PN Compound Fracture (Preschooler)

For which problem(s) should Candy's parents be instructed to contact the healthcare provider? (Select all that apply.)

C. An unusual odor is coming from the cast. E. Warm spots are felt on the cast.

What action should the PN take?

C. Give Candy a few crackers and stay with her while she eats them.

Which change in serum lab values would the PN need to report, most likely indicate the onset of osteomyelitis?

C. Increased erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count.

Which nursing action has the highest priority?

C. Observe the appearance of Candy's foot.

How should the PN respond to this situation?

C. Support the mother's decision to hold Candy accountable for her own misbehavior.

Since Cora's parents are divorced, which parent should be contacted first?

C. The parent who has been assigned legal custody of Candy by the court.

Which nursing intervention should be included in the plan of care while Candy is in traction?

D. Ensure that the amount of weight remains consistent.

How is the presence of crepitus determined when assessing Candy's fractured femur?

D. Listen for grating sound when the affected area is moved.

Which task should be delegated to the UAP at this time?

D. Spend time with Candy to distract her from the discomfort.

What volume of medication should be administered?

0.3

Which activity is the best choice for Candy?

A. Pretend beauty parlor.

Which snack selection is the best choice for Candy while she is immobilized?

A. Pudding.

What action should the PN implement?

A. Request the charge nurse administer another dose of IV morphine now.

Which task can be delegated to the UAP?

D. Assisting the postoperative client with crutches.

When an older child is sitting on a booster seat, where is the best place to locate the seat?

D. Back seat of a car with lap and shoulder belts.

What response should the PN suggest she use with Candy?

B. "I am sad that you are throwing things at me."

Which traction is a type of skeletal traction?

B. 90-90 Femoral.

What feature identifies Candy's fracture as an open fracture?

B. Bone fragments protruding through the skin.

Which nursing intervention should be included in the plan of care to prevent this complication?

B. Cleanse around the pin site with half-strength hydrogen peroxide.

If unable to reach Candy's parents, what guidelines will determine the staff's ability to provide needed care?

B. Emergency care may be provided after a reasonable attempt to reach the parents has been made.

The implementation of which nursing intervention will reduce this risk?

B. Initiate hourly observation of Candy's foot distal to the fracture site.

How should the PN respond?

B. Instruct the parent that the child's age and size still require the use of a safety seat.

In addition to notifying the healthcare provider of this development, what action should the PN implement?

B. Obtain equipment needed for cast removal.

What additional data should the PN collect?

B. Toe movement.

Which technique is most beneficial when preparing a preschooler for a procedure that may be frightening?

D. Describe what the child will experience shortly before the procedure takes place.

What is the best response by the PN?

D. "It is natural to be upset when your child expresses anger toward you."

What action should the PN take?

D. Acknowledge that the parents have correctly learned how to move the cast while wet.