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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Correct Answer is A

Explanation

A. Stretching exercises:

Stretching exercises involve gently elongating muscles and tendons, promoting flexibility and range of motion. For individuals with osteoporosis, stretching exercises can improve balance and reduce the risk of falls, which is crucial as osteoporosis weakens bones and makes individuals more prone to fractures.
B. Riding a bicycle:

Bicycling is a low-impact cardiovascular exercise that is easy on the joints. It can help improve cardiovascular health, but it might not specifically address the balance and flexibility issues often associated with osteoporosis. However, it's a good option for overall fitness and joint health.
C. Walking briskly:

Brisk walking is an excellent low-impact aerobic exercise. It improves cardiovascular health, strengthens muscles, and aids in weight management. Walking can be adapted to various fitness levels, making it a suitable exercise for many older adults. While it doesn't specifically focus on flexibility, it promotes overall health and well-being.
D. High-impact aerobics:

High-impact aerobics involve activities like jumping, running, or intense dancing. These exercises can stress the bones and joints, potentially leading to injuries, especially for individuals with osteoporosis. High-impact exercises are generally discouraged for people with osteoporosis due to the increased risk of fractures.

A. Applying ice intermittently B. Elevating the injured limb C. Resting the affected extremity D. Massaging the affected limb E. Compression dressings

Correct Answer is ["A","B","C","E"]

Explanation

A. Applying ice intermittently - Ice application helps reduce swelling and inflammation by constricting blood vessels. It is effective in managing pain and preventing further tissue damage in contusions, strains, and sprains.

B. Elevating the injured limb - Elevating the injured limb above the level of the heart helps reduce swelling by allowing fluids to drain away from the injured area. This is particularly important in managing contusions, strains, and sprains where swelling is a common symptom. Elevation supports the body's natural healing processes.

C. Resting the affected extremity - Rest is essential to allow the injured tissue to heal. Avoiding movement and stress on the affected area prevents further damage and promotes the healing process. Resting the extremity prevents additional strain on the injured muscles, ligaments, or tendons, allowing the body to repair the damaged tissues effectively.

D. Massaging the affected limb - Massaging the affected limb is generally not recommended in the acute phase of musculoskeletal injuries, especially contusions, strains, or sprains. Massaging can potentially worsen the injury, increase swelling, and cause further tissue damage. It is important to wait until the initial acute phase has passed and consult a healthcare professional before considering massage therapy.

E. Compression dressings - Compression helps control swelling by applying pressure to the injured area. Compression dressings or bandages provide support to the injured limb, minimize swelling, and reduce the risk of further injury. However, it's essential to apply compression correctly to avoid cutting off circulation, and it's usually best done under the guidance of a healthcare provider.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?

Correct Answer is A

Explanation

A nurse in a busy emergency department provides care for many clients who present with contusions, strains, or sprains. What are treatment modalities that are common to all of these musculoskeletal injuries? Select all that apply.

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is talking with a young adult client who has a family history of osteoporosis, Which health promotion activity should the nurse recommend as a possible preventive measure?

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The nurse is assessing a client admitted with renal stones. During the admission assessment, what is the priority questions to ask?

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