. A nurse is caring for a client who develops a fat embolism after sustaining multiple fractures in a motor vehicle accident. Which of the following interventions should the nurse implement first?
Initiate intravenous fluid therapy
Prepare the client for emergency surgery
Administer high flow oxygen via a non-rebreather mask
Apply sequential compression devices (SCDs)
The Correct Answer is C
A. Initiate intravenous fluid therapy. While fluid therapy is essential to support circulation and reduce the risk of shock, oxygenation takes priority in fat embolism management.
B. Prepare the client for emergency surgery. Surgery is not typically the first-line intervention for fat embolism; management focuses on supportive care, particularly respiratory support.
C. Administer high-flow oxygen via a non-rebreather mask. High-flow oxygen is the first priority to address hypoxia caused by fat embolism and should be administered immediately to maintain adequate oxygenation.
D. Apply sequential compression devices (SCDs). SCDs are used to prevent venous thromboembolism, but they do not help with the treatment of fat embolism.
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Correct Answer is D
Explanation
A. Irritable bowel syndrome. IBS management typically involves dietary changes, fiber, and stress management, not antibiotics or clear liquids.
B. Chronic diverticulosis. Diverticulosis, when asymptomatic, does not require antibiotics. Treatment focuses on a high-fiber diet to prevent diverticulitis.
C. Complicated diverticulitis with abscess. Complicated diverticulitis may require IV antibiotics, hospitalization, or even surgical intervention if there are abscesses.
D. Uncomplicated diverticulitis. Uncomplicated diverticulitis, without abscess or perforation, is treated with oral antibiotics and a clear liquid diet for bowel rest.
Correct Answer is B
Explanation
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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.