Question

Which one of the following clients is at greatest risk for the development of a pulmonary embolus? A. 21-year-old male who has a fractured radius B. 40-year-old female who had a total hysterectomy C. 55-year-old male with type II diabetes mellitus D. 65-year-old female with hyperthyroidism

Short answer

Answer: Client B: the 40-year-old female who had a total hysterectomy.

Step-by-step solution

Client A: 21-year-old male with a fractured radius

A fractured radius is a broken bone in the forearm. Although a broken bone can cause some immobility, it is not a significant risk factor for the development of a pulmonary embolus, especially in a young and otherwise healthy individual.

Client B: 40-year-old female who had a total hysterectomy

A total hysterectomy is a surgical procedure that involves the removal of the uterus. Surgery, particularly involving the pelvis or lower limbs, increases the risk of developing blood clots in the veins, which can lead to a pulmonary embolus. Additionally, this client's age puts her at a higher risk than Client A.

Client C: 55-year-old male with type II diabetes mellitus

Type II diabetes mellitus is a chronic disease that can affect multiple organ systems in the body. People with diabetes are generally at a slightly increased risk for developing blood clots. However, in comparison to the other clients, this risk is not as significant.

Client D: 65-year-old female with hyperthyroidism

Hyperthyroidism is a condition in which the thyroid gland produces too much thyroid hormone, leading to an increased metabolism. It is not a direct risk factor for pulmonary embolism, but age can put this client at a higher risk compared to younger individuals. However, this risk is not as significant as those for Client B, who underwent surgery.

Conclusion

Based on the analysis of each client's condition and risk factors for the development of a pulmonary embolus, the client at the greatest risk is Client B: the 40-year-old female who had a total hysterectomy. Surgery and immobility are significant risk factors for pulmonary embolism, making Client B the most suitable answer.

Key concepts

NCLEX-RN Exam Preparation

Preparing for the NCLEX-RN exam requires a thorough understanding of various medical conditions and their associated risk factors. A common scenario on the exam may involve identifying patients at greater risk for specific complications, such as pulmonary emboli. To tackle these questions, it's essential to study risk factors across a broad range of conditions, including surgical history, immobility, age, chronic diseases, and more.

In relation to the exercise concerning pulmonary embolus risk assessment, test-takers should study not just each condition in isolation but also how these conditions can interact with common postoperative complications. A deep dive into topics like thrombophlebitis, immobility-related risks, and post-surgical monitoring can make these questions more approachable. Preparing for the NCLEX-RN is pivotal to ensure a well-rounded knowledge base and the ability to apply this knowledge in practical, clinical scenarios.

Postoperative Complications

Postoperative complications are a significant concern in the medical field and are often highlighted in NCLEX-RN exam questions. A comprehensive understanding is crucial as it directly impacts patient safety and recovery. Pulmonary embolism, for example, is a potentially life-threatening condition and a serious postoperative risk, particularly after pelvic surgeries like hysterectomies.

Patient education on recognizing symptoms is also an essential aspect of managing postoperative complications. Symptoms may include dyspnea, chest pain, and hemoptysis. Understanding risk factors, such as prolonged immobilization, underlying coagulopathies, and use of estrogen-containing medications, enhances nursing judgement and prevention strategies. Awareness and preventive measures, such as early mobilization, anticoagulant therapy, and the use of compression devices, should be included in postoperative care plans to mitigate risks for patients.

Blood Clot Prevention in Medical Patients

For those in the medical field, preventing blood clots, particularly venous thromboembolism (VTE), is a priority in patient care. This holds true in both exam preparation for nursing students and daily practices in healthcare settings. Patients, especially those with reduced mobility due to surgery or chronic conditions, are at an elevated risk of developing blood clots.

Preventative strategies should include knowledge about anticoagulant medications, the use of intermittent pneumatic compression devices, and patient education on the importance of regular movement and hydration. The implementation of individualized risk assessments upon admission and throughout a patient's hospital stay is essential for conducting timely interventions. Addressing risk factors like obesity, smoking, and history of VTE can further help tailor preventive measures to each patient's need, improving outcomes and reducing the incidence of complications such as a pulmonary embolism.