A client is diagnosed with osteomyelitis. Which clinical manifestation would the nurse expect to assess?
Frequent urination
Increased range of motion
Localized bone pain and tenderness
Hyperpigmentation of the skin
The Correct Answer is C
A. Frequent urination: Frequent urination is not associated with osteomyelitis, a bone infection.
B. Increased range of motion: Osteomyelitis typically causes pain and restricted movement, not increased range of motion.
C. Localized bone pain and tenderness: Osteomyelitis commonly presents with localized bone pain, tenderness, and possibly swelling due to infection.
D. Hyperpigmentation of the skin: Hyperpigmentation is not a typical sign of osteomyelitis.
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Correct Answer is B
Explanation
A. Interferon Gamma Release Assays (IGRAs): IGRAs are useful for detecting TB infection but do not confirm active TB disease. They measure the immune response to TB bacteria but don’t differentiate between latent and active infection.
B. Sputum culture: Sputum culture is the gold standard for confirming active TB because it identifies Mycobacterium tuberculosis bacteria directly, confirming active infection.
C. Tuberculin Skin Test (TST): The TST can indicate TB infection but cannot distinguish between latent and active TB, making it unsuitable as a confirmatory test for active disease.
D. Chest X-ray: A chest X-ray can show signs suggestive of TB but cannot confirm the presence of TB bacteria, so it is not definitive for diagnosing active TB.
Correct Answer is D
Explanation
A. Warfarin. Warfarin (Coumadin) is an anticoagulant used to prevent blood clots, but it typically requires several days to achieve a therapeutic effect and needs close monitoring of INR (International Normalized Ratio) levels. While it can be used for long-term prevention of DVT, it's not the immediate choice for post-operative prophylaxis.
B. Alteplase (tPA). Alteplase is a thrombolytic agent, used to break down existing clots, not prevent their formation. It is typically used in emergency situations, such as for treating ischemic stroke.
C. Clopidogrel. Clopidogrel is an antiplatelet agent, often used to prevent arterial clots, not DVTs. It is more commonly used in conditions like stroke and heart disease.
D. Enoxaparin. Enoxaparin, a low molecular weight heparin, is commonly used to prevent DVT after surgery by inhibiting specific clotting factors. It’s frequently prescribed for DVT prevention in orthopedic surgery patients.