A nurse is caring for a toddler who has a fractured right femur and is in Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following?

The correct answer is D) A child whose parents answer questions for the child.

Here is a detailed explanation for each choice:

Choice A reason:

A child who has a BMI indicating obesity: While obesity can be a concern for a child’s health, it is not a direct indicator of abuse. Obesity can result from various factors, including genetics, diet, and physical activity levels. It does not necessarily suggest that the child is experiencing abuse or neglect.

Choice B reason:

A child who has frequent visitors: Frequent visitors can indicate a strong support system and concern for the child’s well-being. It is not typically associated with abuse. In fact, children who are abused often have fewer visitors and less social support.

Choice C reason:

A child who uses the call light frequently: Frequent use of the call light may indicate that the child is seeking attention or has unmet needs, but it is not a specific indicator of abuse. Children may use the call light for various reasons, including anxiety, pain, or a need for reassurance.

Choice D reason:

A child whose parents answer questions for the child: This behavior can be a red flag for abuse. When parents consistently answer questions for the child, it may indicate that they are controlling the child’s communication and preventing them from speaking freely. This can be a sign of emotional abuse or manipulation.

Choice A reason: Discouraging a high level of fluid intake is incorrect, as hydration is essential for preventing sickle cell crises and reducing blood viscosity. The nurse should encourage the child to drink at least 1.5 times the normal fluid requirement.

Choice B reason: Administering meperidine every 4 hr for pain is incorrect, as meperidine is not recommended for sickle cell pain due to the risk of neurotoxicity and seizures. The nurse should use other opioids such as morphine or hydromorphone for pain management.

Choice C reason: Applying cold compresses to painful, swollen joints is incorrect, as cold can cause vasoconstriction and worsen the sickling of red blood cells. The nurse should use warm compresses or heating pads to promote vasodilation and blood flow.

Choice D reason: Observing for indications of hypokalemia is correct, as sickle cell anemia can cause hemolysis and potassium loss. The nurse should monitor the child's serum potassium level and watch for signs of hypokalemia such as muscle weakness, cramps, arrhythmias, and constipation.