A patient presents to the clinic with symptoms of a sore throat, nasal congestion, watery eyes, sneezing, malaise, and a nonproductive cough. The nurse notes that the patient's temperature is normal. Based on this information, which of the following is the most likely diagnosis?
influenza
Strep Throat
Rhinitis
Bacterial pharyngitis
The Correct Answer is C
A. Influenza: Influenza typically presents with a high fever, muscle aches, and fatigue, which are not present in this case.
B. Strep Throat: Strep throat usually presents with a sore throat, high fever, and swollen lymph nodes, not nasal congestion or watery eyes.
C. Rhinitis: Rhinitis, particularly allergic rhinitis, causes symptoms such as sneezing, nasal congestion, watery eyes, and malaise without fever, making it the most likely diagnosis.
D. Bacterial Pharyngitis: Bacterial pharyngitis often presents with a sore throat, fever, and swollen lymph nodes, but typically does not include nasal congestion or watery eyes.
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Correct Answer is C
Explanation
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.
Correct Answer is A
Explanation
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.