A child is hospitalized after a serious motor vehicle crash and has developed increased urination. What action by the nurse takes priority?

When caring for a child with an open fracture, the nurse should carefully assess for signs and symptoms of infection. An open fracture refers to a fracture where the bone is exposed through the skin, creating a direct pathway for microorganisms to enter and cause infection. Infection is a significant concern in open fractures and can lead to serious complications if not identified and treated promptly. Signs of infection may include increased pain, swelling, redness, warmth, purulent drainage, fever, or systemic signs of infection such as elevated white blood cell count.

Osteoarthritis in (option A) is incorrect because it, is not an immediate concern in the care of a child with an open fracture. Osteoarthritis refers to degenerative joint disease that typically develops over time and is not directly related to the acute management of an open fracture.

epiphyseal disruption in (option B) is incorrect because it, refers to an injury involving the growth plate (epiphyseal plate) that can affect bone growth and development. While it is a potential concern in fractures that involve the growth plate, it is not specific to open fractures and may not be an immediate priority in the initial assessment of an open fracture.

periosteum thickening in (option D) is incorrect because it, may occur in response to injury and fracture healing, but it is not specifically associated with open fractures and is not a primary focus in the initial assessment of an open fracture.

Hypoglycaemia is characterized by low blood sugar levels. In children, symptoms of hypoglycaemia can vary, but irritability is a common sign. Other signs and symptoms of hypoglycaemia in children may include sweating, trembling, pale skin, hunger, weakness, confusion, and dizziness.

Normal sensorium and serum glucose greater than 160 mg/dL in (Option A) is incorrect because a normal sensorium (normal level of consciousness) and a serum glucose level greater than 160 mg/dL would not be indicative of hypoglycaemia.

Urine positive for ketones and serum glucose greater than 300 mg/dL in (Option B) is incorrect because it describes characteristics of hyperglycaemia (high blood sugar levels) rather than hypoglycaemia. Positive urine ketones and a serum glucose level greater than 300 mg/dL are commonly seen in diabetic ketoacidosis, a complication of high blood sugar levels in diabetes.

Increased urination and serum glucose less than 120 mg/dL in (Option D) is incorrect because it describes increased urination and a serum glucose level less than 120 mg/dL. While a serum glucose level less than 120 mg/dL could indicate hypoglycaemia, increased urination is not a typical sign of hypoglycaemia. Increased urination may be seen in conditions such as diabetes mellitus when blood sugar levels are consistently high.