Sherpath: Skeletal Disorders and Immobilization

A patient is being treated for osteomyelitis. What symptoms would the nurse report to the health care provider? Select all that apply. A. An elevated temperature B. Increased range of motion C. Complaints of localized pain D. Pain radiating away from site E. Increased redness and swelling around site

*A. An elevated temperature An elevated temperature could indicate the antibiotic is not working. *D. Pain radiating away from site Radiating pain to an adjacent joint necessitates an assessment for possible septic arthritis. *E. Increased redness and swelling around site If signs and symptoms get worse, the health care provider should be notified.

The nurse is caring for two patients, one with a fracture that has not broken the skin and one with a fracture that has pierced the skin. The nurse will need to monitor for which complication that can occur with both fractures? A. Infection B. Hemorrhaging C. Impaired skin integrity D. Compartment syndrome

B. Hemorrhaging Hemorrhaging is a complication for both simple (fracture that has not broken the skin) and compound (fracture that has broken the skin) fractures. The patient with the simple fracture is at risk for internal hemorrhaging, while the patient with compound fracture is at risk for external hemorrhaging.

A nurse receives orders that state a 9-year-old patient should be placed in traction after returning to the unit. Surgery was performed for a femoral fracture. Based on this information, which type of traction should the nurse prepare? Select all that apply. A. Skin traction B. Skeletal traction C. Continuous traction D. Intermittent traction E. Cervical (halo) traction

B. Skeletal traction > Skeletal traction is indicated because the patient is older than 3 years and has had a bone fracture. C. Continuous traction > The nurse should always assume that traction is continuous unless otherwise stated by the health care provider.

A child with clubfoot was treated with Ponseti casting. Following completion of the casting treatments, the patient has the final cast removed. The parents are upset because the foot appears overcorrected. Which explanation can the nurse provide regarding the rationale for the overcorrection? A. Overcorrection is necessary so that surgery will be possible. B. The foot is purposefully overcorrected and a brace will be used to prevent the recurrence of the deformity. C. Unfortunately, the overcorrection was not intended and an additional cast will be used to fix the problem. D. The overcorrection will prevent recurrence and is the last step before initiating the French physiotherapy treatment.

B. The foot is purposefully overcorrected and a brace will be used to prevent the recurrence of the deformity. The foot is overcorrected and the correction is maintained by using abduction orthosis full-time for 3 weeks, followed by 12-hour nightly use until at least 2 years of age.

A nursing student is preparing to conduct a clinical conference regarding osteomyelitis. Which event triggering the inflammatory process should be included in the discussion? Pus accumulates under the periosteum. Bacteria enter the bone through blood vessels. Pus moves from the metaphyseal area into a joint. Pus accumulates and moves toward the medullary canal.

Bacteria enter the bone through blood vessels. In the initial stage, bacteria enter the metaphysis by small capillaries, and the inflammatory process begins. The presence of bacteria alerts the body's immunological defense system to react, resulting in an inflammatory reaction.

Which statement can the nurse use to explain to parents why nonsurgical treatments are used instead of surgical treatments when treating clubfoot? A. "The surgical method takes too long to complete." B. "Nonsurgical methods allow for a faster correction of the deformity." C. "Nonsurgical treatment will limit long-term complications and recurrence." D. "The surgical method has a limited coverage by the insurance company."

C. "Nonsurgical treatment will limit long-term complications and recurrence." Because long-term complications and recurrence were found to occur after surgical correction, nonoperative treatment modalities are now used.

A 13-year-old patient is admitted with a fractured femur. For which signs and symptoms should the nurse evaluate the patient to identify potential systemic complications? Select all that apply. A. Arrhythmia B. Immobility C. Color changes D. Axillary petechiae E. Shallow rapid breathing

C. Color changes > Color changes can be a symptom of a blocked vessel (emboli) or shock and should be further investigated. D. Axillary petechiae > Axillary petechiae can be an indication of fat emboli, a systemic complication of a fracture (particularly a femur fracture). When a bone is fractured, fat tissue from the bone marrow can leak into the blood. Long bones (like the femur) especially have more marrow than shorter bones, increasing the risk of fat emboli. E. Shallow rapid breathing A fractured femur will result in a large amount of bleeding that can lead to hypovolemic shock, which may be indicated by shallow, rapid breathing.

