The triage nurse in the emergency department is assessing a client who reports pain and swelling in the right lower leg. The client's pain became much worse last night and appeared along with fever, chills, and sweating. The client states, "I hit my leg on the car door 4 or 5 days ago, and the sore is getting bigger" The client has a history of diabetes mellitus type 2. Which condition should the nurse anticipate for this client?

Venous thromboembolism (VTE)

Cellulitis

Arterial insufficiency

Thrombocytopenia

Answer and Explanation

The Correct Answer is B

A. Venous thromboembolism (VTE) - While VTE can cause leg pain and swelling, the presence of fever, chills, and localized trauma history in this scenario points more toward cellulitis.

B. Cellulitis
The client's symptoms, including pain, swelling, fever, chills, and sweating, are indicative of cellulitis, which is a bacterial skin infection. The history of trauma to the leg (hitting the leg on the car door) could have introduced bacteria into the skin, leading to the infection. The client's diabetes mellitus type 2 also increases the risk of developing skin infections due to impaired immune function and circulation. Cellulitis often presents with localized pain, swelling, warmth, redness, and systemic symptoms like fever and chills. Immediate medical evaluation and appropriate antibiotic treatment are necessary for cellulitis.

C. Arterial insufficiency - Arterial insufficiency typically presents with symptoms like intermittent claudication, rest pain, and non-healing wounds due to poor circulation. The symptoms described in the scenario are more consistent with an acute infection (cellulitis) rather than chronic arterial insufficiency.

D. Thrombocytopenia - Thrombocytopenia is a condition characterized by low platelet count and does not directly cause localized pain, swelling, and redness in the leg as described in the scenario.

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Free Nursing Study Resources

Correct Answer is ["200"]

Explanation

To calculate the rate at which the nurse should program the pump in milliliters per hour, you can use the following formula:

Rate (mL/hour) = Volume (mL) / Time (hours)

In this case, the volume is 1,000 mL (1 liter), and the time is 5 hours. Plugging these values into the formula:

Rate (mL/hour) = 1,000 mL / 5 hours = 200 mL/hour

So, the nurse should program the pump to administer the normal saline at a rate of 200 milliliters per hour.

A. Use Echinacea to manage joint pain. B. Maintain a recommended body weight. C. Apply ice to the joint before exercising. D. Reduce the amount of purine in the diet.

Correct Answer is B

Explanation

A. Use Echinacea to manage joint pain:
Echinacea is a natural supplement, but its effectiveness in managing joint pain related to osteoarthritis is not well-established. It's important for individuals to consult their healthcare provider before using any supplements, as they may interact with medications or have other adverse effects.

B. Maintain a recommended body weight.
Maintaining a healthy body weight is an important recommendation for managing osteoarthritis. Excess weight puts additional stress on weight-bearing joints, such as knees and hips, which can worsen osteoarthritis symptoms. Losing weight, if necessary, or maintaining a healthy weight can help reduce joint pain and improve mobility in individuals with osteoarthritis.

C. Apply ice to the joint before exercising:
Applying ice can help reduce inflammation and provide pain relief, but it's typically used after exercising or during acute flare-ups, not necessarily before exercising. Heat is often recommended before exercise to warm up the joint and improve flexibility.

D. Reduce the amount of purine in the diet:
This recommendation is more relevant for managing gout, a different type of arthritis caused by the buildup of uric acid crystals in the joints. Purine-rich foods can trigger gout attacks but are not directly related to osteoarthritis. Osteoarthritis is primarily related to wear and tear of the joints over time.

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Naxlex Comprehensive Predictor Exams

A nurse is to administer one 1L bag of normal saline to a client over 5 hours. At what rate should the nurse program the pump in milliliters per hour? (Round to the whole number. Assume no interruptions.)

Correct Answer is ["200"]

Explanation

A nurse is teaching a group of clients about osteoarthritis. Which of the following recommendations should the nurse include in the teaching?

Correct Answer is B

Explanation

A client is admitted to the orthopedic unit with a fractured femur after a motorcycle accident. The client has been placed in traction until his femur can be rodded in surgery. For what early complications should the nurse monitor this client? Select all that apply.

The nurse is caring for an 84-year-old female client who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect?

The nurse is caring for a client who is diagnosed with an arterial insufficiency ulcer. The nurse should plan interventions to address which priority issue?

A client has come to the orthopedic clinic for a follow-up appointment 6 weeks after fracturing his ankle. Diagnostic imaging reveals that bone union is not taking place. What factor most likely contributed to this complication?

An 82-year-old diabetic client is being treated in the hospital for a sacral pressure ulcer. What age-related change is most likely to affect the client's course of treatment?

A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedural care?