What findings on assessment would indicate to the nurse that a client has developed osteomyelitis 10 weeks after a right shoulder arthroplasty? (Select All that Apply.)

Bradycardia

Chills

Elevated temperature of 102 degrees F.

Difficulty breathing.

Client complaining of increasing pain in shoulder with movement.

Answer and Explanation

Correct Answer : B,C,E

A.   Bradycardia (a slow heart rate) is not a typical sign of osteomyelitis. Instead, infections often cause tachycardia (increased heart rate) due to the body's response to fever and inflammation. Therefore, this finding would not indicate osteomyelitis.
B.   Chills can be a sign of infection, including osteomyelitis. They often occur as a result of the body trying to regulate temperature in response to fever. The presence of chills would raise suspicion of an underlying infection.
C.   An elevated temperature, particularly above normal (typically defined as over 100.4 degrees F), is a classic sign of infection. A temperature of 102 degrees F suggests that the body is fighting an infection, which could indicate osteomyelitis.
D.   Difficulty breathing is not a direct symptom of osteomyelitis and may indicate other conditions such as respiratory issues or complications unrelated to the shoulder infection. Therefore, this finding is not typically associated with osteomyelitis.
E.   Increased pain in the affected area, especially with movement, can indicate inflammation or infection. In the case of osteomyelitis, localized pain at the site of infection is a common symptom.

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Correct Answer is C

Explanation

A. This level indicates average blood glucose over the past 2-3 months and is higher than the target range (usually under 7% for many patients with diabetes). While this result suggests the need for adjustments in management, it is not an immediate emergency.
B. A random plasma glucose level of 205 mg/dL indicates hyperglycemia, but it is not typically considered an immediate danger unless accompanied by symptoms of hyperglycemia. This level would warrant further monitoring and possibly an adjustment in treatment, but it doesn't require urgent intervention.
C. A blood glucose level of 45 mg/dL indicates hypoglycemia, which is a critical condition that requires immediate action. Hypoglycemia can lead to symptoms such as confusion, seizures, or loss of consciousness, and it must be addressed quickly, usually with fast-acting carbohydrates.
D. While a fasting blood glucose level of 300 mg/dL indicates significant hyperglycemia, it does not require immediate action like hypoglycemia does. This level indicates a need for further management but is not acutely dangerous compared to a severely low blood glucose level.

A. Fever of more than 104°F and anorexia B. Headache and photophobia C. Fatigue. night sweats, and hemoptysis D. Chest and lower back pain

Correct Answer is C

Explanation

A. While fever and anorexia can occur with active TB, a fever of more than 104°F is uncommon. Typically, TB may cause a low-grade fever rather than such a high temperature. Anorexia is also present, but this option does not fully capture the classic symptoms of active TB.
B. These symptoms are not typical of tuberculosis. Headaches and photophobia are more associated with conditions affecting the central nervous system, such as meningitis or migraines. They do not specifically relate to active TB.
C. These symptoms are classic indicators of active tuberculosis. Fatigue and night sweats are common, and hemoptysis (coughing up blood) is a serious symptom that can occur in pulmonary TB. This combination of symptoms is a hallmark of the disease and would prompt further investigation.
D. While chest pain can occur due to lung involvement in TB, lower back pain is not a typical symptom of pulmonary TB. Chest pain might be experienced, but it is not as definitive as the other symptoms associated with active TB.

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What findings on assessment would indicate to the nurse that a client has developed osteomyelitis 10 weeks after a right shoulder arthroplasty? (Select All that Apply.)

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