A nurse is assessing the parenting styles of a family. Which of the following parent statements identify characteristics of authoritarian parenting?

Rationale for correct choices

• Compartment syndrome: The child has a nondisplaced fracture of the radius and ulna, which can lead to swelling and increased pressure within the forearm compartments. Compartment syndrome is a serious complication that can compromise circulation and nerve function if not identified and treated promptly. Early recognition is critical to prevent permanent muscle and nerve damage.

• Paresthesia: The child reports mild tingling in the fingers, indicating early sensory nerve involvement. Paresthesia is a key early sign of neurovascular compromise in compartment syndrome. Monitoring for worsening tingling, numbness, or pain is essential for timely intervention, such as fasciotomy if needed.

Rationale for incorrect choices

• Deep vein thrombosis: DVT is uncommon in pediatric patients, especially in the absence of immobility, central lines, or hypercoagulable conditions. While fractures increase risk in adults, it is not the highest-priority risk in this 9-year-old child with an acute upper extremity fracture.

• Malunion: Malunion refers to healing of a fracture in an abnormal position. While possible, this risk develops over time and is not the immediate concern in the acute phase. Neurovascular compromise and compartment syndrome are more urgent.

• Type of fracture: While the fracture type (nondisplaced radius and ulna) informs management, it does not by itself represent the complication risk. The clinical symptoms of tingling are more directly indicative of acute neurovascular compromise.

• Ecchymosis: Bruising reflects local tissue trauma but is not a definitive indicator of compartment syndrome. Ecchymosis should be monitored but does not provide the highest-priority evidence of risk.

• Location of fracture: The midshaft location guides treatment, such as splinting, but the presence of paresthesia is more directly associated with risk for compartment syndrome. Location alone does not indicate imminent neurovascular compromise.

Rationale:

A. Assign the AP to ask the client if she has taken her antidiabetic medication today: Asking about medication adherence is part of assessment and requires clinical judgment. Delegating this task to an AP is inappropriate because it involves interpreting client responses and making clinical decisions.

B. Determine if the AP has the skills to perform the test: Before delegating any task, the nurse must verify that the AP is competent and trained to perform the procedure safely. Ensuring skill competency protects the client from harm and aligns with the nurse’s responsibility for delegation.

C. Have the AP check the medical record for prior blood glucose test results: Reviewing medical records and interpreting trends involves clinical judgment and falls outside the typical scope of practice for an AP. This task should remain with the licensed nurse.

D. Help the AP perform the blood glucose test: Assisting the AP is not necessary if the AP is competent and has been properly trained. The nurse’s role is to delegate appropriately, supervise as needed, and ensure safe completion, rather than performing the task alongside the AP.