A school-age child is admitted for treatment of osteomyelitis. Which complication would the nurse expect to see in this patient? A. Depression B. Social isolation C. Impaired mobility D. Fluid volume insufficiency

C. Impaired mobility The nurse would expect the child to have difficulty with mobility secondary to the infection of the bone in the right leg. It is most often accompanied by pain.

A child was just diagnosed with benign postural kyphosis. What should the nurse emphasize to facilitate correction of this type of kyphosis? A. Importance of wearing a brace every day B. Importance of standing rather than sitting C. Importance of following and maintaining a core muscle strengthening program D. Importance of scheduling surgery as soon as possible to prevent further injury

C. Importance of following and maintaining a core muscle strengthening program > By strengthening the core muscles, proper postural techniques will improve and the postural kyphosis will resolve.

Which statements would the nurse use to explain the relationship between complex fractures and external fixators? Select all that apply. Complex fractures may require external fixators to lengthen bones. External fixators keep the bone ends separated and in alignment. External fixators shorten the healing time by decreasing the bone length in complex fractures. External fixators correct angular deformities that involve bone and soft tissue in complex fractures. External fixators do not allow for periodic changes in alignment and bone length which is necessary for complex fractures.

Complex fractures may require external fixators to lengthen bones. External fixators keep the bone ends separated and in alignment. External fixators correct angular deformities that involve bone and soft tissue in complex fractures.

A 5-year-old patient presents with a rib hump and visible curvature of the spine measuring 20 degrees. Which is the preferred treatment that the nurse can anticipate for this patient? A. Brace B. Surgery C. Exercise D. Observation

D. Observation Observation is recommended for a curve less than 25 degrees. Patients closer to 25 degrees who are skeletally immature will require more frequent radiographic observation than a patient with a smaller curvature who is skeletally mature.

How is the treatment environment related to the anxiety levels of an infant going through casting for clubfoot? A. Making the parents leave the room helps to decrease the anxiety of the infant. B. A treatment environment with a loud noise level decreases the anxiety of the infant. C. A cold environment helps to calm the infant, which will decrease the anxiety level. D. When parental involvement is incorporated, the anxiety level of the infant is decreased.

D. When parental involvement is incorporated, the anxiety level of the infant is decreased. Parental involvement is comforting to infants and helps them relax, or even sleep during the session.

During a physical assessment the nurse evaluates the hip of an infant and finds the head of the femur is outside of the acetabulum. How would this dysplasia be classified? Fracture of the hip Instability of the hip Dislocation of the hip Subluxation of the hip

Dislocation of the hip Dislocation of the hip occurs when the head of the femur lies outside the acetabulum. In DDH the acetabulum is shallow which does not all the femur to fit adequately in the joint. This can occur as a late stage of developmental dysplasia of the hip and it can occur in children with certain neuromuscular disorders.

Match the fracture type with the clinical presentation.

Simple Bone is fractured but did not pierce skin Compound Fractured bone is protruding from the skin Greenstick Fracture occurred on only one side of bone Comminuted Bone is fragmented

A school-age child is admitted with osteomyelitis. Which statement by the parent will require further attention by the nurse and health care provider? "Our child has had several cavities." "Our child has been on antibiotics frequently." "Our child has poor coordination and falls often." "We have noticed a change in our child's energy levels."

"Our child has had several cavities." Children with poor oral hygiene, as may be indicated by several cavities, are at increased risk for systemic infections and illness, including osteomyelitis.

A child is in skeletal traction. What nursing interventions will decrease the risk of infection? Select all that apply. A. Check pin sites for signs of redness and inflammation. B. Use soap and water to cleanse the area around the pins. C. Leave drainage in place to keep from disrupting the area where the pins are arranged on the skin. D. Careful examination of the pin entry sites to view any signs of loose pins. E. Remove the patient from traction for a short period of time to improve circulation.

A. Check pin sites for signs of redness and inflammation. > Check the pin entry sites for redness and inflammation that may indicate infection. B. Use soap and water to cleanse the area around the pins. > Cleanse the area around the pin entry sites with soap and water. Other approved cleanser may also be used. D. Careful examination of the pin entry sites to view any signs of loose pins. > To decrease the likelihood of an infection in a patient with pins from traction, meticulous assessment of entry sites for signs of loose pins is needed.

A patient is nervous about having the pins used for traction removed and asks the nurse what to expect. Which statement is correct about pin removal? A. General anesthesia is used for skeletal traction removal; the patient won't be conscious during the procedure. B. The patient will receive local anesthetics to relieve pain and the area will be draped to prevent visualization of the procedure. C. General anesthesia is used for the procedure but the patient will be conscious for immediate mobility assessment. D. Topical analgesics will be used for the procedure. The bone does not contain pain receptors so the patient feels no pain as the pin is removed.

