17-year-old male arrives at the emergency department following playing baseball. He slid into a base, felt a 'pop', and had pain in his right ankle.

The client reports pain of 7 out of 10 in his right ankle, which is described as throbbing. Right pedal pulse was 2+, and the sensation was intact.

The client had a limited and painful range of motion in his ankle. Significant swelling and bruising in the ankle were observed.

Exhibits

The emergency department nurse cares for a client with right ankle pain.
Complete the statement below:

While teaching the client how to use crutches, the nurse should instruct the client to ambulate using the

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and based on the client

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.

Choice A rationale: This is a normal value, indicating normal renal function. The client does not have any signs of kidney damage or impairment.

Choice B rationale: This is an elevated value, indicating an infection or inflammation in the body. Acute appendicitis is a common cause of increased white blood cells, as the appendix becomes inflamed and infected. This finding requires immediate follow-up to monitor the client's condition and prevent complications such as perforation or peritonitis.

Choice C rationale: This is a high value, indicating impaired renal function or dehydration. The client may have decreased urine output due to vomiting and fluid loss, or may have underlying kidney problems. This finding requires immediate follow-up to assess the client's hydration status and renal function, and to provide appropriate fluid and electrolyte replacement.

Choice D rationale: This is a sign of peritoneal irritation, which may indicate that the appendix has ruptured or is close to rupturing. This is a medical emergency that requires immediate surgical intervention to remove the appendix and prevent sepsis and shock.

Choice E rationale: This is a low value, indicating hypokalemia or low potassium levels in the blood. The client may have lost potassium due to vomiting and fluid loss, or may have underlying electrolyte imbalances. This finding requires immediate follow-up to assess the client's cardiac function and muscle strength, and to provide appropriate potassium supplementation.

Choice F rationale: These are common symptoms of acute appendicitis, as the inflammation and infection of the appendix cause irritation of the gastrointestinal tract. These symptoms do not require immediate follow-up, but they should be managed with antiemetics and fluids to prevent dehydration and electrolyte imbalances.

Choice A rationale: candidiasis - The described symptoms of inflammation, cottage

cheese-like discharge, and vaginal/vulvar inflammation are indicative of a yeast infection or candidiasis.

Choice B rationale: Chlamydia - Chlamydia often presents with different symptoms such as discharge, but it's not typically associated with a cottage cheese-like appearance.

Choice C rationale: bacterial vaginosis - Bacterial vaginosis typically presents with a different type of discharge, often described as "fishy" smelling, rather than a cottage cheese appearance.

Choice D rationale: trichomoniasis - Symptoms of trichomoniasis usually include frothy, malodorous discharge, not consistent with the described cottage cheese-like discharge.