A nurse is providing nutritional teaching to the guardian of a 12.month.old toddler. Which of the following information should the nurse include?

Rationale for Correct Choices:

• Compartment syndrome: Occurs when pressure within a closed muscle compartment compromises circulation and tissue function. The client presents with classic signs: pain out of proportion, pallor (cool foot), pulselessness (non-palpable pulses), paresthesia (numbness), and paralysis (inability to move foot/toes) which are hallmark signs of compromised perfusion.

• Osteomyelitis: The presence of drainage from the splint site, increasing temperature, and markedly elevated WBC count (from 14,000 to 28,000/mm³) strongly suggest developing bone infection. The client’s open fracture and internal fixation increase susceptibility, especially with new signs of systemic infection and localized inflammation at the injury site.

Rationale for Incorrect Choices:

• Deep vein thrombosis (DVT): While trauma and immobility increase DVT risk, there is no evidence of unilateral leg swelling, calf tenderness, or redness. The primary concern here is neurovascular compromise, not venous thromboembolism, and the symptoms point more urgently to compartment syndrome and infection.

• Fat embolism syndrome: Fat embolism is a risk with long bone fractures, typically presenting within 24–72 hours with respiratory distress, hypoxia, confusion, and a petechial rash. This client is alert and not in respiratory distress, with normal oxygen saturations and no mental status changes, making fat embolism less likely at this stage.

A. Abdominal aortic aneurysm: While this condition is serious, it does not directly affect the safety of applying localized heat therapy to a distal site like the foot, unless systemic complications are present.
B. Osteoarthritis: Heat therapy is often beneficial in osteoarthritis, as it helps reduce joint stiffness and improve circulation to the affected area, making it a common and safe intervention.
C. Phlebitis: Warm compresses are sometimes used in phlebitis to reduce inflammation and promote comfort, provided there are no signs of infection or severe vascular compromise.
D. Peripheral neuropathy: Clients with peripheral neuropathy have impaired sensation and may not feel excessive heat, increasing the risk of burns or tissue injury. This makes heat therapy unsafe for these individuals.