A nurse in an acute care facility is caring for a toddler.

Exhibits

For each assessment finding below, click to specify if the assessment finding is consistent with Crohn's disease, appendicitis, or intussusception. Each finding may support more than 1 disease process.

Rationale:
A. Beneficence: Beneficence involves promoting the well-being of clients. While both clients’ needs are important, the issue here is unequal access to resources, not the nurse’s intent to benefit them.

B. Autonomy: Autonomy relates to the client’s right to make informed decisions about their own care. The situation does not interfere with either client’s ability to make choices.

C. Nonmaleficence: Nonmaleficence means avoiding harm. Although delayed access to supplies could indirectly cause harm, the primary ethical concern is the fairness in distribution, not direct harm by action.

D. Justice: Justice involves fairness and equitable treatment. Providing supplies to one client based on insurance status while requiring the other to obtain them elsewhere reflects unequal treatment and a breach of the principle of justice.

Rationale for Correct Choices

• Compartment syndrome: The child’s nondisplaced midshaft fracture of the radius and ulna places them at risk for compartment syndrome, whereby increased pressure within the muscle compartments impairs circulation and tissue perfusion. Early recognition is crucial to prevent permanent nerve or muscle damage.

• Paresthesia: The child reports tingling in the fingers, which indicates nerve involvement or compression—an early warning sign of compartment syndrome. Monitoring for paresthesia helps the nurse identify worsening neurovascular compromise promptly.

Rationale for Incorrect Choices

• Osteomyelitis: Infection of the bone is unlikely immediately after a closed nondisplaced fracture without open wounds or surgical intervention. There is no evidence of systemic infection at this stage.

• Nonunion: Fracture nonunion is a long-term complication that occurs if healing fails over weeks to months. The child’s fracture is recent, so immediate risk is low.

• Physical damage: While trauma caused the fracture, “physical damage” is a broad term and does not specify a complication requiring acute monitoring.

• Ecchymosis: Bruising indicates soft tissue injury but does not predict compartment syndrome or other severe complications.

• Type of fracture: While important for diagnosis and treatment planning, the fracture type (nondisplaced) does not directly indicate the acute risk for neurovascular compromise.

• Location of fracture: The midshaft location contributes to fracture management but is not as clinically relevant as the early signs of compartment syndrome, such as paresthesia.