RN Nursing · Total Joint Replacement · Practice question
A nurse is admitting four clients who are to undergo total joint arthroplasty. Which of the following clients should the nurse identify as having the greatest risk of complications?
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A client who has an abscessed tooth
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A client who has diabetes mellitus and a fasting blood glucose level of 107 mg/dL (74 to 106 mg/dL)
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A client who has controlled hypertension
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A client who has urinary stress incontinence
Answer & explanation
Correct: A client who has an abscessed tooth
An abscessed tooth represents an active source of infection and bacteria. Joint prostheses are at high risk for hematogenous seeding; bacteremia from dental abscesses can seed the prosthesis and cause periprosthetic joint infection, a devastating complication. Surgery should be postponed until the infection is resolved. Mildly elevated fasting blood glucose (107 mg/dL) is only slightly above normal and poses less immediate risk. Controlled hypertension and stress incontinence are manageable perioperative concerns but do not carry the same level of acute infective risk as an active dental abscess.
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