A nurse is caring for a client who has an ectopic pregnancy. Which of the following findings should the nurse expect?

Rationale:
A. "Avoid exercising in warm places.": Heat can temporarily worsen symptoms of multiple sclerosis, such as fatigue, weakness, and spasticity, due to slowed nerve conduction. Clients should exercise in cool environments or use cooling techniques to prevent symptom exacerbation.

B. "Walk with your feet close together.": Walking with feet close together can increase the risk of imbalance and falls in clients with MS, who often have gait disturbances. Maintaining a wider stance or using assistive devices improves stability and safety during ambulation.

C. "Decrease your daily fluid intake.": Fluid restriction is not recommended for MS and can lead to dehydration and urinary tract complications. Adequate hydration helps maintain bladder function and overall health.

D. "Apply an ice pack to spastic muscles.": Cold therapy does not effectively relieve muscle spasticity in MS; instead, heat may temporarily reduce muscle stiffness. Ice packs are more appropriate for acute inflammation or injury rather than chronic spasticity.

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.