting a catheter into the stoma and instilling fluid to flush out the bowel. This requires advanced skills and knowledge that are beyond the scope of practice of UAP.

Choice C reason: Client requiring vital signs immediately following open heart surgery is not an appropriate assignment for UAP. This client is in a critical condition and needs frequent and accurate assessment and evaluation by a licensed nurse.

Choice D reason: Client requiring a urine specimen collection is the most appropriate assignment for UAP. This is a routine and non-invasive task that can be delegated to UAP under the supervision of a licensed nurse.

Choice A reason: Providing cast care to bilateral lower extremities is not an action that would be included in the nurse's plan of care for a client in skeletal traction, as it is not relevant to the type of traction. Skeletal traction involves the insertion of pins, wires, or screws into the bone, and does not require a cast. Cast care is more applicable to clients in plaster or fiberglass casts.

Choice B reason: Instituting measures to prevent skin breakdown is an action that would be included in the nurse's plan of care for a client in skeletal traction, as it is a potential complication of prolonged immobilization and pressure. The nurse should inspect the skin regularly, change the bed linens frequently, use pressure-relieving devices, and encourage the client to shift positions as much as possible.

Choice C reason: Cleaning the pins every hour with peroxide to prevent infection is not an action that would be included in the nurse's plan of care for a client in skeletal traction, as it is excessive and harmful. The nurse should follow the facility's protocol for pin site care, which usually involves cleaning the pins once or twice a day with a mild antiseptic solution, such as chlorhexidine or saline. Peroxide is not recommended, as it can damage the tissue and delay the healing.

Choice D reason: Placing the client on contact precautions is not an action that would be included in the nurse's plan of care for a client in skeletal traction, as it is not indicated for this type of traction. Contact precautions are used for clients who have infections that can be transmitted by direct or indirect contact, such as MRSA, VRE, or C. difficile. Skeletal traction does not pose a high risk of infection, unless there is a pin site infection or osteomyelitis.

Choice E reason: Maintaining proper alignment and position of the traction is an action that would be included in the nurse's plan of care for a client in skeletal traction, as it is essential for the effectiveness and safety of the traction. The nurse should ensure that the traction is applied correctly, that the weights are hanging freely, that the ropes are not twisted or frayed, and that the pulleys are not obstructed. The nurse should also avoid lifting or moving the weights, as it can alter the traction force and cause complications.