The nurse is continuing to care for the child.

Exhibits
Select the 3 priority actions that the nurse should take.

Elevate the affected forearm with pillows.

Administer Ibuprofen 200 mg PO.

Place a non adherent dressing on the right knee abrasion.

Review cast care instructions with the child's parents.

Explain the cast application procedure to the child.

Apply ice packs to the fingers and along the right forearm.

Answer and Explanation

Correct Answer : A,B,F

Rationale:
A. Elevate the affected forearm with pillows: Elevation helps reduce swelling and promotes venous return, which is critical in the immediate management of a fracture to prevent complications such as increased edema or impaired circulation.

B. Administer Ibuprofen 200 mg PO: The child reports pain at a level of 5, meeting the prescription threshold. Administering analgesia promptly helps manage discomfort and supports cooperation with further interventions, such as casting.

C. Place a nonadherent dressing on the right knee abrasion: While wound care is important, the abrasion is minor and not the most urgent concern. Prioritization focuses on the fractured limb and pain management.

D. Review cast care instructions with the child's parents: Education is important but is not the immediate priority before the cast is applied. It can be provided after the child is stabilized and pain is managed.

E. Explain the cast application procedure to the child: While preparing the child psychologically is important, immediate interventions to reduce pain and swelling take precedence over anticipatory teaching.

F. Apply ice packs to the fingers and along the right forearm: Ice helps reduce swelling and pain in the acute phase of the fracture. Applying ice in combination with elevation supports circulation and comfort while awaiting casting.

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Correct Answer is C

Explanation

Rationale:
A. Oxygen saturation 97% on room air: Adequate oxygenation is essential for wound healing because oxygen supports collagen synthesis and tissue repair. An oxygen saturation of 97% indicates sufficient oxygen delivery to tissues and does not place the client at risk for delayed healing.

B. Pain level of 1 on a scale of 0 to 10: Minimal pain suggests effective postoperative pain management and allows the client to move, breathe deeply, and participate in recovery activities. Pain at this level does not negatively impact the wound-healing process.

C. BMI 35: Obesity is associated with delayed wound healing due to poor vascularity in adipose tissue, which reduces oxygen and nutrient delivery to the wound. Increased tension on wound edges and a higher risk of infection also contribute to impaired healing in obese clients.

D. Capillary refill time 1 second: A capillary refill of 1 second reflects adequate peripheral perfusion, which supports effective oxygen and nutrient delivery to tissues. Normal circulation facilitates the healing process rather than delaying it.

A. "Avoid exercising in warm places." B. "Walk with your feet close together." C. "Decrease your daily fluid intake. D. "Apply an ice pack to spastic muscles."

Correct Answer is A

Explanation

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.

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The nurse is continuing to care for the child. Exhibits Select the 3 priority actions that the nurse should take.

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The nurse is continuing to care for the child.

Exhibits
Select the 3 priority actions that the nurse should take.