A. General anesthesia is used for skeletal traction removal; the patient won't be conscious during the procedure. > Pin removal can be scary for a patient. Inform the patient of the use of general anesthesia to decrease anxiety.

The nurse develops a discharge plan for a teen who is overweight with slipped capital femoral epiphysis (SCFE). Which instructions should the nurse include in the plan? Select all that apply. A. Instruct the patient on the proper use of crutches. B. Teach the child how to perform isometric exercises. C. Instruct that patient to wear a Pavlik harness to protect the hip. D. Provide instructions regarding the use of an abduction orthosis. E. Provide information to help the patient develop good nutritional habits to reduce weight.

A. Instruct the patient on the proper use of crutches. > The patient will require the use of crutches to limit weight bearing down on the affected hip. Crutches are typically used for 4-6 weeks. B. Teach the child how to perform isometric exercises. > The isometric exercises will improve strength in muscles that support the hip joint. E. Provide information to help the patient develop good nutritional habits to reduce weight. > Weight reduction will help reduce the risk of SCFE. The nurse should help the patient identify high-calorie foods that should be avoided.

An adolescent presents to the urgent care clinic with a suspected fracture in the lower extremity. What are the priority assessments? Select all that apply. A. Pain assessment B. Ability to properly use crutches for ambulation C. Ability to bear weight on the affected extremity D. Sensation, color and pulse of the affected extremity E. Thorough review of pain medication that was taken prior to arriving to the clinic

A. Pain Assessment > Pain should be addressed in the immediate assessment of the patient's suspected fracture. The presence of pain is part of the neurovascular assessment D. Sensation, color and pulse of the affected extremity Sensation, color and pulse are part of the 5Ps that should be immediately addressed with suspected fractures in order to assess the neurovascular status.

The charge nurse is assisting a new nurse to prepare a toddler for skin traction. What interventions will help prevent skin damage? Select all that apply. A. Use an egg-crate-type mattress for comfort. B. Use alcohol to clean areas that are prone to irritation. C. Use lotion, powder, or talc on areas prone to irritation. D. Provide a trapeze to facilitate independent repositioning. E. Applying tincture of benzoin to the intact skin that has potential for irritation.

A. Use an egg-crate-type mattress for comfort. > Egg-crate-type or sheepskin mattress provides comfort under the back and lower legs. Additionally, it will wick moisture from the skin to decrease skin irritation. D. Provide a trapeze to facilitate independent repositioning. > Providing a trapeze to facilitate independent repositioning would be an appropriate intervention in this situation. E. Applying tincture of benzoin to the intact skin that has potential for irritation. > Applying tincture of benzoin to the intact skin before the traction is applied may protect against skin irritation.

A 3-month-old infant is seen in the emergency department and an x-ray shows a femur fracture. What is the primary nursing assessment? Assess pedal pulse in affected limb Assess parent knowledge on infant care Assess family home and financial situation Assess feeding schedule and weight gain of infant

Assess pedal pulse in affected limb Circulation of the injured limb is a priority assessment to detect potential serious complications.

The nurse is caring for a patient in a Pavlik harness. Which critical task specific to this harness should be performed by the nurse? Ensure immobility Assess the skin under the harness Assess the anxiety level of the parents Ensure the harness is tight against the chest

Assess the skin under the harness Monitoring the skin integrity of child in a Pavlik harness or spica cast is important because extended wear can lead to impaired skin integrity.

The nurse knows that developmental dysplasia of the hip differs between the infant and neonate in which way? Patellar subluxation Complete hip immobility Presence of a femur fracture Asymmetry of gluteal skinfolds

Asymmetry of gluteal skinfolds Infants beyond the neonatal period exhibit asymmetry of the gluteal skinfolds when lying with the legs extended against the examining table (or when the infant is held upright with the legs dangling).

A child is observed limping and walking on his toes. An x-ray reveals subluxation of the femoral head. Which nursing care plan is indicated for this patient? A. Have the patient walk for 30 minutes to monitor gait. B. Provide ways to alleviate the anxiety of the diagnosis. C. Monitor neurovascular status of the affected extremity. D. Teach the patient how to walk straight without limping.

B. Provide ways to alleviate the anxiety of the diagnosis. After diagnosis, nursing interventions focus on the parents' anxiety and coping abilities.

