The nurse is providing teaching to a school-age child with left femoral osteomyelitis and the child's parent prior to discharge.

Which instruction should the nurse provide related to the initial phase of treatment?

Administer topical antibiotic therapy daily.

Provide passive range of motion exercises.

Ensure no weight bearing on the aﬀected extremity.

Schedule ice pack applications to the infected area.

Answer and Explanation

The Correct Answer is C

During the initial phase of treatment for osteomyelitis, the nurse should instruct the child and parent to ensure that there is no weight bearing on the aﬀected extremity. This may require the use of assistive devices such as crutches or a wheelchair. Administering topical antibiotic therapy, providing passive range of motion exercises, and scheduling ice pack applications to the infected area are not appropriate interventions during the initial phase of treatment.

Topical antibiotics may be used later in the course of treatment, after the initial phase of intravenous antibiotics has been completed.

Passive range of motion exercises may be appropriate during the later phases of treatment to prevent joint contractures.

Ice pack applications may be appropriate for pain relief, but they are not a primary intervention for osteomyelitis.

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Correct Answer is D

Explanation

Aortic stenosis is a narrowing of the aortic valve, which can cause decreased blood ﬂow from the left ventricle to the systemic circulation. In infants with aortic stenosis, the left ventricle must work harder to pump blood through the narrowed valve, which can lead to left ventricular hypertrophy, heart failure, and pulmonary edema. Bilateral fine crackles in both lung fields may indicate ﬂuid overload in the lungs, which is a common complication of heart failure. Hypotension and tachycardia may also be present due to decreased cardiac output.

Option A is not a typical finding associated with aortic stenosis.

Option B is not directly related to the infant's cardiac condition.

Option C is not a typical finding associated with heart failure.

A. Osteosarcoma B. Growing pains C. Rhabdomyolysis D. Hemosiderosis

Correct Answer is A

Explanation

The adolescent client's symptoms of localized pain, swelling, and tenderness, particularly at night, are suggestive of a malignancy such as osteosarcoma, which is the most common primary bone tumor in children and adolescents.

Radial ossification in the soft tissues is a characteristic finding in osteosarcoma and is indicative of bone production by malignant cells. Other imaging modalities, such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI), may also reveal osteolytic or osteoblastic lesions in the bone.

Growing pains are a common, benign condition that occur in children and do not typically present with the

symptoms described in the case scenario.

Rhabdomyolysis is a medical emergency that involves the breakdown of skeletal muscle tissue and release of muscle fiber contents into the bloodstream. It can present with muscle pain, swelling, and tenderness, but typically occurs as a result of injury, infection, or drug toxicity.

Hemosiderosis is a rare condition characterized by the accumulation of iron in various tissues, including the liver, spleen, and bone marrow. It may present with symptoms such as fatigue, joint pain, and abdominal pain, but is not typically associated with the symptoms and imaging findings described in the case scenario.

Therefore, the nurse should consider osteosarcoma as the probable cause of the adolescent client's symptoms and imaging findings, and should collaborate with the healthcare team to develop a plan of care for diagnosis and treatment.

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The nurse is providing teaching to a school-age child with left femoral osteomyelitis and the child's parent prior to discharge. Which instruction should the nurse provide related to the initial phase of treatment?

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Correct Answer is D

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The nurse is providing teaching to a school-age child with left femoral osteomyelitis and the child's parent prior to discharge.

Which instruction should the nurse provide related to the initial phase of treatment?