Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which of the following observation would prompt you to call the doctor?

Correct Answer: B

Rationale: The correct answer is B because a cold left foot with an absent pedal pulse could indicate compromised blood flow, which is concerning for potential vascular compromise or development of a blood clot post ORIF. This observation warrants immediate medical attention to prevent serious complications such as ischemia or thrombosis. Choices A, C, and D are not as urgent as they do not directly indicate potential vascular compromise or circulatory issues. A partially soiled dressing (Choice A) may require changing but does not indicate immediate danger. Limited functional anatomic position (Choice C) may be addressed with repositioning but does not signal an emergency. Normal blood pressure and pulse rate (Choice D) are within acceptable ranges and do not raise immediate concerns.

Correct Answer: A

Rationale: The correct answer is A: Localized heat and redness. This is because heat and redness are classic signs of inflammation, which can indicate an infection developing in a surgical incision. The increased blood flow to the area causes heat, and the dilation of blood vessels causes redness. Serosanguinous exudates (choice B) and separation of the incision (choice C) are more indicative of normal wound healing or other complications rather than infection. Blood clots and scar tissue (choice D) are not typical signs of impending infection.

Correct Answer: C

Rationale: The correct answer is C: Take a video of the entire intra-operative procedure. This is not part of JCAHO's universal protocol for surgical and invasive procedures. The other choices are correct as they are essential components of the protocol to prevent wrong site, wrong person, and wrong procedure/surgery. A: Marking the operative site helps ensure the correct site is operated on. B: Conducting pre-procedure verification process ensures all necessary steps are taken before the procedure. D: Conducting a 'time out' immediately before starting the procedure allows the surgical team to confirm key details before proceeding.

Correct Answer: C

Rationale: Rationale: Choice C is correct because eating balanced meals at regular intervals helps regulate colostomy function by maintaining consistent digestion and bowel movements. This ensures proper nutrient absorption and prevents complications. Summary of other choices: A: Irrigating after lunch is unnecessary and can disrupt the natural bowel function. B: While fruits and vegetables are important for overall health, they do not specifically regulate colostomy function. D: Restricting exercise to walking only may not be sufficient for promoting regular bowel movements and overall health.

Correct Answer: D

Rationale: The correct answer is D: Semiformed. This indicates proper colostomy function. Green liquid (A) suggests rapid transit time. Solid formed (B) can indicate constipation. Loose, bloody (C) indicates inflammation or infection. Semiformed (D) is the ideal consistency for colostomy drainage, indicating proper digestion and absorption.