A child in traction is frustrated because of feeling trapped. The child is experiencing constipation and says breathing feels hard at times. Which nursing interventions would benefit this patient? Select all that apply. A. Decrease fluid intake. B. Reposition the body. C. Provide a high fiber diet. D. Move the bed to play area. E. Play with bubbles or an incentive spirometer. F. Encourage more rest to decrease movement.

B. Reposition the body. Repositioning the body is useful to prevent skin damage, promote defecation, and facilitate breathing. C. Provide a high fiber diet. > A high fiber diet should decrease constipation. D. Move the bed to play area. > Moving the bed to the play area provides a new environment for the child. E. Play with bubbles or an incentive spirometer. > Playing with bubbles or an incentive spirometer will encourage deep breaths and better lung function.

A patient is admitted for surgery due to complication of osteomyelitis. As the nurse monitors the wound after surgery, which assessment would cause the nurse to be concerned that the antibiotic is not effective? A. Scab formation is noted at the affected site. B. Thick discharge is present at the affected site. C. The patient complains of discomfort at the affected site. D. A temperature change to 99.9° F from a previous recording of 101.8° F.

B. Thick discharge is present at the affected site. > Redness, inflammation, and discharge indicate worsening of an infection. This would indicate the antibiotics are not effective.

How should the nurse communicate with the family to educate them on a child's clubfoot condition? Be very descriptive but use lay terms. Be slightly vague to avoid causing distress. Give a handout and encourage self-directed reading. Use scientific verbiage to provide an in-depth explanation of the condition.

Be very descriptive but use lay terms. When talking with families, use descriptive lay language rather than scientific terms.

A preteen with no previous issues is noted to have uneven shoulders, and when performing the Adam's forward bend test the nurse observes what appears to be a rib hump. On which condition does the nurse anticipate educating the patient? A. Scheuermann's Kyphosis B. Early onset scoliosis (EOS) C. Adolescent idiopathic scoliosis D. Previously undiagnosed congenital scoliosis

C. Adolescent idiopathic scoliosis Adolescent, idiopathic scoliosis would have onset at 10 years or older. A lack of previous history suggests this is idiopathic onset.

A patient diagnosed with Legg-Calvé-Perthes (LCP) disease is informed that the disease has progressed to a point where necrosis is occurring in the joint. Which statement demonstrates the nurse's knowledge of LCP progression? A. Necrosis occurs after bone is reabsorbed by the body during Stage 4. B. Necrosis occurs after the fragmentation stage and is Stage 3 of the disease. C. LCP is caused by ischemia of the head of the femur. This leads to extensive reconstitution before the onset of necrosis, stage 5. D. LCP is caused by limited blood supply to the ball of the femur. As blood flow decreases, the tissue begins to die, entering necrosis or Stage 2 of the disease.

D. LCP is caused by limited blood supply to the ball of the femur. As blood flow decreases, the tissue begins to die, entering necrosis or Stage 2 of the disease. LCP is caused by ischemia of the head of the femur. As tissues receive less blood, the cells die, which is necrosis and Stage 2 of LCP.

A child in halo traction reports severe and unrelenting pain, is very pale, and reports a tingling feeling. Which should be the nurse's response to these findings? A. Obtain an order for IV fluids for the patient. B. Document complaints and reassess the patient in an hour. C. Encourage the patient to use guided imagery to decrease pain. D. Report the findings to the health care provider immediately.

D. Report the findings to the health care provider immediately. Prompt referral to a health care provider and intervention is crucial if neurovascular impairment is to be prevented.

An overweight adolescent complains of knee pain and limps while walking. Radiographs have been obtained to confirm the condition. The nurse would anticipate educating the patient on which condition? A. Scoliosis B. Osteomyelitis C. Legg-Calvé-Perthes disease D. Slipped Capital Femoral Epiphysis (SCFE)

D. Slipped Capital Femoral Epiphysis (SCFE) The classic symptoms of SCFE include a limp and pain. Radiographs confirm the diagnosis.

A child presents with signs of developmental dysplasia of the hip. Which statement shows the nurse understands the dysplasia? A. Dislocation has a femur that is partially in place but still stable. B. Subluxation has a femur that is fully displaced from the acetabulum. C. Dislocation has a partial displacement of the femur from the acetabulum. D. Subluxation has a partial displacement of the femur from the acetabulum.

