The nurse is caring for the client.

Exhibits

The nurse reviews the client's history and physical and assessment findings. For each assessment finding, click to specify if the finding is consistent with a fracture or deep vein thrombosis (DVT). Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Rationale for correct choices

• Limb immobilization: Immobilization is the primary treatment for a nondisplaced fracture to maintain bone alignment, promote healing, and prevent further injury. Splints, casts, or braces may be used depending on the fracture location and stability. Proper immobilization also helps reduce pain and swelling by limiting movement of the injured extremity.

• Pain medication: Pain management is essential to ensure comfort and facilitate cooperation with care. Mild to moderate pain from a nondisplaced fracture can be managed with acetaminophen or ibuprofen. Effective analgesia also helps the child maintain mobility of unaffected areas and reduces stress associated with the injury.

Rationale for incorrect choices

• Antibiotics: Antibiotics are not routinely prescribed for closed fractures unless there is an open wound or risk of infection. The child’s abrasion on the knee may require topical care, but systemic antibiotics are not indicated for the fracture itself.

• Bed rest: Strict bed rest is not necessary for a nondisplaced upper extremity fracture. The child can usually participate in age-appropriate activities while the limb is immobilized, as long as the extremity is protected.

• Surgical consultation: Surgical intervention is typically reserved for displaced fractures, open fractures, or fractures with neurovascular compromise. This child’s fracture is nondisplaced and stable, so surgery is not anticipated at this stage.

• Skin traction: Skin traction is generally used for lower extremity fractures or severe fractures requiring alignment before surgical intervention. It is not indicated for a stable, nondisplaced forearm fracture in a child.

Rationale:

A. "My provider will make my health care decisions if I complete advance directives.": Advance directives are designed to communicate the client’s own wishes regarding medical care, not to give the provider decision-making authority. The client retains the right to guide their care through these legal documents.

B. "A living will is a document that includes my wishes about health care decisions.": This statement demonstrates understanding because a living will specifies the client’s preferences for medical treatments, such as resuscitation or life-sustaining measures, in the event they are unable to communicate their wishes.

C. "My partner needs to be present as a witness when I sign a living will.": Witness requirements vary by state, but typically a living will requires impartial adult witnesses, not necessarily a partner, to prevent conflicts of interest. Believing the partner must be present reflects a misunderstanding of legal requirements.

D. "Advance directives outline who inherits my material possessions in the event of my death.": This describes a will, not an advance directive. Advance directives pertain to medical care decisions, not the distribution of property or assets.