A school nurse is planning a health fair for the caregivers of children entering kindergarten. Which of the following primary prevention topics should the nurse include?

Rationale:

A. Explain the cast application procedure to the child: Preparing the child for a future procedure is helpful but not immediately necessary. At this point, pain control and reduction of swelling take precedence to prevent complications and stabilize the injury.

B. Review cast care instructions with the child's parents: While parent education is important, it is secondary to immediate interventions that address pain, swelling, and preparation for the procedure. Priority actions focus first on the child’s current needs and safety.

C. Elevate the affected forearm with pillows: Elevation helps reduce edema and pain in the fractured extremity and prevents further swelling. This is a critical nursing intervention for acute fracture management before and after casting.

D. Apply ice packs to the fingers and along the right forearm: Ice helps manage pain and inflammation by vasoconstriction, limiting fluid accumulation in tissues. Applying it early post-injury is crucial to controlling swelling in a fractured limb.

E. Place a nonadherent dressing on the right knee abrasion: Caring for minor abrasions is important but is not a priority compared with interventions addressing fracture management, pain, and preparation for cast application.

F. Administer Ibuprofen 200 mg PO: Pain management is a priority in fracture care to maintain comfort and reduce distress. Administering analgesics before cast application helps the child tolerate the procedure and facilitates cooperation.

Rationale:

• Sensation: Tingling indicates possible nerve irritation or mild neurovascular compromise. This is often seen in fractures when swelling or bone displacement compresses nerves near the injury site, especially in long bones like the radius.
• Edema: Swelling is a nonspecific but common response to tissue injury. It occurs with ligament strain (sprain), bone disruption (fracture), and joint trauma (dislocation), all of which lead to localized inflammation and fluid accumulation.
• Ecchymosis: Bruising results from soft tissue bleeding and is common in all three conditions due to trauma to blood vessels. Ligament tears (sprain), bone injury (fracture), and capsule damage (dislocation) can all lead to ecchymosis.
• Pain level: Moderate pain, such as a 4/10 rating, is consistent with both sprains and fractures. Sprains stretch or tear ligaments, while fractures disrupt bone structure. Dislocations usually present with severe, sharp pain that impairs joint movement entirely.