D. Subluxation has a partial displacement of the femur from the acetabulum. Subluxation is a partial displacement of the femur from the acetabulum, whereas dislocation is a complete displacement.

The parent of a child being screened for developmental dysplasia of the hip (DDH) asks the nurse why ultrasonography, not radiography, is being used. Which statement could the nurse use to explain the reason for selecting ultrasonography? A. Ultrasonography is more sensitive because it uses low dose radiation. B. Radiography is more sensitive because it uses high intensity radiation. C. Radiography is more sensitive because it can be used to view the dislocation at any age. D. Ultrasonography is more sensitive because it allows for a penetrating look at hip abnormalities.

D. Ultrasonography is more sensitive because it allows for a penetrating look at hip abnormalities. Ultrasonography provides the ability to view the entire anatomy. Current research supports the concept that ultrasonography is a more sensitive indicator of abnormalities of the infant hip than radiography.

A school-aged patient has a lateral spine curvature of 25 degrees. The nurse anticipates which intervention according to these results? Education on use of a brace Immediate surgical repair Education on core strengthening Monitor for a year for changes

Education on use of a brace Nonoperative management is the preferred treatment for patients with spine curvature ≥ 25 degrees and who are still skeletally immature. The nurse would anticipate providing patient teaching on use of a brace.

A preteen has been diagnosed with scoliosis and the nurse suspects it is an idiopathic scoliosis. How does the nurse come to this conclusion? Congenital scoliosis is present at birth and idiopathic scoliosis occurs after age 10 years. Congenital scoliosis typically involves a curvature 20-45 degrees. Idiopathic scoliosis involves a curvature > 45 degrees. Congenital scoliosis is present at birth and then resolves shortly after birth. Idiopathic scoliosis appears later in adolescence. Idiopathic scoliosis can be diagnosed for the first time in older children, whereas congenital scoliosis is present at birth.

Idiopathic scoliosis can be diagnosed for the first time in older children, whereas congenital scoliosis is present at birth. Congenital scoliosis is present at birth and idiopathic scoliosis can occur at any point in a child's growth and is classified by age at presentation.

The nurse provides education on home care for a child in a cast. Which of the following statements demonstrate parental understanding regarding indications to contact the health care provider? Select all that apply. If the child has persistent inflammation, contact the health care provider. If the cast feels hot or has an unusual odor, contact the health care provider. If the child can move the digits distal to the cast, contact the health care provider. If the child develops a sporadic itch under the cast, contact the health care provider. If the child complains of pain, burning, numbness, or tingling, contact the health care provider.

If the child has persistent inflammation, contact the health care provider. If the cast feels hot or has an unusual odor, contact the health care provider. If the child complains of pain, burning, numbness, or tingling, contact the health care provider.

A child has a painful limp and the X-ray was negative for fracture and dislocation. An MRI reveals increased bone density of the femoral head. Based on these findings, which does the nurse suspect as the pathology for this patient? Osteomyelitis Osgood-Schlatter disease Legg-Calvé-Perthes disease Slipped Capital Femoral Epiphysis (SCFE)

Legg-Calvé-Perthes disease Legg-Calvé-Perthes disease occurs when blood flow to the femoral head is diminished which leads to eventual necrosis. During this process, x-rays may be negative but MRI will reveal the damage to the femoral head.

A child in traction complains of tingling, intensifying pain in the extremity and requests additional pain medication. Which immediate action should the nurse take to care for this patient? Increase the pain medication as requested by the patient. Remove the patient from the traction device to relieve symptoms. Notify the health care provider that the patient has signs of compartment syndrome. Notify the health care provider that the patient has developed osteomyelitis.

Notify the health care provider that the patient has signs of compartment syndrome.

A nurse performs a neurovascular assessment on a leg in a cast. Which assessment findings warrant immediate interventions? Select all that apply. Paresthesia Normal mobility Decreased capillary refill Minor pain (relieved by analgesics) Difference between proximal and distal pulse

Paresthesia Decreased capillary refill Difference between proximal and distal pulse

A school-age child is admitted with osteomyelitis. What assessments would the nurse expect to perform if erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are elevated? Vital sign assessment Patient allergy history Evaluation of patient dressing Patient history of recent falls

Patient allergy history The given laboratory results, along with patient symptoms, indicate infection, which will require IV antibiotics. Prior to antibiotic administration, the nurse should take a patient history to evaluate allergies and any problems the child experienced during previous antibiotic administration.

A patient with an external fixation device placed in the tibia is being discharged. The parents describe their anxiety about caring for the child at home to the nurse. Which information should the nurse provide to increase their confidence? Select all that apply. Provide information regarding the removal of the fixator pins. Provide information and request return demonstration on pin entry site care. Provide information regarding when to contact the health care provider. Provide information regarding community resources (PT, OT, school personnel). Provide information and request return demonstration on how to perform the neurovascular assessment and what the findings indicate.

Provide information and request return demonstration on pin entry site care. Provide information regarding when to contact the health care provider. Provide information regarding community resources (PT, OT, school personnel). Provide information and request return demonstration on how to perform the neurovascular assessment and what the findings indicate.

A child with clubfoot experiences discomfort every time TAL (tendoachillis lengthening) is required and care is implemented. Which actions can the nurse take to help the child feel more comfortable? Select all that apply. Provide soft music Dim the lights and reduced loud sound Administer IV pain medication as ordered Pre-medicate with local anesthetic if required Have the parents hold the child during treatment

Provide soft music Dim the lights and reduced loud sound Pre-medicate with local anesthetic if required Have the parents hold the child during treatment

In which ways can a nurse help to relieve anxiety in an adolescent having surgery for a spine abnormality? Select all that apply. Reassure the adolescent to allay fears. Allow the adolescent to have quite time for reflection. Discuss activity limitations and provide ideas for alternatives. Correct any misunderstandings the adolescent has about the surgery. Determine the adolescent's need for specific information, particularly about postoperative care.

Reassure the adolescent to allay fears. Discuss activity limitations and provide ideas for alternatives. Correct any misunderstandings the adolescent has about the surgery. Determine the adolescent's need for specific information, particularly about postoperative care.

Which order of pathological events describes the development of osteomyelitis?

Rupture of small capillaries Pus spreads to the outside of the bone (under periosteum) Connective tissue of the bone is displaced from the accumulation of pus Abscess forms

Which type of traction should the nurse anticipate for a patient with hemarthrosis? Halo traction Skin traction Femoral traction Skull tongs traction

Skin traction Skin traction is preferred for conditions in which invasive procedures are contraindicated, such as hemarthrosis (collection of blood in the joint) as a result of hemophilia.

A child has a skeletal growth disorder. Which disorder occurs when the femoral neck is displaced from the femoral head? Scoliosis Osteomyelitis Legg-Calvé-Perthes disease Slipped Capital Femoral Epiphysis (SCFE)

Slipped Capital Femoral Epiphysis (SCFE) Increased body weight and height place more stress on the epiphyses, causing a relative displacement (slip) of the femoral neck from the femoral head.

A nurse is caring for an infant with a clubfoot. When planning care, what should the nurse consider regarding the Ponseti casting method? Select all that apply. Stretch the misaligned bones on a weekly basis. Forced stretching is performed to soften the tissue. After weekly manipulation, apply a long-leg plaster cast. Limit manipulation to allow the foot to contract before applying the cast. Surgery is performed 3 weeks after manipulation of the misaligned bones to prepare the foot for casting.

Stretch the misaligned bones on a weekly basis. After weekly manipulation, apply a long-leg plaster cast.

A nurse is caring for a child with impaired physical mobility. What is an appropriate outcome for this child? The child has decreased mobility and strength in unaffected joints. The child will maintain mobility but will have decreased strength in the unaffected joints. The child will not be able to maintain strength in unaffected joints but will tolerate activity restriction. The child will maintain mobility and strength of all unaffected joints and tolerate activity restrictions.

The child will maintain mobility and strength of all unaffected joints and tolerate activity restrictions. Maintaining mobility and strength of all unaffected joints and tolerating activity restrictions is the expected outcome of a child with an impaired physical mobility diagnosis. Working towards this goal will help to improve the physical mobility of the child.

An 8-year-old patient comes to the emergency department with a femur fracture. The health care provider has obtained x-rays of the fractured femur and the unaffected femur. The nurse knows that both x-rays need to be done for the patient for which reason? X-rays of both extremities allows for observation of bone growth. X-rays of both extremities is part of the hospital protocol for children. X-rays of both extremities allows for the comparison between the extremities. X-rays of both extremities allows the health care provider to observe inflammation.

X-rays of both extremities allows for the comparison between the extremities. A radiograph of the unaffected extremity may be obtained for comparison purposes, especially when trying to determine whether a line on the radiograph represents a fracture or merely an epiphyseal line.